Continuing the topic, I want to pay attention to such aspects of women's experience associated with pregnancy as infertility, miscarriage (frozen pregnancy, miscarriages) and abortion. Of course, there are many more problems and painful situations associated with the experience of pregnancy. And they are all worthy of attention. And women help. I chose to talk about three situations because I have accumulated a lot of observations, thoughts and therapeutic experiences about them related to different stories of different women. I take the situation of a frozen pregnancy and miscarriage as the basis for my story. The fact is that these situations, in my opinion, to one degree or another include the entire spectrum of a woman’s possible experiences and experiences. Because a woman who has lost a pregnancy is faced with the experience of the inability to give birth to a child (both temporary and long-term, if there are complications), she also experiences the loss of a child and, as a rule, experiences the experience of an abortion. Of course, infertility, miscarriage and abortion are completely different experiences. But I think it will be easier for me to first describe the general and then talk about the nuances. Frozen pregnancy, miscarriage. I discovered that a large number of stories, questions on the Internet, cries for help, have practically no answer - there is no literature for women on how to survive this and how to help a woman cope (unlike how many books about how to be a mother and be pregnant). There are isolated article-notes - either from survivors or from psychologists. Perhaps, somewhere deep in the network or in libraries you can find valuable texts, but if you type “frozen pregnancy” into a search engine, then more often information comes up about the causes, symptoms, treatment, recovery time... and also forums where women share their experiences and try to support each other. This situation convinces me even more that many women live their pain alone, as best they can, intuitively, and some part, probably, without sufficient support and understanding of what is happening to them. Therefore, further I will write in detail about what a woman who has had a missed pregnancy or miscarriage may experience. A woman, experiencing a missed pregnancy or miscarriage, goes through anxiety, fear, and sometimes horror, loneliness, guilt, shame and a feeling of humiliation, resentment, anger (rage, anger), envy and other feelings. This list is probably not complete. It is also likely that not every woman experiences the entire range of feelings listed. I will talk here about what is generally possible and what happens. In order to imagine the full scale and depth of a woman’s experiences, it is more convenient to describe what is happening like this: there are several recipients of these experiences and several spheres of relationships in which these experiences unfold. A child. Pregnancy freezes or spontaneously terminates at different stages of fetal development. This is even before the appearance of the embryo and the heartbeat, when we are talking only about the fertilized egg and the yolk sac. These are later periods, when the embryo and heartbeat appeared, and those when, for example, a five-month-old baby is inside the mother. It may be tempting to compare losses with each other, because objectively it seems that losing a pregnancy at 4 weeks or at 23 are completely different things, just like the loss of a born or unborn child. But in this article I see no point in philosophizing on this topic. In any case, we are talking about loss. And I noticed that for women, especially for those for whom pregnancy was desired, this is the loss of a child. Even if, strictly speaking, in some cases it would be more accurate to speak not about the child, but about the idea of ​​the child. This does not, in my opinion, have significant significance from the point of view of subjective experiences. As you know, the destruction of hope, the destruction of a goal, the destruction of meaning for a person can be as painful as the loss of a real loved one. The woman herself. Even if we imagine that a woman’s suffering about the child itself is insignificant (for example,she lost her pregnancy in the early stages, even before she could get used to the idea and be impressed by the fact that a new life is developing inside her, or she is less sentimental to suffer from the loss of a fertilized egg that did not even contain an embryo), we will only have to admit that everything that happened happened to the woman herself. It didn't just affect her, it happened inside her. And in a way, no matter how pathetic it may sound, it is at the very center of her being. This is both an emotional and a special bodily experience, which includes both issues of attitude towards oneself and one’s body, and a real threat to health and life. Those around you. Other people, both directly involved in the situation and third parties. Whom I especially want to highlight here: - the father of the child; - doctors; - other women (both close ones and strangers); - relatives; - close and distant acquaintances. I’ll try in order. First, I will describe the process of experiencing a frozen pregnancy and recovering from it. It seems to me that the very understanding of what this process consists of, as it happens, finding words for some vague, unexpressed experiences can already be a little healing. And then I will try to formulate some recommendations or guidelines on how to live further and how you can try to help. Child. The loss of a child entails the experience of grief. This means that a woman will have to go through everything that the grieving process includes. There are many articles and studies on this topic. I will provide links to some of them at the end of the section. I would really not like to repeat myself if everything has already been described a long time ago. Here, for a brief introduction to the topic for those who are hearing about grief for the first time as a psychological process, I will write several theses. In psychology, there is such a thing as “the work of grief.” Its essence is that grief is not just some kind of painful emotional reaction that needs to be stopped and eliminated as quickly as possible, but this is an important process, important mental work of parting with the object of loss and returning to a life in which there is no more and will not be of this object. I use the not very pleasant word “object”, because grief is possible not only about a person. On the other hand, the other person in relation to us, in some way, is always an object - the object of our thoughts, our feelings, etc. Analyzed experience over many years has allowed specialists to identify patterns and different stages in the process of grief. Of course, the grief of an individual will have its own uniqueness, its own characteristics and differences. And, of course, as in any science, there are several opinions about exactly what stages a grieving person goes through. But there is something common in these descriptions that is recognizable to many people. Knowing the stages of grief, understanding their essence and the logic of the process can help loved ones better understand and support the grieving person. And to help the grieving person live through this period. There are also concepts of “normal work of grief” or “normal” grief and “painful reactions of grief”, “pathological work of grief”, “unfinished grief”, etc. If you understand these concepts and the phenomena they describe, then we will talk about the fact that various kinds of complications arise if a person fails to safely go through the grief process (he gets stuck at one of the stages or the process is simply interrupted due to some internal or external events). If the experience of loss is not completed, it leaves a painful mark on a person’s soul and affects his future life. Acute grief can last several months, and the entire process of normal, uncomplicated grief from the stage of shock to the stage of acceptance of what happened, on average, takes about a year . In some ways, one of the key, important points is living the anniversary of the event. Experiencing grief is characterized by the following manifestations: horror, emotional stupor, “petrification,” or, conversely, an explosion of emotions, disorganization (lostness, absent-mindedness, inability to carry out ordinary activities), symptoms of powerlessness andexhaustion, lack of appetite; sometimes vain hopes and attempts to deny reality that seem strange from the outside (for example, despite the facts and checks, a woman’s disbelief that the pregnancy is frozen); aggression (anger, anger, rage). In this case, it is directed at doctors, at others (and it can even affect those who show sympathy, understanding and care), at oneself, at those who have not suffered, at life, the world in general. Here is the search for someone to blame - both among others and in relation to oneself (who missed what and what, what did I do wrong, why?). Possible physiological symptoms and behavioral manifestations: sleep disturbances, fears, loss of appetite with weight loss, asthenia, mood swings, seemingly causeless bouts of crying, changes in sexual activity, muscle tremors, detachment, a tendency to solitude, or vice versa, a constant need to talk to someone about loss. melancholy, loneliness, withdrawal. About relief, approaching the stage of acceptance loss and the end of grief are indicated by such manifestations as the restoration of vital functions (the appearance of appetite, improved sleep), the expansion of consciousness from just thoughts about the loss to everyday life, to profession, affairs, relationships, and even to plans for the future. This does not happen immediately and consistently. This happens gradually, with “relapses” to acute reactions, painful memories, etc. For example, painful memories and feelings can be caused by: the sight of another pregnant woman, the news of the pregnancy or successful birth of one of your relatives or friends, the sight of a baby or a woman (man) with a baby, some associations that return to the time when the child was conceived, or, conversely, a few months later, a woman may acutely perceive the date that she tentatively assumed as the time of birth (“on these days my child could be born”). It is somewhat more difficult for me to describe (since I do not have data and references to article), how in the context of the loss of an unborn child a bright memory of him can manifest itself. This is one of the signs of accepting the loss of a loved one - when dark and sorrowful experiences give way to bright sadness and memory of the departed. But from what I was able to witness, I would name several manifestations. The ability to remember an event, if something prompts it, more as a story of “healing” rather than a “tragedy”, about an experience that was survived, about an experience that entailed a reassessment of values ​​that is important for a woman today, relationships, a new understanding of life, etc. It is even possible (and this happens) that this story somehow contributed to some important and valuable changes in the way of life, in relationships, and became the starting point for some new decisions that ultimately changed life for the better. Sometimes women simply talk about the feeling of love for their unborn child. An important sign of integration and acceptance of loss is, in my opinion, that the event is perceived as important and sad, but does not tear life apart into “before” and “after.” Where the “after” is darker, more painful, and there remains some feeling of an insurmountable and painful loss of a part of oneself (which, for example, is quite typical and natural for the initial stage of grief). Of course, a lot depends on the woman’s personal history, on her resources at the time fading pregnancy or miscarriage (both internal personal and external), and on whether, in my opinion, the child was long-awaited, long-planned, what was the emotional involvement of the woman in the process, etc. I also think that a complicating factor in the loss is how it happened. At one time, the idea that the loss of one object could include several losses was a revelation to me. We are talking about situations where the loss is not sudden, but extended over time. For example, a situation when a loved one first becomes seriously ill, then loses himself psychologically (for example, an elderly person changes mentally during the course of his illness, and is no longer the same person with whom he had a relationship, changes very much) and only thendies. In this process, three stages of loss can be distinguished - the loss of a loved one as a healthy person (after all, this is a shock and a sharp change in life not only for the sick person, but also for those who are nearby), the loss of a loved one as a partner in a relationship from a psychological point of view, and after that - the complete loss of a loved one. Now let’s imagine that pregnancy loss does not occur immediately. For example, first a woman is informed of a threat (based on some signs in tests, clinical symptoms, ultrasound data), then a period of waiting for new confirmations or refutations begins, then one specialist can diagnose “frozen”, and another say that there is hope. Or - and this also happens - everything can indicate that the pregnancy is frozen and the woman is preparing for termination, and then suddenly the pregnancy turns out to be alive. Then some decisions may follow based on the doctor's recommendations for maintenance treatment. But in the end it still ends in loss. In other words, during this period of waiting or even fighting for a child, a woman can lose him several times. Another example could be the not so frequent, but occurring cases of multiple pregnancies, when one fetus dies and this, on the one hand, is a loss in itself, and on the other, a possible threat to the survivor. And then a struggle unfolds to preserve the latter, which may or may not be successful. What to do? By accepting that a woman who has lost a pregnancy is going through grief, and that there are several stages in this process, you can help her by allowing her to grieve. That is, you will not prematurely reassure her, insistently tell her that she should stop crying and remembering what happened, that she needs to move on with her life, etc. In my opinion, this happens more often for two reasons. Or because of ignorance and reliance on your own experience of grief, interrupted by someone else. Or because it is alarming, scary and unbearable to be around a loved one who is grieving. I'm scared for him. Well, you open your own wounds. Read some good articles about the grieving process and how you can help a person get through it. Use those recommendations that you understand and that do not cause violent resistance in you, that is, accepted by you. Each stage of grief has its own characteristics, and by understanding them, you can better understand the grieving woman. You may find it easier to answer the question “How can I help her?” For example, the words of a young woman “I never want children again,” which sometimes frighten loved ones, can have completely different meanings at different stages of grief. If this is said by a woman 2-3 days after the incident, this can primarily be interpreted as an acute reaction of grief. And it makes no sense to perceive such words as a true decision and try to convince her and reason with her. Because these words are more likely to mean: “I’m in terrible pain right now. I can’t even imagine that I would decide to get pregnant again.” And these words can have a completely different meaning if several months, or even years, have passed since the event. In this situation, there is more reason to assume that the grieving process is not completed and the woman has not recovered from it, or she has made a conscious decision to no longer try to carry and give birth to a child. Those who are grieving themselves can benefit more from the support of loved ones than from knowledge about the grieving process. But it also happens that familiarity with the idea of ​​grief and the stages of this process at least a little explains to the suffering woman what is happening to her. And then what happens to a woman can become less frightening for her. Maybe this knowledge will help some women accept themselves with their strong feelings and difficult experiences that throw them out of the normal rhythm of life. And they will allow themselves to take their time getting back on track and pretend (even to themselves) that everything is already over and doesn’t matter. And according to my observations, most people do this, unfortunately. And this is due to the fact that the culture of grief inin our modern society, in my opinion, no. And, of course, remember that, despite the universality of human experience, there is also a unique story for each person. Everyone experiences grief differently. There is no need to follow what you read in books as a rigid recipe that is suitable for everyone in all situations. You always need to take a closer look at the specific person you want to help. And if you feel that literature is not helping you, you can always turn to a psychologist - either to someone who is lost about how to support a loved one, or to the woman herself who is experiencing loss.ps There is a lot of information on grief on the Internet. To begin with, you can look at these materials (since there is a limit on the number of external links in the article, I ask you to use search engines using the suggested names of materials): Umansky S.V. Bereavement and grief. Psychological and clinical aspects. Psychology of extreme situations for rescuers and firefighters. Chapter 10. Experience of loss. Now about the woman herself. A frozen pregnancy is dangerous to a woman’s health. It's simple. There is a dead fetus inside the woman's body. This means that there is a risk of inflammation. But the process of liberation from this pregnancy also poses a danger. In some cases, especially in the early stages, the body itself can free itself from what remains. In some cases, again, in the absence of complicating factors and other other conditions (as determined by doctors), a woman may be offered a medical abortion. The possibility of using this method also depends on the traditions of the medical institution where the woman is observed, and on the region, and on other factors. Another way to get rid of a frozen pregnancy is surgery, which has two very eloquent names - “scraping” and “cleaning”. In essence, this is the same abortion. Personally, the very name of the procedure evokes the most unpleasant experiences for me. Many women who have had a miscarriage go through this same procedure. Unfortunately, during a miscarriage, the uterus is not always completely freed from the baby's place and fertilized egg. Therefore, a miscarriage is often followed by a “purge.” Otherwise, there is a high risk of inflammation and other complications. I think that I should not go into details of all the possible risks that any surgical intervention entails, as well as this particular one. In general, if in essence, then the woman falls under a special knife. The operation can be performed under local or general anesthesia. However, from what I know, local anesthesia is suitable for women with a fairly high pain threshold. In hospitals, in the absence of contraindications, general anesthesia is still practiced. So, a woman who is in the process of experiencing loss, at the same time, is faced with the inevitable (in most cases) prospect of surgery. Naturally, her reaction to this prospect can range from unpleasant excitement and anxiety to horror, depending on a number of factors. These factors include: emotionality and sensitivity, in general; resistance to such stressful situations; absence or presence of previous experience of surgical interventions (in particular, experience of abortion or curettage), and the favorable outcome of previous interventions; attitude towards your body in general; the degree of psychological resistance to various manipulations with the body and much more. All other things being equal, this event can be especially traumatic for women who have not had experience of an abortion or similar operation and who lose their first pregnancy. Listening to the stories of women, having the opportunity to see some examples, I would venture to say that for some women this prospect of brutal violence... with only one difference - that for the sake of her own health. Violence in the sense that it is a gross invasion of the most intimate in her body - the physical center of her sexuality, femininity, motherhood. I do not at all pretend to attribute suchexperiences for all women, but I assume that for some these words will help recognize their own experiences in the past or present. Some women may even talk about psychosomatic symptoms of disturbances in the field of sexual life that appeared after this experience (decreased sensitivity or hypersensitivity, deterioration of sexual relationships, feeling frozen as a woman, etc.) So, what was a child or the idea of ​​a child becomes “ danger" or even "enemy" within the woman herself. And this fact can cause conflicting experiences. What was expected and desired has disappeared and become a threat. The threat now and the threat “later”, because no one can guarantee how the operation will go, whether it will have to be done again, whether there will be complications, how the uterus will be restored, whether this will affect the possibility of conception and pregnancy in the future. If you look objectively , then the operation, for example, in the early stages lasts very little (15-20 minutes), the period of postoperative rehabilitation with a positive outcome is a couple of days (and the woman will be sent home if all is well), and outpatient rehabilitation lasts 3-6 months (doctors often call 6). After which you can make the next attempt. And, by the way, with the best intentions, doctors often recommend doing it. What is there to worry about? This is, indeed, not cancer, not AIDS, not a global disorder in the body. As they say, it’s a matter of everyday life. But I'm talking about subjective experience. About reactions to the proposed and performed surgical intervention, about the attitude of an individual woman to this event against the background of all the above individual factors. And in this regard, a woman does not just lose a child. A woman literally loses a piece of herself. It is not lost in a natural way, as happens in a normal female cycle or if a spontaneous complete miscarriage occurs without the need to “finish” nature’s work surgically. And she loses through pain and often strong natural biologically and psychologically conditioned resistance. Also, a woman loses herself in this particular situation in the psychological sense as a mother - as a mother bearing a child, as the mother of an unborn child. She has to accept the fact that in this situation she is a failed mother or, if you want, she is the mother of a dead child, a mother who has lost a child. I'm sure it always hurts. At a minimum, if a woman wanted to take on this role. And I also think that this can be especially acute for women who do not yet have children. And if this is not the first time this happens to a childless woman (chronic miscarriage), a difficult situation arises here. In part, it intersects with that stage of experiencing the grief of loss, where aggression begins to unfold and a woman can look for someone to blame. Thanks to modern medicine, its discoveries and technologies, it may seem that people have gained control over this phenomenon. Numerous screenings, ultrasounds that help maintain pregnancy, drugs, IVF and other achievements can create the impression of some omnipotence of people in this topic. However, nature still takes its toll. And on the one hand, as they say, in my opinion, wise doctors, nature “decides” whether a child will be or not, and on the other hand, since this happens in a woman’s body, it is difficult for her not to think about her own contribution and her own guilt. “What did I leave unfinished or did I do wrong?”, “Where did I miss?”, “What did I not foresee?” And if we also take the abundance of popular ideas about how important it is to be in a good psychological state during pregnancy, how a mother provides the child with the necessary atmosphere in her body with the help of positive thoughts, attitude and love, then almost every woman will find in her pregnancy, Why reproach yourself? Here I didn’t take the information that I was pregnant the right way, here I doubted it, here I was afraid, worried, here I was nervous, here I had a fight with my husband, I probably conceived at the wrong moment and in the wrong mood, etc. Special mention should be made of the feelingguilt among women who doubted their desire to continue pregnancy perceived the news about pregnancy ambiguously (with doubts) or clearly negatively (fear, reluctance). Often, in their perception, a direct connection is established between their doubts (reluctance) and the fading of pregnancy (miscarriage). Here I will immediately note: practice shows that there is no direct, unambiguous connection between doubts, reluctance and fading of pregnancy, miscarriage. In this situation, two possible vectors of experiences appear. One is experiences towards oneself as a person, as consciousness, as a subject of activity. They just about “who am I?”, “what am I?”, “what did I do wrong?”, “why?”, “why with me?”, “what’s wrong with me?”. These thoughts are accompanied by guilt (what am I to blame for, what did I do wrong), shame (I’m bad, I’m a woman “with a defect”), resentment or anger (why me? It shouldn’t be like that!), powerlessness, because no the answer to all these questions. Also, some women experience guilt and shame about the relief they felt when they miscarried. Relief associated with the resolution of doubts, with the absence of the need to make a decision about an abortion of one’s own free will, etc. Often, this turns out to be a new experience of experiencing oneself, about which a woman can say with bitterness and pain: “I would never have thought this about myself - that I would react to it this way, that I would experience it this way (that there would be doubts, that there would be reluctance, that there will be relief when the pregnancy is terminated).” On the other hand, these are experiences in relation to one’s body. And so the body can begin to be perceived as a “traitor” or as something “alien”, since it behaved “against the woman” (her conscious beginning) if she wanted to bear and give birth. The body simultaneously becomes both a victim and an “enemy.” There may be feelings of distrust of the body, anger, disgust, shame of one’s own body. Regarding shame in connection with the body, I would like to note several aspects. Firstly, this shame may be associated with a feeling of one’s own helplessness - the inability to influence what is happening inside oneself , objective helplessness associated with the situation of dying or miscarriage itself, with the situation of anesthesia and surgery. Secondly, it may be shame, partly associated with the culture of medical care in a particular medical institution and team. And I think that this is due both to the technical organization of the operation and other procedures, and to the behavior of medical workers (from doctors to nurses and orderlies). And this aspect varies greatly from institution to institution, from region to region. I will now outline one of the real pictures of a Russian hospital. Not the best. But real. To make it clear what I’m talking about in connection with shame and the attitude of the staff. When a woman enters an examination room (where, in particular, “cleanings” are currently carried out under certain conditions), in which there are two chairs (for examination and mini-operations), between which there is no elementary screen. When a woman, while in the hospital, watches every day, as if on a conveyor belt, women enter the examination room, and are taken out of there unconscious on gurneys, with their bodies not really covered. When a new arrival in the ward sees how tired and angry nurses serving several departments do not shift, but sometimes with irritation push a woman recovering from anesthesia into her bed. When doctors (often women), tired of physical and emotional stress and their own problems, talk to patients as if they were inanimate objects. When all this happens in a department with peeling walls, floors, windows, broken beds, unwashed toilets, where there are always traces of blood around (it’s gynecology, no matter what), with unwashed floors in the wards, where a layer of dust has accumulated for several days. And when what is about to happen to a woman or has already happened is called “cleansing,” it’s time to feel dirty, trapped in “purgatory.” This is a completely irrational experience. Simultaneouslya woman can feel despair, anger, and resentment. But she may also feel humiliated and unable to defend herself. Because she is trying to cope with her own emotions about the event itself, about herself, because she depends on these people who are treating her, because she is not able to defend herself. And when a person fails to protect and defend himself, one of the experiences of such a situation becomes shame. As in the previous part, it should be noted that, of course, every woman experiences what is happening differently. Not everyone’s experiences will be so vivid and strong, so traumatic. To a greater extent, in my opinion, this affects women who, even before pregnancy, were not very loyal to themselves, were prone to self-deprecation, women who are self-critical, prone to control and achievement (the experience of “I couldn’t” is difficult for them to tolerate), perfectionism (when you need to be the best, everything should be “A”), emotionally less stable and impressionable women. Women who are more emotionally stable and have a more positive attitude towards themselves may be less traumatized by this situation, not as deeply, or the recovery period from these experiences will be easier and shorter (less stuck). If a woman is undergoing a medical abortion (depending on region, medical institution and specific doctor, it is offered to patients for short periods, even with a frozen pregnancy, in order to protect the muscles of the uterus), her psychological experiences in connection with the threat to her health, and bodily experiences may be less intense. Especially if the medical interruption is effective (no surgical intervention is required, which happens) and without complications (for example, uterine bleeding). In general, medical abortion (let me remind you that essentially removing a frozen pregnancy or cleaning after a miscarriage is also an abortion, just for medical reasons) according to official statistics is better tolerated by women psychologically and, in particular, physiologically, if it is performed under close supervision doctor However, this procedure can also be quite stressful for a woman’s body and psyche. A woman may feel severe pain, severe weakness, faintness, nausea, vomiting and other symptoms. Some doctors suggest that women collect material for histology (special tissue analysis) to establish the causes of freezing. The woman collects tissues discarded by the uterus, washes them and “packs” them into a given “test tube” for sending for analysis. It should also be noted that if a woman undergoes surgery after trying to maintain a pregnancy in the hospital, then during the struggle for her child, she undergoes many other medical procedures aimed at preserving her health and the health of the fetus - these are various injections (which can be 5-6 or more injections per day, when not a single island of untouched muscle remains), these are IVs, this is regular (sometimes daily ) passing any tests, constant examinations and other possible medical procedures. The woman does all this for the sake of herself and the child, living this period as best she can - to the best of her abilities for emotional self-regulation. And after the loss, traces of all this still remain, and the body needs time to recover, just like after the operation itself. In addition, it happens that after attempts to maintain a pregnancy, and then after a medical or surgical abortion (cleansing), a woman is faced with the fact that some of her chronic diseases become worse or new symptoms appear. And the body continues and continues to hurt and suffer. The rehabilitation period is delayed and can take a year, a year and a half, or even more. I want to illustrate my words with one woman’s description of her sensations and feelings: “I had an operation. Three days later I left the hospital, and within 24 hours a complication began to develop. I didn’t even have time to experience the relief that after several weeks of wandering around hospitals, I was at least home. I was in so much pain that I could only get to the doctor athalf-bent state. Then another course of treatment, outpatient, and an anxious wait to see whether the body will cope on its own or whether a second operation will be required. It worked out. But when it was all over, my back hurt. This is my weak point. I know. Only this time no physical training helped, although before it worked 100%. I went to a neurologist. During the examination, the neurologist behaved like a sadist, probing some muscle and continuing to press on it. I could hardly bear the pain and told the doctor about it. But she didn’t seem to hear. She continued to press silently. Then she simply prescribed blockades. I'm so tired of these endless procedures. And I didn’t know who to turn to so that the blockades would be done well. And I decided to try another way. An osteopath has been recommended to me for a long time. But since then I haven’t gotten around to it. But this time I decided to go. This was the first appointment and consultation. Almost from his first touches, I felt tears welling up and almost burst into tears. He touched me so gently, and I felt how much I now need careful caring attitude towards my body. And how unusual such an attitude has been for me from a doctor lately.” Let me summarize the above. I think that quite often the moment of losing oneself (one’s identity, one’s integrity) is somehow missed - both by those around and by the woman herself. It is not given much importance. Firstly, the loss of a child seems more obvious (she conceived, but did not carry it to term, was inside, and did not become). Secondly, I think it's partly cultural. It is customary to mourn the loss of someone - this is understandable, it is not condemned, it is acceptable. Mourning oneself, feeling sorry for oneself, in our society, as far as I can see, is often considered a shameful activity: “What is there to mourn? You don’t have cancer, your leg wasn’t cut off... think about it, abortion, think about it, surgery, think about it, it didn’t work out.” "You're not the first, you're not the last." “Women lose five times before giving birth, and you feel sorry for yourself.” “Routine operation. Thousands of women go through it, nothing special.” “If you want to be a mother, there’s no point in being a fuss.” “Do you know how women used to live through all this without anesthesia? How did you work in the fields throughout your pregnancy?” etc. and so on. Not that everyone says so, of course. But sometimes this is simply implied: in order to feel sorry and mourn yourself, there must be a very, very good reason. And for many this is not a reason. Although, if you look objectively, the woman was not yet familiar with the child - she was only in contact with her body. But physically she really suffers. And if we also remember that while the child is in the womb, it is a unity, and the child during this period is part of the mother? It’s not for nothing that there is such a thing as postpartum depression. And it is connected with the first physical and psychological separation - the transition of the child from merging with the mother (and the mother from merging with the child) to a separate existence in space. And if you look from this point of view, the loss of an unborn child is the loss of a part of yourself... irrevocable. Therefore, I think that if a woman’s grief is prolonged (it also happens that she herself already realizes that she seems stuck), she mourns everything and mourns a child, it may be appropriate to find out whether the woman mourned herself, as a mother who has lost a part of herself, as a woman whose motherhood was cut short in this way, as a woman who has experienced physical and mental suffering. What to do, how to help? I am sure that part of the help may already consist in turning the woman to you. Especially in that situation, if she does not take herself into account at all, and is fixated specifically on the loss of the child. This kind of self-compassion and self-compassion alone can be healing for some women. Therefore, I hope that women reading me who have experienced pregnancy loss will pay attention to this. And for those who want to help, I will say this. It’s good if you can become that part of a woman’s environment who is capable of sincere compassion and from whom the woman can accept this sympathy. But the culture of compassion in our society is also notEverything is fine. In both life and work, I constantly encounter how people suffer greatly and push away sympathy and self-pity with the same force with which they need it. Therefore, just as it can be very difficult for others to express their regret and sympathy for a woman, it can also be very difficult for the experiencing woman to accept this in her address. Some kind of vicious circle. Just try. Look for words, look for sympathy within yourself. In my opinion, it’s better for a loved one to be embarrassed, confused in words, but sincerely sympathize and try to talk about it. Or he can just come up and hug. Or stay nearby. This is better than when he pretends that nothing is happening and is afraid to express himself at all. Or he begins to pressure with advice and moralizing. In general, this is the active work of the soul - to support a loved one in his experiences. And don’t expect a miraculous effect right away, that you will regret it once and everything will pass. If you already understand one of the main ideas of the article: experiencing is a process. It takes time. Therefore, learn to sympathize, have compassion, and express it in appropriate forms (and they are appropriate depending on the situation and specific people). And be patient. In theory, a separate article should be written about compassion and empathy. About the forms in which it comes, and how it can be expressed in a given situation. But since I’m talking here about what to do and how to help, I’ll try to at least sketch out examples. There is only one single and fundamental condition - look for words and try to act only if you really sympathize and want to support and help. Words and actions themselves do not help if they do not contain a living feeling of your soul. Otherwise, there are a great many options for all occasions. Here are just a few examples of how you can make it clear that you are with a woman who is worried. From actions: hug, let her cry on your shoulder, on your chest... talk about how sorry you are for her, how bitter it is that she suffered so much. Hold her hand, say that you regret that this happened, that you see how the woman is hurting, that you sympathize with her for what she experienced. If this is a conversation on the phone (with a friend, for example), and you want to support, offer to meet, say that you really want to help and are ready to support, and even just come or see each other. Do this instead of encouraging them to move on with their lives. Maybe it doesn’t occur to you at all what it sometimes means for a suffering person when someone just like that, in response to a voice, can say: “I’ll come to you now. Wait." And come. Not to straighten your brains out, but to just be there. If you have ever experienced something like this, tell me about it. Share what you can imagine how she suffered, how painful it is to go through such trials. And if you don’t have such experience, try to imagine. And if you feel it, then say so. For example, like this: “You know... I tried to imagine what you had to go through... and I’m so scared and in pain. And you experienced it all for real. It’s very difficult.” And one more thing. You can cry. You can cry together. If suddenly you also have tears. In the end, if you sympathize, but don’t know how to approach a person close to you with this, and are afraid of offending him once again, you can just say: “I think (see) that it hurts you. I really want to support you. But I'm afraid of doing something wrong. Let me feel sorry for you”... Or at least like this: “I don’t know what to do for you, I don’t know how to say the right words, I don’t know how to hug and feel sorry, but I want you to know that I sympathize with you, I really do.” .Women have another way of support, of course. Not only this direct way - cry, hug... Sometimes they drag each other out into the world. Or they have a sit-down with a bottle of wine and just talk about life, disconnecting a little from the suffering itself. You're welcome, I don't mind at all. I'm just talking about other support now. About the one that is usually little or not at all. About the straight line. About notdistract and pull out of experiences. And about helping a woman meet them, go through them, live them. And more. I have a couple of notes. I felt sorry for myself. If the topic resonates with you, read it. I think they might come in handy: Self-pity Self-pity. Continuation: Guilt and shame. The first thing loved ones can do is think about what they are saying to the worried woman. And don’t throw accusations and reproaches. And also - spontaneous reflections on the topic “Why were you punished like that. Think about what you did wrong. Nothing in life happens for nothing. So you need to think about it.” As a rule, women, even without outside help, have enough self-criticism to think about how they are to blame. Regarding a woman’s guilt and responsibility, it is also useful to know that in the list of scientifically proven factors leading to pregnancy loss (miscarriage, fading) you can more often see: genetic (random combinations of genes that led to its non-viability, genetic incompatibility of parents, etc.), hormonal (not only the state of the ovaries, but also the work of other hormonal glands), immune (autoimmune diseases), infectious (and it’s not so much about obvious infections, how many about hidden ones, which a woman may not know about), gynecological diseases, in particular, fibroids, endometriosis, etc. And only taking into account these factors, it makes sense to talk about lifestyle, psychological state and other factors, that could influence. Pregnancy is a mysterious process. Both in itself and in the context of life in general. I often talk to women who punish themselves for their loss about how many women carry children and give birth while using nicotine, alcohol and drugs, being in constant stress, living with a man who beats them when they are pregnant. And about how women carry and give birth to children without preparing for pregnancy and without seeing doctors at all. That it is not uncommon for children to be born after sexual violence. We, however, can only collect in one list all the factors that are one way or another known as miscarriage factors. But in each specific case, we most often cannot know for sure what exactly was the reason. I hope that in some way my explanations about the sources of guilt and shame can be useful. And if you share my point of view that quite often the reasons for missed pregnancy and miscarriage are either impossible to establish, or there are many reasons, and most often, the woman is not to blame, then you should tell her about it. If you hear self-blame from her or assume that she blames herself, and you see options on how you can talk about this topic. Regarding shame and relationships with your own body. It's quite difficult for me to give advice here. This is a subtle and deep topic, and I will not undertake to reveal it in detail here. If I do this seriously, I simply won’t have enough time. Therefore, very briefly. To begin with, it is simply important that a woman takes care of herself. So she can do it herself. And for those around you to also participate in this if possible. It is easier to take care of yourself if this idea and environment supports it. And it helps to create such an opportunity. It is very important to rest (going somewhere on vacation, a sanatorium). Vacations are often viewed as a way to get distracted, to change the situation, to forget, to get over it faster. That's not what I'm talking about. I mean that after such severe stress, hospital wanderings, complications, medical procedures, etc. just give yourself time to recover. Give yourself the opportunity to sleep and not owe anything to anyone (which can be quite difficult without a vacation - we all have responsibilities). It is important that a woman can listen to herself and do what she loves for herself and her body. Massage, swimming pool, walks, exercise, something else. Naturally, this is allowed for health reasons. If painful symptoms, bodily tensions (pain or tension in the lumbar and lower abdomen, fear of bleeding,