In Chile there is an old saying, from when there was no way to diagnose a pregnancy, which says: “Less than 3 months is late, more than 3 pregnant.”
And although the rhyme is old and local, it refers to an unspoken principle that many women around the world follow today: it is better not to share the news until after the first trimester in case something “goes wrong” and the pregnancy does not come. I finish it.
It is not only a tradition that many women adopt without giving much thought to the matter, it is a recommendation that some doctors and midwives also make to supposedly protect parents from having to deal publicly with the bad news.
According to the US National Library of Medicine, one in four recognized pregnancies ends in miscarriage.
The total percentage is estimated to be even higher given that the vast majority of miscarriages (which occur mostly due to a chromosomal abnormality) occur in the first few weeks, sometimes even before the woman is aware of her condition.
However, for many experts in gestational or perinatal grief —which addresses the loss of the embryo from any age until death after birth—, this secrecy around the first weeks of pregnancy can be counterproductive.
Not to mention a spontaneous abortion in the event that it occurs, say both experts and women who have gone through it, invalidates and makes invisible a duel that for many can be extremely painful.
“Nobody got to want it”
Perinatal bereavement studies show that, indeed, “when there was an abortion in week 8 or 9, to give an example, to the grief of this mother who lost her child, the grief of losing a child who never it existed, that it was never enough to announce it to anyone, that it was non-existent”.
This is how Andrea Von Hovelin, a gynecologist who was part of the advisory team of the Dominga Law promulgated in Chile in 2021, which establishes a universal protocol in hospitals and clinics against perinatal loss, explains to BBC Mundo.
Instead, when the news is shared, it can happen the other way around. “Sometimes there is an element of consolation in knowing that the grandparents came to love him, or there is a farewell element like the little shoes that his uncle gave him.”
“The feeling that if we hide the existence of the pregnancy, if it is lost, it will hurt less, is very biased, very masculine,” says Von Hovelin.
“There are times when parents are more relieved by not having to tell it, but the experience you gain from the women’s stories is the opposite. They tell you: no one ever wanted it, it never existed. I had this son, it’s a fact, I want to make him part of my biography and no one found out. If no one knew, how do I vindicate my duel?
On the other hand, abortions at this early stage tend to generate very little empathy, says the expert.
“When someone wants to do some kind of funeral or farewell rite for this child, many times what you find in the environment is mockery or frank or evasive misunderstanding.”
“They tell you things like you have to think about your other child, or at least you know that you are fertile. Things that, even with the best intentions, prevent us from expressing ourselves and completely invalidate the existence of that child, as if one were going to remain pathologically in mourning, when in reality it has been shown that duels that end have a better prognosis from the mental health perspective.
“They told me phrases like ‘hey, but it wasn’t even formed yet, nature is wise: it kills the bad eggs.’ I understand that rationally, but for me it was not a bad egg, it was my son”, says Von Hovelin, who suffered a miscarriage during the first trimester of pregnancy.
“Yes, nature is wise, but tremendously cruel. And, at that moment, for me it was more cruel than wise, ”she recalls.
It’s not the weeks, it’s your projection
Assessing the psychological impact of a first-trimester pregnancy loss is somewhat complex.
Although we tend to think that the more advanced the pregnancy, the greater the penalty, it is not a mathematical relationship. A miscarriage in the first few weeks can also have a profound impact on some women or couples.
“It varies enormously from person to person, depending on their own psychological profile, their history of loss, the support around them and even how they feel about their body, because unfortunately we hear in these cases many women who feel that their body has failed them and they blame themselves for something that is out of their control,” Jessica Zucker, a Los Angeles-based doctor of psychology and author of “I had a miscarriage” (I had a miscarriage, in Spanish).
Uxía*, mother of an 11-year-old daughter and a 7-year-old daughter, who suffered 2 spontaneous abortions after the first daughter and before the second, around the seventh week, says that the experience was devastating for her.
“I had gone to the doctor for another issue and when I told him I was pregnant they gave me an ultrasound. When they didn’t find the heartbeat, it was an emotional shock for me. I hadn’t had any leaks, there was no indication that anything was wrong,” she says.
“Although it is only 7 weeks, on an emotional level it is brutal. I remember trying to convince myself saying: don’t worry, it’s just a small group of cells, an embryo”.
“But even if you know that it is only a small group of cells that developed badly, you have already projected yourself to a year with a baby, you have imagined yourself as a mother, you have begun to make plans. So, emotionally, the mourning you go through is much bigger than the scientific description of what you lose.
“Also, your body is still pregnant (if you test after a miscarriage you still test positive). You have a hormonal revolution that lasts much longer than the abortion itself. I looked in the mirror and I still had a belly, my breasts were swollen, I was still constipated”, recalls Uxía.
Another thing that does not forget is the feeling of guilt. “’How could something have gone wrong and I didn’t notice anything?’, he would ask me”.
“And when I analyzed what had happened, I was thinking if maybe I should have rested more or done something different.”
Uxía sought psychological help, a group to share her experience (in Spain, her native country, and in the United Kingdom, where she currently lives) and at that time, she found nothing that suited her particular situation.
#Ihadamiscarriage
It was precisely the lack of information and the desire to understand why women do not talk about this, why they feel guilty and see themselves as a failure for not having been able to conceive a healthy child, that motivated the other side of the Jessica Zucker, who in addition to specializing in the subject, lost her baby in the second trimester, to launch a campaign to make spontaneous abortion visible.
Using the hashtag #Ihadamiscarriage (I had a miscarriage), she set out to spark “a global conversation on this issue.”
“I’m not saying we all have to shout our loss out loud, we don’t all have to become advocates in this space, but if you’re not sharing (your loss) because you feel ashamed, or because you think there’s something wrong with you , or because it is something that should not be done, let’s ask ourselves why”, says Zucker.
“We need to change this once and for all, because it’s not good for anyone.”
The 12-week rule is “incredibly damaging to women and their families. We all need support, regardless of whether the pregnancy continues or not”, affirms the expert.
And when the news is good…
Although everything can go smoothly and the pregnancy progresses without major inconveniences, keeping the pregnancy hidden in the first weeks can also have a direct impact on the pregnant woman, since this is usually the most strenuous and mobilizing period both from the point of view of emotional and physical view.
Zucker notes that this is the stage where you may feel nauseous, or “be very worried because you’re leaking and you think you’re miscarrying, so you may need support sooner.”
In retrospect, Uxía believes that if he had shared the news, his quality of life at that time would have improved.
“After going through 2 full-term pregnancies, I realized that when I felt most vulnerable and with the least energy, it was in the first three months,” she says.
“The changes in your body are tremendous, everything is new, and if it is your first pregnancy you are full of anxieties and illusion, all together.”
“In my experience, I would have needed a lot more help, understanding or work flexibility in the first 3 months than in the last 3 months, because I didn’t have half the energy there than in the fourth, fifth or sixth, when I was high”.
“It’s an irony that just when I most needed flexibility at work or just some understanding from my colleagues for the situation I was going through, I didn’t have it. But in the end it is these rules of society that are imposed and in one way or another limit women”, says Uxía.
This is not, of course, about forcing any woman to share or reveal information that she considers private and does not wish to make public. It is a very individual decision, the experts consulted by BBC Mundo agree.
The important thing is precisely to let oneself be carried away by intuition, by one’s own need and not by social rules, whether explicit or tacit.
*Uxía is a fictitious name that we use to protect the identity of the woman who gave her testimony in this story.
It may interest you:
* What is the genetic conflict that is naturally unleashed with pregnancy and why it can cause complications for the fetus and the mother
* Why women with an irregular weight are at greater risk of miscarriage
* What is an ectopic pregnancy and how to identify it
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