María Llopis

An easy (and wild) guide to miscarriage

Paper (1.500 words)

1.- Definition of terms. What is a spontaneous abortion?

A spontaneous abortion or miscarriage refers to the loss of an embryo when it is not intentionally provoked. As such, it differs from an induced abortion. The term only applies where the loss happens before week 20 of a pregnancy, when it becomes known as premature birth.

2.- Before aborting.

The causes of miscarriages remain a mystery to Western medical science, and doctors cannot do anything to prevent them. If a doctor tries to prescribe progesterone to you, say no. There is no evidence that it works, and it will just put you in a depressive, suicidal mood.

If anybody tells you not to have sexual relations, don’t believe them. It is common to advise against sex when there is a risk of miscarriage (such as spotting), but there is no scientific proof that sex induces spontaneous abortion. You may find that you start to miscarry after having intercourse. But the sex isn’t the cause, it simply stimulates a process that has ALREADY started inside of you. It’s like when you get your periods after fucking. You don’t get your period because you fuck, but because you did not get pregnant. Don’t let them confuse you. Some gynaecologists love to play priests.

3.- Don’t go to a medical centre.

If you have an ultrasound and there is no heartbeat (that is, the embryo has died), you are going to miscarry. It is only a matter of time. You need to be patient, because it can take weeks. Prepare your body and say goodbye. Every case is different. You’ll know when it starts, you’ll start bleeding and having cramps. Don’t go to a medical centre because you will probably end up undergoing a highly aggressive and totally unnecessary intervention.

Miscarrying is painful and difficult. It is much more comfortable to do it in the privacy of your home, or a familiar place, than in a hospital surrounded by strangers. You can do it yourself, you just need the help of a good friend. Several friends, if possible.

I personally recommend going to a beach (nudist and deserted, to avoid an unwanted audience) or the mountains. You will feel the need to squat down and push. Do it. It’s obviously not very practical to do this in your living room, as the furniture will end up covered in blood. That’s why it’s much more practical to do it in nature, where the seawater and the soil will help you to clean and absorb the flow. But only if the weather allows, of course. If it’s cold, it won’t be a good idea, because the cold will make the cramps stronger and more painful.

But if it’s summer and it’s warm and you have a beach or mountain nearby, don’t think twice. Ask your friends or your partner to put you in the car and take you into nature. All you will need is some painkillers.
If in spite of my recommendations for a natural, wild, miscarriage you have decided that nature is not for you, and you choose to stay home, my advice (and that of many manuals) is to sit comfortably on the WC. You will bleed so much that there’s no point endlessly changing pads and getting dressed and undressed. Everything will end up bloody.

One of the main drawbacks of this option is that it will be difficult for you to inspect the tissue that you expel. And this is a very important step, because apart from all the blood tissue, you will also expel what is known as the “gestational sac”. Its size will depend on your stage of gestation. It is important to expel it, so make sure that it comes out. When you have it, you can bury it in the ground, throw it into the sea or carry out whatever farewell ritual you like.

4.- Final ultrasound to check that everything has gone wildly right.

Once you have finished miscarrying, go to a gynaecologist to have an ultrasound so that you can be sure that the abortion has finished properly and that no tissue remains in the uterus. Wait a while before you go, because the process may take up to ten days. It is a routine visit the gynaecologist. These kinds of visits make gynaecologists somewhat frustrated, because it is all too obvious that we are only interested is the gadget for the ultrasound. Look at the scan carefully, ultrasounds are relatively easy to read. In this case, the uterus should look smooth and beautiful, with a fine line that indicates where the gestational sac was implanted.

5.- Don’t stay on your own.

Make sure you line up some help for at least a week. Somebody to cook for you, to make you got drinks, go and buy you painkillers, hold your hand when you have cramps, and, above all, to support you psychologically. If you stay on your own, you will have a very hard time. Remember that the pain will make it difficult for you to even walk.

Cancel work and personal appointments as far as possible. For the next few weeks, you won’t feel well at all. Don’t start a new job or move to a different country or another house. You will feel very tired and sad. Make it easy for yourself. Don’t stay on your own. The weeks after you miscarry are like an eternal downer after taking party pills. You think you’re going crazy. If you’re by yourself, you might. If you surround yourself with friends and affection, you won’t.

6.- Don’t blame yourself.

Western medical science does not know what causes miscarriages. They have only been able to come up with some hypothesis linked to chromosomal abnormalities and mysteries of various kinds. So don’t blame yourself.

One of the most highly respected books on the subject, written by the director of the Recurrent Miscarriage Clinic at St Mary’s Hospital in London, concludes that a pregnancy is more likely to continue if the woman feels loved and cared for. The world’s best specialists have spent years and years on research and studies, in order to come to this conclusion: the thing a woman needs in order to go ahead with a pregnancy is tender loving care. As simple as that.

The book in question ins called Miscarriage: What Every Woman Needs to Know, by Lesley Regan. I highly recommend it.

The statistics on spontaneous abortions are very high. In fact, miscarriage is the most common complication in pregnancy. Apparently, one in every five pregnancies ends in miscarriage. Perhaps even more. Nevertheless, it is a subject that is rarely talked about, and in a sense our society considers it taboo. The tradition of not announcing a pregnancy until the fourth month is due to the high possibility of miscarrying in the first three months. But when you make your own miscarriage public, other women start to talk about it. Mothers who had never admitted to their children that they had suffered miscarriages, neighbours, aunties, cousins, admit their spontaneous abortions when you mention yours. Talk.

7.- Trust your instinct.

Our instinct is all we have. Medical science will try to convince you that you don’t know anything, that it is impossible to feel the death of an embryo in your uterus, or to know the moment you get pregnant. Ignore them. If you listen to your own body, you can be aware of everything. The hardest thing will be ignoring the outrageous things that gynaecologists, lovers, friends and neighbours say to you. You’ll find everybody wants to have a say, and worst of all, many of them will judge and condemn you for refusing to follow the patriarchal game rules.
Long, long ago, in the time of witches and matriarchy, women knew much more about their bodies and their lives. They knew how to listen to themselves and society respected their decisions in relation to their bodies and children. Nowadays, any woman who doesn’t want to obey the orders of an inconsistent medical system is attacked and insulted. Wait till you see the comments in response to this post.

I asked the Recurrent Miscarriages Clinic at St Mary’s Hospital in London what protocol should be followed in the case of miscarriage. The gynaecologist answered that it depended on the woman’s wishes. That each woman had different needs. I was incredibly surprised by the logic of this response. I assure you that this is not generally the attitude of the health system in Spain. I think that St Mary’s is a good hospital.

Follow your instincts and insist that your doctors, friends and relatives respect your needs. This guide aims to assist in a relatively simple process, so that we can break free from unnecessary, painful medical practices that have been proved ineffective. As the gynaecologist at St Mary’s said, let each woman miscarry however she wishes.

María Llopis´ lecture. Muestra Marrana, Barcelona 2011.