Midwives and families, on extending leave for the loss of a baby: "It would be a very great advance for women"

La reform of the sexual and reproductive health law and voluntary termination of pregnancy, which will address the perinatal grief, has reopened the debate on the need for of who lose their baby can enjoy a permission of maternity, as they already do in cases of perinatal death when they have exceeded 6 months of gestation.

The Teruel native Anabel Hernandez, 40 years old, found herself in this situation in 2013, after losing her first child in childbirth while pregnant at 42 weeks. She was able to enjoy the leave, but this was not the case with her ex-partner. "When he went to Social Security to request it, the answer he got was that he was not a father. With all that pain that you have, because although no one has known him, for you he is your son, It is not only how bad you are psychologically, but at that moment the couple is recovering from childbirth., cesarean section in my case, and also needs help. There are cases in which the mother is convalescing and has other children to care for. I think that granting leave for pregnancy loss is a very great advance for women., who could thus recover from the loss both physically and psychologically and return to his life with another integrity," defends Hernández, founding partner of the Aragonese association 'Butterfly Breeze', which pays attention to the grief of these people. 

Seven years after that birth that marked her life, this woman from Teruel She became a mother again a year ago, in the middle of the pandemic, and although "fear" accompanied her throughout much of her second pregnancy, she acknowledges having learned an important lesson. "At first, out of ignorance, one thinks that all pregnancies end with a happy ending and that everything is wonderful. Then when it happens and you come into contact with other families, you find out about more cases, you know more things... it comes to you again fear, and in my case I have had to work a lot internally to not transmit that to him.", he confesses. His second son, Xoel, who is already one year old, was born in Obispo Polanco Hospital from Teruel in the middle of the pandemic, on June 30, 2020. And despite the covid, the experience for this mother was very good. "As everyone knew about my previous situation, they treated me with a lot of empathy and a lot of delicacy. Although in general you were more isolated (they didn't let you go accompanied to ultrasounds, etc.), with us they did make that exception and They allowed my partner to be with me at all times", says this Aragonese woman. 

Permission to "heal"

Now Anabel Hernandez, like other women who have gone through the same thing, welcome the fact that the new abortion law addresses the perinatal grief, and they defend the inclusion in it of maternity permission extendable to all those families that find themselves in a situation of this type. Currently, when a baby who is more than 180 days pregnant is stillborn, the mother has the right to the child's birth and care benefit, which lasts 16 weeks (the first six are mandatory). Looking ahead to the future abortion law, A petition opened on Change.org wants to get bereavement leave approved in cases of pregnancy loss that includes the couple, if there is one, and that it is recognized when the baby is less than six months old. "It would be a great help if they could have this low. First, to recover physically… because at the end of the day you just went through childbirth. But above all psychologically, because the moment you become a mother without a baby you are sunk and it is a very big 'shock' because you do not expect that that is going to happen to you. You are embracing life and suddenly you find yourself embracing death. It was a tremendous effort for me to go out into the street and see other families, baby strollers... I didn't understand that I couldn't enjoy that until with grief therapy you accept everything.", acknowledges this mother. 

If granted beyond six weeks of gestation, Hernández believes that it would be a "very big advance for women", who could thus recover from the perinatal loss both physically and psychologically and "return to her life with another integrity", which in her opinion would also prevent many women from the risk of developing a mental illness due to poorly handled grief. "If it happens to you in the first trimester you can also end up getting a low due to depression, because the woman is forced to recover in two or three days and return to work as if nothing had happened. On the other hand, if it can be prevented with this time for you, It is a significant improvement. Everyone has the right to recover", emphasizes this mother.

The woman from Teruel found herself in a similar situation. María MartínWho at 39 weeks and five days she suffered an intrauterine loss. She worked as a midwife in Zaragoza and She applied advice that she gave to other parturients to be able to overcome grief with the support of those around her., professional colleagues and alternative therapies. "I gave birth to my daughter and I gave birth to her dead. In my case I did have the right to maternity leave but my partner did not. Paternity leave was given to adapt to the new situation and there were CCs. AA. in which it had been granted. Here in Aragón we requested it, but they denied it and my husband He had to go to the family doctor, who gave him sick leave due to depression.", remember.

Martín considers that the best option in these cases would be for there to be a specific type of leave for the families who lose a baby in circumstances like this. "The law is made from fetal viability, and since carrying a child forward at less than 26 weeks is very complicated or can have serious consequences, it is not considered, but Yes, there would have to be leave for bereavement or early pregnancy loss (before 180 days) and that each person should decide.", indicates this nurse, who, working as a midwife, was not able to return to her position until some time had passed. "There are people for whom working after a situation like this is good for them. In my case it wasn't like that because everything reminded me... and in fact I was out for two years"he points out. 

Today, She and her husband (a lawyer by profession) continue to fight for recognition of a "painful" and "traumatic" situation for families. "I gave birth to my daughter when she was already full (in fact she weighed 2,8 kg), but I don't have her in my family book or anything. After losing her I couldn't take care of myself or my other son, and they forced him to join work. This emotionally hurts both the woman and the other parent. We were denied permission and we appealed to the TSJA, which also denied it, and now it is admitted for processing for a unification of the doctrine. , because if the mother has the right What we are asking for is the equality of the couple, whether they are homosexual or heterosexual.", defends this family, who three years later continues to wonder why the father does not have the right to also enjoy this leave. "The other parent has also lost his daughter and also has to go through this leave. In the new situation, with the child, the father helps. But in a situation without a child he still helps more. I needed someone to take care of me and my other son...", confesses María, who is now the mother of a large family. 

Blanca L., another 31-year-old Aragonese mother who went through this grief in February 2021, when she voluntarily and informedly terminated her pregnancy at 17 weeks, believes that a maternity leave in her situation would have only increased her pain, but called something else - or a specific one for these cases - it would be, in her opinion, an "advance" for all families. "I consider that There should be a permit, since both body and mind must recover. And I think it should be applied (voluntarily) to all women who suffer a loss in any given week. In just a few weeks, they may not need physical recovery, but they do need mental recovery. Each family is a world, and that loss can come after a lot of struggle and a great desire, even if they find out about the pregnancy at the same moment of the loss," he points out. 

When she and her partner made the decision to abort, it was consensual and very informed. The date, she explains, was neither natural nor chosen. "It could have been from week 12 to week 20. And we waited until we had all the necessary information to know that our girl's life was going to be very hard and limited due to her illness. We requested it one day, and they scheduled us for the next day. As it was a voluntary interruption, We were referred to a private clinic in Zaragoza. I was admitted in the morning, they performed the intervention, and I returned that afternoon to my house in Teruel," recalls this patient, who also highlights the pain that in these cases accompanies her two parents. 

"A baby brings many changes to life, especially if it is the first. And the most painful thing, at least in our case, is seeing that life remains exactly the same, when it should have changed so much. a permit, called something else, or specific for these cases, and of a certain shorter duration (in my case 15 days or a month) would have served to justify both the time before (from week 12 we knew that this would probably happen) and what came after: my lack of performance, my mood, my general behavior, and most importantly of everything: It would have served to make my loss visible as something real", something that happens in this world and that hurts as much or more than other losses," confesses Blanca, who regrets not having had time, after this experience, to "think, write or cry," and thus be able to have time with her partner an "emotional farewell." 

That's why now that abortion law reform promises to address perinatal griefBlanca emphasizes the importance of there being a permit and that it be extendable to the partner of pregnant mothers who suffer a loss. "Our couple also faces the loss of a loved one (despite not suffering from it physically), in addition to having extreme concern for us, because they know that we suffer from it "more." If the law allows it, they should at least have a couple of days minimum as in all losses due to the death of a close relative," he believes.

Protocols and assistance to these patients

To Miguel Ángel García, midwife and member of the Zaragoza Nursing College, this measure would undoubtedly be an improvement for the woman, but also for the family that finds itself in a situation of this type. "Pregnancy is always thought to be a fantastic and wonderful moment., but unfortunately these episodes occur and will continue to happen. Everything that involves an expansion aimed at assisting these patients, both at a health and social level, is more than welcome and necessary for both them," defends this health professional, explaining that Perinatal grief care protocols They have improved a lot in recent years. 

"From the point of view of assistance, we already in the Miguel Servet Hospital from Zaragoza we have noticed a change. Specific protocols were developed, staff were trained and extra consideration is given to all these patients who must be treated with greater care. because of the critical and vital moment they are going through," defends this midwife. 

Anabel Hernández from Teruel, who gave birth again last year in the same hospital where she lost her first child, reiterates that care in this area has greatly improved. "As Teruel is a small city, with a small hospital, everyone knew about my case... And Yes, at that time I felt that they had "mistreated" me, when in truth they did not know how to do it., because there was a lot of ignorance, This time it was the complete opposite. They were concerned about my situation, about how I had been before, and that has been a help for me, because when you are in the hands of others in the same place where you experienced a traumatic situation, you feel more vulnerable," adds this patient, who Now enjoy motherhood in a different way. "I compare it to the little lie of kings (when you discover that they are the parents). The next time you live it with hope, but without that innocence. You come home with your baby and you are very happy. But you don't forget the first child "People think that if you have another one, you'll get over it. I don't want Xoel to forget that when he's older he will know that he had a brother before him," says this mother, who trusts that the new law will also help make these things visible. personal stories and those of their babies, something that they have been fighting for for many years in the association to improve assistance to these families.That this permission be considered beyond six months is to make your grief more legitimate., it means that they are recognizing them, and we are always fighting for it," emphasizes the founding member of this Aragonese association.

Also for them?

Both the families and the health professionals consulted would welcome this permission being extended to all parties, with priority given to mothers. "The fact of having to complete paperwork is perhaps the least important, but it is already necessary to have a few days to be able to focus. At the level of family life, as a couple, being able to handle this situation together, or if you have other explaining to the elders what has happened would avoid pathological grief. In the end everything takes time, and it is not something that you can solve in 24 or 48 hours," emphasizes the midwife. Miguel Ángel García, who emphasizes an important issue. Whether the woman suffers an abortion after three months, or the most extreme case of a full-term pregnancy, both women must go through a birth process. "And physically," this health worker emphasizes, "the repercussions are similar." 

On a psychological level, García emphasizes the importance of not falling into the cliché of pronouncing certain phrases, such as "it will pass" or "you will be able to have more children." 

"That is not the right thing to do, and of course the Being able to have social support, whether it be benefits or psychological assistance, will always be welcome.", assures this professional. 

Regarding the possibility that this permission could also be extended to the parents or the mother's partner, this health worker considers that it should be regulated in a similar way to the take maternity leave. "There should be a mandatory part and another that can be transferred to the couple. After all, when the news is given that the woman is pregnant it is a reason for happiness for both, and from that moment on, any episode that arises against pregnancy will always be a pain for both the mother and the couple," says this health worker, who also reiterates that grief occurs at the time of abortion, "even if it is for a few weeks." 

In her opinion, this experience is a "unique" experience in a woman's life, but the feeling of loss is for everyone. "It is something that you expected to go well and it hasn't. Therefore, it is good that there is a benefit for both, but it is true that The one who undergoes the physical process is the woman and it is a priority that she is the one who enjoys all possible permission. But if, due to whatever circumstance, they don't want to or can't, then let the couple enjoy it," he concludes.