Do the children make up for it?

by Claudia Ravaldi

After a perinatal bereavement, couples face moments of great uncertainty and bewilderment. The death of the expected child is in fact associated with a “temporary” dismantling of the sense of self: the parental project is interrupted, one’s own internal narrative thread, which was launched towards motherhood / fatherhood, is broken.

Are you still a mother, even without a baby in your arms? Are you still a father? Have you ever been, if you have not reached the final part of the project, that of “and did they all live happily ever after?”.

This aspect of uncertainty (who I am, why us, what have we done to deserve this, what is wrong with my body, in my head, in my couple), which is pervasive in the first three or four months, is a a real time bomb, ready to explode and “contaminate” all areas of the couple’s life. At times, it is so profound that it even takes the place of mourning for the child, who remains as if suspended, in the background, behind the legitimate urgency to “perceive” oneself again as we knew each other. Feeling in full control of our life and decisions again. Feeling pregnant again, if possible, and happy again.

This mental status is very common for most couples: often, immediately after the bad news, the first question we ask doctors is: will we be able to have more? Often, immediately after the discharge, the first thing we think is that we are missing the belly. We miss the life from before. We want to re-tie the broken thread, exactly in that point, with an imperceptible knot, which is barely visible.

We no longer want to suffer, because suffering is tiring, for the body and for the mind. Suffering alone, as we are used to in our country, is even more tiring.

And it is therefore natural to look for openings, ways out, to develop strategies to quickly see the light again.

A solution to the uncertainty of mourning, which is often served to us on a silver platter, is to “change thread” and re-tie two ends of two different balls, as if they were the same thread. “Make another one!” it is proposed as a panacea (and in this article the therapist colleague Diletta Arzilli explains to us that no, it is not a panacea).

I already talked many years ago about the emotional roller coaster that makes parents (and unborn babies) jump in subsequent pregnancies here .

Don’t wait too long, please!“is another of the clockwork suggestions that are given to us. Too much? Too much what? Questions that we often do not have the courage and strength to ask, because mourning makes us at first a little automaton and a little fragile at times at the mercy of the first one who passes by who seems more “expert” than us. (NB: this feeling of walking in the fog, usually after three or four months passes and we return a little more “lucid”).

In this issue of Lancet 2011 promoted for Italy by CiaoLapo with a special press conference in Italian on April 15, 2011, the problem of “to have a child again soon “had already been reported as critical for our country: in fact, we were the last countries studied to” recommend “to forget mourning and undertake a new pregnancy as soon as possible, despite the guidelines of other countries suggest caution and a specific timing for each pair.

Lancet 2016 has taken up and deepened the aspects related to the management of stillbirth, the in-depth diagnostic analysis and periconceptional counseling for couples wishing to undertake a new pregnancy: it clearly emerges in all the articles and in the commentaries how attention to the couple passes from recognizing them bereavement and proper family planning.

Most couples after perinatal bereavement are pregnant again within the year. As the couple is accompanied during this year, the quality of the care offered since the inauspicious diagnosis, the presence of an adequately trained team throughout the process (including the management of the subsequent pregnancy and the puerperium) affect the psychophysical health of the woman and the its rainbow. We have an ongoing research project on this topic and we are collecting the testimonies of women in order to be able to begin to reflect more appropriately in Italy on perinatal bereavement.

“Those children”, the lost ones, do not make up for it. Engaging the body and mind with too early a subsequent pregnancy is a leap in the dark, associated with high levels of anxiety and depression .

Mothers should not be pushed into the abyss by distracted and outdated operators, but accompanied on a path of resilience specifically calibrated on their specific resources, on their experiences and on their medical and psychological history. The same, obviously the fathers.

“On Monday I went back to the hospital for a check-up with my gynecologist (I think she will be my ex gynecologist) … she advised me not to let too much time pass if I want to have another child .. (I am not not even 2 months ago !!!) since there are no other tests to do considering that the baby was healthy. “

The measure of how far there is still to go and how desperately we need up-to-date and widespread guidelines among our operators is all in this sentence.

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