We publish today the second part of Babies' interview and more to the psychologist Mónica Álvarez, family therapist and specialist in gestational and perinatal grief.
Monica has gone through the experience of losing a pregnancy and, in addition to professionally, she attends to the mothers in the forum Overcoming an abortion and in its pages Gestational and perinatal grief and Perinatal psychotherapy.
In the first part of this interview we have already deepened on the psychological aspects of abortion, today we are going to talk about the cases that need support from a specialist and also the attention that should be given to these mothers in hospitals. And above all, we will understand better the duel that follows an abortion.
When would it be convenient to think about a new pregnancy?
Physically, the body after quarantine is ready to conceive again, as soon as there is ovulation again. Emotionally it is another matter. It takes time to say goodbye to the baby who left, to elaborate the duel.
You can get pregnant, but you have to know that this duel will take place sooner or later. In cases of repeated abortion there is usually also a difficulty in getting pregnant and in many cases it takes up to another year to get back to stay, which gives considerable time for the work of grieving. Sometimes there are women who have no difficulty conceiving and get pregnant right away. If there is a new loss, or even a third, the woman usually discovers a day that in less than 9 months she has lost three babies and is physically and emotionally exhausted; He needs a rest time, to raise awareness, say goodbye to his children and the woman he will never be again. If the next pregnancy occurs and goes ahead, there will be a curious situation of pregnancy and grief. Or it may be that the duel is parked for later and arises on another occasion when another loss occurs.
The point is that one does not leave this life with undone duties. Sooner or later it will be necessary to elaborate, live, transit that duel and the psycho-emotional growth that it entails. No one gets rid.
What kind of professional can help a woman in this process?
From the moment a woman enters the emergency room with bleeding or with any difficulty, from the person who attends her at the entrance window, to the assistant who takes her food, through gynecologists, midwives, nurses ... All They should be prepared to properly care for a woman who has lost a baby or is in the process of doing so, regardless of the gestation month in which the loss occurs.
How will we recognize that the professional does not help us?
This is the same as for a delivery. The mother goes to the hospital in a situation of extreme helplessness, with the added anguish that she may be losing her child or the knowledge that she has already lost him. The mother has to go through a birth to give birth to her child, no matter what gestational week she is. The more advanced the pregnancy will be more similar to a birth and the less more similar to a strong rule. Ideally, the delivery should not be intervened, let the body do its job, with its times, its hormones. There are no studies, because no one has yet been put to it, but with the experience of those who have gone through it (and we are a few) we know that the oxytocin that is generated in the body with the pain of contractions helps and empties the mother. Giving birth to your child always leaves you with that taste of knowing that your body works that it has done what it had to do. Avoiding a woman from having that experience is going against her. There are those who prefer to enter through the script offered by the system, but there are those who do not and should be able to choose. There are many women who would have chosen expectant driving before and did not because they did not know what could be done. Unfortunately, medical mythology speaks of terrible consequences for the mother (infections, death ...) if she chooses to give birth to her child (be it an embryo or a baby) and that is the message that "those who know" convey. I have accompanied many women in the expectant management of the loss of their pregnancies for a few weeks and very few have finally needed a curettage. My partner M. Àngels once said that those who were born were to the gestational loss what the unnecessary ones were to childbirth. The curettage leaves a feeling of emptiness in the mother. Live the blood ritual that involves feeling your son go, empondera. But it takes information and a lot of support. And respect to let you choose one thing or another.
Is it necessary to medicate to overcome a postabortion depression?
After an abortion there is not always a depression. What happens to a loss is a duel, not a depression.
It is true that grief can lead to pathological grief, but the pathology could be in the line of a depression but also in the line of a psychotic disorder. It would be difficult to explain here in detail. In these cases, treatment with a professional is necessary, since the success of the treatment, as in many others, depends on the fact that the disease can be caught at the beginning. It is not the most common, but it could happen. As for supplying medications, it will be the psychiatrist who deems it necessary, because psychologists cannot medicate. The moment of loss can occur episodes of anxiety, unreality, dizziness ... It is common to give anxiolytics to avoid all this. It is known from the attention to victims of disasters that this practice helps in the short term because it eliminates the symptomatology, but that in the long term it is negative because it prevents the proper neuronal connections that help the person to face the following stages from being made in the brain of the duel and not remain blocked in any.
Is the term post-abortion depression correct or is it not always exactly a depression that causes the pain of abortion that needs help?
There are many factors that mark this. In principle, grief is a normal psychophysiological reaction of the body-mind after a loss. It is said that a year elapses to start "raising your head." Then the pain is there, but resources have been learned to accept it. Time mitigates the intensity of pain ... Depression is a term that would speak of pathology and would need psychotherapeutic treatment to overcome it.
Seeing the fetus or the deceased baby help establish a duel?
It helps tremendously, but I think that as in everything, you have to be respectful of the parents' decision, and if they don't want to see it, you can't force it. We are not used to "seeing dead."
Also in hospitals where a protocol for attention to perinatal death has been developed, the midwife washes and dresses the child, sometimes covering areas that may present with some malformation, so that it is more bearable to the parents. There is another practice in which they are photographed and the photos are saved in the history so that if parents who did not want to see it then want to do so they can access them and put a face on a child they will not know beyond months in the womb One of the main problems when establishing a duel is denial, as if nothing has happened. If the grandfather dies it is difficult to deny that death because you have all the memories of a life to keep that memory alive. In the case of intrauterine deaths or childbirth it is easier to do as if that child had not occurred. I have already said that our society is very denial as far as death is concerned and there are a lot of mechanisms that help to follow "as if nothing had happened." Seeing your son, putting on a face, a name, seeing that he looks like the father, who has the grandmother's ears, Uncle Juan's chin ... is to make it more real, although it hurts more, it is to enter the duel through the door big. How many mothers I know who did not let their children see (so that they would not suffer) that they keep as the greatest penalty for not being able to put a face on their son.
I think that if parents are emotionally supported, they are explained what they are going to see, which does not have to be scary, many more would choose to see it.
Is giving him a name or keeping memories of him beneficial or causes more grief?
As I said before, it is to enter through the big door in the work of mourning. At first glance it is true that it causes more grief, but because it makes the loss more real, has weight, it does not let us escape reality.
A mother who has had an abortion is a mother too, right?
Of course. And today we know thanks to Science that it is not something that is said only to console one. From the beginning of pregnancy there is an exchange of blood between the mother and the child. Although the baby dies it is known that these cells remain in the mother until 20 years later.
Motherhood goes much further than having a baby in her arms.
Is abortion forgotten or overcome?
I believe that neither. You learn to live with it. It is believed that a loss of a few weeks should not be a great loss for someone since they have not had visible physical life. The truth is that a mother is able to feel love for her baby from the minute 0 of her conception and even before !! Losing it is a great tragedy from which it is very difficult to recover. And more because, as I have said, in our society there are no rituals, neither sacred nor everyday, that mark a scheme of how life is to go forward, with which parents are terribly confused and disoriented. That of course does not help much.
If the duel, the time, have other children, can not partially relieve the pain. But in many cases the emotional and energetic scar will be like those physical scars that hurt when the weather is going to change. A child is a child and will always be present in one way or another in the life of the parents. And of the brothers and grandparents ...
How to channel that pain and that love to someone who is no longer there?
Making it present. Not only through a box of memories. Maybe you have more children and make them a little cross-stitch with their name; why not also record the name of the child who is not there. A mother told how grandmother knitted a blanket for the granddaughter and stopped knitting when she was spoiled; After the months the blanket was finished and the mother keeps it as something precious. There are those who plant a tree to commemorate the birth of their children. Why not plant one also for which he did not live outside the womb? In my city there is a very nice initiative to repopulate the surrounding mountains. The town hall gives you the possibility of planting a tree for every baby that is born. Recently it was planted with babies born last year. There we went many families in the buses that put. It is a community gesture, because it is always good that the forest is reforested, and seeing so many there, because it was very beautiful. My little daughter has a tree growing along with her.
Can you imagine that they did the same for dead babies at the time of pregnancy or childbirth or a few days after birth? At first it may sound macabre, but if you think about it it would be a social and community act of recognition towards all those children. The parents would be happy to do something for their lost children and the mountain would appreciate it too. It is not macabre at all, it is a gesture like any other. And it's just a little imagination to come up with more ideas.
With this we finish, grateful, the interview with psychologist Mónica Álvarez, which has explained to us many things that, given the loss of a pregnancy, we should know everyone, both mothers, their families and the professionals who care for them.
