Tuesday 1 December 2015

Surviving miscarriage

Written by Dr Parul Chopra Buttan

I was reading a newspaper report on Paris recently when my inquisitive 2 year old comes by and seeing the picture of a woman crying, asks innocently, "Mumma, aunty kyun ro rahi hain?" Not wanting to thwart her curiosity, I answer despite my discomfort, "because her baby got hurt" [her child was killed]. "Why did the baby get hurt?" I noticed the 'Why' instead of 'How'. That's one deep question, Why? Why do innocent people get hurt? Why does it all happen? Why do we go through this pain of untimely loss?

I couldn't find words and I wasn't prepared for this conversation, so I kissed her and distracted her into a game, much lighter, more age-appropriate for her. But I could sense her disappointment at not getting her answer. I lived with it, mentally making a note to work on an answer and get back better prepared the next time around.
I was dwelling intermittently on this need for an answer to everything, when a conversation with a very intelligent patient of mine happened. She said, "Doctors are like the barrier between us and death, us and mishaps. And when they fail to give us answers, it's deeply disappointing."

Yes, it's 2015. Yes, we are sitting on a mountain of medical research of the past two and a half centuries. But no, we don't have all the answers yet. Our knowledge, even though, has come a long way, certainly has a long way to go. I talked about miscarriage in my last post. In almost 20% of the pregnancies lost early, despite extensive investigations the exact reason for miscarriage may remain unknown. We will not be able to pin the occurrence of a miscarriage on something you did or did not do. We will not be able to justify the guilt you may be feeling or the blame, because it really is nobody's fault.

I'm sorry for the answers we can't provide today. I'm sorry for the pain we can't take away. But here's what we can do. And it is my mission to do my best in this endeavour.

1.     Allow the woman space to feel her emotions

Often, the myriad of emotions a woman may go through, disappointment, guilt, anger, loss, bereavement, grief, get shoved under the carpet. "It's only a miscarriage! People go through much worse!” she is told. Though it is true, much worse horrors are possible and do happen in this miraculous world of making babies, the experience of 'pain' is very individual. Only the wearer knows where the shoe hurts.

2.     Accept her state of mind

Non-judgemental acceptance of the waves of emotions she's going through is paramount to healing. Just when we allow ourselves to feel an emotion rather than resist it, does it flow through us and pass. It resolves, leaving us cleansed. The gynaecologist's chamber should be the one place where the woman can bring up any issue and any doubts around it, any number of times. We will answer them calmly, repeatedly, with the best possible explanation of the current scenario.

3.     Reassurance

Often, the event of losing a pregnancy haunts the woman all through the next one. As gynaecologists, we are happy to repeatedly offer you very encouraging statistical and medical evidence and research, all through the next pregnancy to reassure you. We are in this journey together and our aim of delivering to you a healthy mother and a healthy baby is an oath. We will go the extra mile to ensure your peace of mind, that comes from a qualified professional's true reassurance.

4.     Precautions

Any precautions (physical or otherwise) and medication that may help in reducing the chance of a mishap the next time around – we will discuss in detail to help you make informed choices. Of course, needless medication and restrictions would certainly be discouraged.


5.     Hope

We hope that when the cries and laughter of your magical bundle of joy fills up your home, it drowns the silence of grief you felt for the pregnancy lost.
Life goes on and brings with it a multitude of experiences. Some we're able to make sense of, some just flow through us with a higher meaning, as yet unrevealed.

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