Why We Need to Talk About Losing a Baby

Originally published by the World Health Organization.

Click HERE to read the original article.

Losing a baby in pregnancy through miscarriage or stillbirth is still a taboo subject worldwide, linked to stigma and shame. Many women still do not receive appropriate and respectful care when their baby dies during pregnancy or childbirth. Here, we share your stories from around the globe.

Miscarriage is the most common reason for losing a baby during pregnancy. Estimates vary, although March of Dimes, an organization that works on maternal and child health, indicates a miscarriage rate of 10-15% in women who knew they were pregnant. Pregnancy loss is defined differently around the world, but in general a baby who dies before 28 weeks of pregnancy is referred to as a miscarriage, and babies who die at or after 28 weeks are stillbirths. Every year, nearly 2 million babies are stillborn, and many of these deaths are preventable. However, miscarriages and stillbirths are not systematically recorded, even in developed countries, suggesting that the numbers could be even higher.

Around the world, women have varied access to healthcare services, and hospitals and clinics in many countries are very often under-resourced and understaffed. As varied as the experience of losing a baby may be, around the world, stigma, shame and guilt emerge as common themes. As these first-person accounts show, women who lose their babies are made to feel that should stay silent about their grief, either because miscarriage and stillbirth are still so common, or because they are perceived to be unavoidable.

"As a clinical psychologist, I specialise in women's reproductive and maternal mental health and have done so for over a decade. It wasn't until I experienced this 16-week miscarriage first-hand that I could truly grasp the anguish and the circuitousness of grief I had heard my patients speak of for so many years. After my miscarriage, I poured over the research which shows that a majority of women report experiencing feelings of shame, self-blame and guilt following pregnancy loss."

Jessica Zucker, clinical psychologist and writer, USA

All of this takes an enormous toll on women. Many women who lose a baby in pregnancy can go on to develop mental health issues that last for months or years– even when they have gone on to have healthy babies.

Cultural and societal attitudes to losing a baby can vary tremendously around the globe. In sub-Saharan Africa, a common belief is that a baby might be stillborn because of witchcraft or evil spirits. Miscarriage is the most common reason for losing a baby during pregnancy. Estimates vary, although March of Dimes, an organization that works on maternal and child health, indicates a miscarriage rate of 10-15% in women who knew they were pregnant. Pregnancy loss is defined differently around the world, but in general a baby who dies before 28 weeks of pregnancy is referred to as a miscarriage, and babies who die at or after 28 weeks are stillbirths. Every year, nearly 2 million babies are stillborn, and many of these deaths are preventable. However, miscarriages and stillbirths are not systematically recorded, even in developed countries, suggesting that the numbers could be even higher.

Around the world, women have varied access to healthcare services, and hospitals and clinics in many countries are very often under-resourced and understaffed. As varied as the experience of losing a baby may be, around the world, stigma, shame and guilt emerge as common themes. As these first-person accounts show, women who lose their babies are made to feel that should stay silent about their grief, either because miscarriage and stillbirth are still so common, or because they are perceived to be unavoidable.

Jessica Zucker, clinical psychologist and writer, USA "As a clinical psychologist, I specialise in women's reproductive and maternal mental health and have done so for over a decade. It wasn't until I experienced this 16-week miscarriage first-hand that I could truly grasp the anguish and the circuitousness of grief I had heard my patients speak of for so many years. After my miscarriage, I poured over the research which shows that a majority of women report experiencing feelings of shame, self-blame and guilt following pregnancy loss." Jessica's story

All of this takes an enormous toll on women. Many women who lose a baby in pregnancy can go on to develop mental health issues that last for months or years– even when they have gone on to have healthy babies. Cultural and societal attitudes to losing a baby can vary tremendously around the globe. In sub-Saharan Africa, a common belief is that a baby might be stillborn because of witchcraft or evil spirits.

“Coping with my miscarriage was traumatic. The medical staff contributed a lot to my grief despite the fact that I am a doctor too. The other issue is the cultural attitude. In most traditional African cultures, people think you can lose a baby because of a curse or witchcraft. Here, child loss is surrounded by stigma because some people believe there is something wrong with a woman who has had recurrent losses, that she may have been promiscuous, and so the loss is seen as a punishment from God."

Larai, 44, pharmacist, Nigeria

People, especially those with high profiles, are taking to social media to share their experiences, like in the case of Kimberly Van Der Beek and her husband, actor James Van Der Beek, best known for his role in American television series Dawson’s Creek. The couple recently shared a heartfelt post on Instagram where they opened up about the painful process of suffering multiple miscarriages — and then learning how to move past it.

There are many reasons why a miscarriage may happen, including fetal abnormalities, the age of the mother, and infections, many of which are preventable such as malaria and syphilis, though pinpointing the exact reason is often challenging.

General advice on preventing miscarriage focuses on eating healthily, exercising, avoiding smoking, drugs and alcohol, limiting caffeine, controlling stress, and being of a healthy weight. This places the emphasis on lifestyle factors, which, in the absence of specific answers, can lead to women feeling guilty that they have caused their miscarriage.

As with other health issues such as mental health, around which there is tremendous taboo still, many women report that no matter their culture, education or upbringing, their friends and family do not want to talk about their loss. This seems to connect with the silence that shrouds talking about grief in general.

Stillbirths happen later in pregnancy, and more than 40% occur during labour, many of which are preventable. Around 84% of stillbirths take place in low- and lower middle-income countries. Providing better quality of care during pregnancy and childbirth could prevent over half a million stillbirths worldwide. Even in high-income countries, substandard care is a significant factor in stillbirths.

“I’ve been on the fertility train for nearly 5 years. As my own IVF began, I quickly learned that I had no idea