Miscarriages: yes, there is something else that can be done to avoid them

• New births that refuse visits: rude or responsible?

12 years ago I suffered a miscarriage at 14 and a half weeks of gestation . To the loss of the embryo or fetus before week 20 the term "recurrent or recurrent" is added when it occurs three or more times in a row, something that happens to 4% of women of reproductive age (1 of each 4 pregnancies), a statistic that increases when the woman turns 40 (due to the genetic deterioration of the ovules).

At that time, I recognize that I ignored these figures. Moreover, I didn't know anyone close, family or friend, to whom it would have happened. I remember that it all started late in the afternoon , with small cramps in the belly and blood losses that gradually became abundant clots and intense pain that I would describe as if they were opening in the canal (and so it was, the cervix it was opening to expel the fetus).

That pain almost knocked me out , but what left me kao was the reaction of the hospital staff I went to the next morning to get an ultrasound, the test that was going to confirm whether or not the pregnancy was taking its course. Yes, despite all those clues, it still had hope.

I'm still seeing that radiologist applying the gel to my stomach. I arrived wanting to talk, to let off steam, but beyond the cordial "good morning and lie there", not a comment came out of his mouth that showed some empathy .

The good woman took exactly one second to say: "Nothing, there is nothing, you have lost it. Do you see it? The bag is empty, you have expelled it." I received those words like a punch in the pit of my stomach. My answer was a sepulchral silence that finally broke with a question: " Why? Have I done something that caused it?"

While I was urging myself to get up from that stretcher (you know, 5 minutes per patient), I answer: "Don't worry, spontaneous abortions are very common . Now, to rest, and when the doctor tells you, to return to try it. "

Horrible . I can only describe it that way. There has been much talk that if the compliment or calendars of naked women hung in trucks or decorating repair shops reify women. Well, that health professional and her comments made me feel like a real piece of meat programmed for the sole purpose of procreation.

I had a feeling of being empty and a huge sadness contained (I was still too scared to cry), but I was supposed to go out urgently and erase that imaginary that I had been riding during all those weeks: will it be a child or girl? Who will it look like, what name will we give it?

It seems that I also had to skip the physical changes that pregnancy had produced in my body, still loaded with chorionic gonadotropin (the pregnancy hormone), and get quick to have sex to conceive as soon as possible, I would not neglect, reach 40 and things got even worse. Incredible but true.

LACK OF PROGESTERONE

More than a decade has passed and, in the end, indeed, everything happens . You have no other. Today I look at my offspring and I barely remember that, but I always wondered how women like this can happen again and again.

And what happens to those who go through all this and never get pregnant ? I wonder if things have changed in any way, both from the point of view of research and psychological attention. Do parents not deserve answers? Do we know anything else about what produces them? Can they be avoided? Is there any type of psychological follow-up after the loss?

Experts in the field say that, although much remains to be done, there is good news about it. To begin with, a few years ago the woman was expected to go through three spontaneous abortions to assess a medical explanation , now as of the second abortion this whole process begins. In that we have advanced.

Also in the precision about the causes that cause it. This is confirmed by Dr. Jan Tesarik, director of the MAR & Gen clinic in Granada. "It was already known that in younger women the cause of habitual abortion is multifactorial, which influence from genetic factors, anatomical abnormalities, autoimmune disorders, endocrine dysfunctions, various forms of thrombophilia (propensity to develop blood clots), lifestyle factors (tobacco, alcohol) and maternal infections. However, the latest research points to another cause, probably much more frequent: the insufficiency of progesterone secretion, "says the gynecologist who, together with his team, has just published the conclusions of his study in the magazine 'Current Opinion in Gynecology and Obstetrics'.

Progesterone is a hormone naturally secreted by the ovaries and the placenta in the early stages of pregnancy and is considered vital to achieve a healthy pregnancy . "Not secreting enough is considered an anomaly, known in medical jargon as 'insufficiency of the luteal phase' , which has been somewhat underestimated so far; since, after implantation, in most cases the embryo dies so soon that pregnancy cannot even be confirmed, "explains Dr. Jan Tesarik.

In line with this specialist are the conclusions of a large-scale study, conducted by the University of Birmingham in collaboration with the research center for spontaneous abortion Tommys National Center.

This research, published last week, urges the British Social Security to defray a hormonal supplement of progesterone (which has an approximate cost of 200 pounds sterling) that, administered in all those women who have blood losses during the first weeks, has demonstrated that it could prevent more than 8,000 spontaneous abortions a year alone in the United Kingdom .

MORE FOLLOW-UP

So, can anything else be done to stop them? "Yes. Most abortions occur between week 15 and 20 , so the doctor should multiply the exams and blood tests on the pregnant woman. They should be done more regularly and, especially, pay particular attention to those women whose results show anomalies, explains Dr. Tesarik.

For example, let's imagine that a woman is undergoing a reproductive treatment and there is an unexpected decrease in the concentration of progesterone in the blood . In this case, these levels should be controlled more frequently. "Once we have transferred the embryos generated by in vitro fertilization, every 3 or 4 days or even before knowing if the patient is pregnant or not. The point is that we must detect what is the problem that causes abortion, before that this can cause the loss of pregnancy, and act therapeutically in an appropriate way, "says the specialist.

PSYCHOLOGICAL SUPPORT

And from the point of view of emotional assistance? Is everything that should be done? The reality is that, although more and more professionals take into account the emotional aspect of early losses, much remains to be done, both in the public and private spheres.

Sabina del Río, director of the Calma Maternity Psychology Center, remembers certain phrases that we often say as a consolation without being aware that they do not help at all : "you are young", " merciful woman, pregnant woman" , "good , you were very little "," is something more frequent than you think "," do not worry, nature is wise ". All this is an example of how from the society (and the health professionals themselves) psychological support is not considered necessary and, therefore, is not offered. But it does take.

The psychologist explains that, "especially in women who are in assisted reproduction treatment and who do not find any apparent cause to their abortions, these losses generate a lot of anguish and enter an endless loop looking for explanations and professionals of different disciplines that can help them: nutritionists, hematologists, immunologists, psychologists, endocrines ... ".

A LIFE WITHOUT CHILDREN?

The truth is that there is a reality that hurts, however much it is camouflaged with hateful hoses of the type "they are things that happen." Without going any further, the habit of not telling anyone the good news until after the first three months of pregnancy (so it may happen) remains in our society.

What happens if it happens? Do you pretend that everything remains the same, that nothing ever happened? Swallowing the pain makes many women feel lonely and misunderstood, so they go to online forums for support from other women who are going through the same .

Sabina del Río says that this sometimes helps, but sometimes it is very counterproductive. "If a woman feels anguish and that the situation is overflowing, she should seek help from a specialist . Above all, seek someone who can help us verbalize the pain of the loss, the fear of never getting a pregnancy, to withstand social pressure and handle certain situations that generate conflict or fear (such as seeing other pregnant women), "recommends the psychologist.

It would be ideal for the public health system to take care of this follow-up, but we already know that psychological attention in our social security shines through its absence. It is very important to assess the emotional aspect of women throughout this process, accompany her from the beginning and, of course, if it is observed that the situation is taking a psychological toll, advise her to stop for a while to recover and prepare psychologically and emotionally for everything That can keep coming.

There is also another option, although it is not easy either. Sabía del Río recognizes that "it is painful, but sometimes it is necessary to begin to consider the option of a life without children and work the enormous duel that this can entail for a couple who has spent a lot of time investing money, energy and illusions to achieve it.

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