Let’s have a conversation about miscarriage

Miscarriage is defined as the loss of a pregnancy during the first 23 weeks and statistics show this is a relatively common occurrence. 

Every year there are more than 200 miscarriages in Malta, with many more probably going unnoticed because they would have happened at a very early stage. 

According to the American Psychology Association, because it is medically common, the impact of miscarriage is often underestimated. 

The impact of miscarriage goes way beyond the immediate physical effects pregnancy loss has on a woman’s body. With proper care, a woman can recover in a matter of weeks from a miscarriage, depending on how advanced the pregnancy was. 

But not the same can be said of the emotional and psychological impact miscarriage has on the woman, and to a certain extent her partner. These effects last for much longer. 

Miscarriage very often causes feelings of guilt, shame and anger. In some instances, the person can even feel worthless as a woman because she is unable to carry a pregnancy to term and have children of her own. In certain cases, family pressure to have children does little to help an already precarious and hurtful situation. 

The experience is traumatic even for women who may already have children. The last thing these women want to hear is someone telling them to ‘at least be grateful’ they have children. A loss remains a loss and the hurt is no less significant just because the person already has a child. 

This emotional and psychological turmoil has consequences that are not always understood or catered for within our health system. Male partners are often emotionally and mentally ill-equipped to act in a supportive manner with the consequence of appearing detached and cold. They too need to be helped. 

Labour MP Katya De Giovanni spoke about her own miscarriage 20 years ago in a recent parliamentary adjournment speech. She detailed the emotional rollercoaster she went through in the aftermath of her miscarriage that eventually also caused her first marriage to fail. 

It was a brave effort on her part to raise awareness about such a common issue that many choose not to talk about for various reasons. 

She called for greater psychological and emotional support for women and their partners during and after a miscarriage. Many times, the couple have to go through the painful experience alone as they come to terms with the sudden disappearance of elation (caused by the pregnancy) and the appearance of an incalculable void.   

Significantly, De Giovanni also called for greater awareness among doctors and medical staff of the psychological impact of miscarriage. She recounted how in her case, after rushing to hospital in pain, the doctor who saw her at emergency delivered the dry news that the pregnancy was lost. There was no empathy in the doctor’s words and actions. 

Admittedly, it is never easy for a doctor or a nurse to deliver bad news. No matter how it is couched, the patient will always focus on the bad. But it helps to soften the blow if the medical professionals are trained to use empathetic language in these circumstances. 

De Giovanni also spoke of the need to have a segregated area in hospital for women who are passing through or have had a miscarriage. She described how she was placed in a ward with expectant mothers, calling it cruel. She is right. 

Unfortunately, this situation persists to this day despite countless pledges to create a separate treatment area for women who suffered a miscarriage. 

All the way back in 2007, just before Mater Dei Hospital was officially opened, the government had promised to have a separate area for women who have lost their pregnancy. Unfortunately, the hospital was opened, and the situation remained unchanged from how it was at St Luke’s Hospital. 

Roll forward to August 2022 and in comments to the Times of Malta, the health ministry said the hospital was in the process of setting up an early pregnancy unit where expectant mothers experiencing problems, such as a miscarriage, will be supported. 

The logistics, including where to locate the unit, were still being planned at the time. It appears that the planning is still going on more than 18 months after those comments were made. 

Women who are miscarrying or who just miscarried continue suffering the emotional stress of grieving while being in the same ward as other women who are waiting to give birth or who have just had a baby. This is cruel and immoral and goes to show that miscarriage is still not given the attention it deserves. 

This leader joins De Giovanni’s plea for greater awareness on miscarriage and the need to have a health system that also caters for the emotional and mental wellbeing of women who experience the trauma. 

But it should not stop at that. Women who have experienced miscarriage, a failed IVF treatment or stillbirth should be afforded at least four weeks of paid leave to help them deal with their loss. As things stand today women who miscarry have no special leave apart from ordinary sick leave. 

One of the large telecoms companies last year started offering up to four weeks of paid leave for pregnancy loss to its employees. The example should be emulated. 

It’s about time this country had a conversation about miscarriage and pregnancy loss in the hope of bettering the care and support for people who pass through this trauma.