Spontaneous abortion is "lonely, painful and demoralizing," writes Michelle Obama in her new memories. However, for some estimates, it ends as 1 out of 5 pregnancies before the 20-week mark.
The disclosure of the first first lady that she and former President Barack Obama suffered from fertility problems, including the loss of a pregnancy, led to conversations about spontaneous abortions, a common but also misunderstood loss.
Psychologists say that ignorance can contribute to the emotional and psychological toll of losing pregnancy, isolating women and their partners and leaving their uncertain beings to comfort them.
Almost five years later, Becky Shaw of Woodbridge, Va., Still remembers sending text messages to her friend after her abortion, only asking if she was about to speak. Within a couple of minutes, he called his friend. "I do not even remember what he was saying, but she made me laugh," said Shaw.
Trauma began at the beginning of his first pregnancy. Shaw, now 35, has experienced some bleeding when she and her husband came forward for their check on Christmas Eve in 2013. The nurse who performed ultrasound used a Santa hat.
"You can tell when something is wrong," said Shaw. "She is just looking at the screen. And then she finally seemed, can you count your breath?"
The nurse struggled to find the baby's heart, which said she was dangerously low and could stop. For weeks, Shaw felt "like a time bomb." She aborted in early January.
Shaw said it is important for a woman like Obama to talk about her involuntary abortion. "It only makes people feel less alone," he said. "My abortion did not affect me, and I had the most supportive friends and the best doctors."
Many mourning counselors are praising Obama for illuminating and normalizing involuntary abortion, helping families to suffer their own loss.
"What is present," said Helen L. Coons, a clinical health psychologist specializing in the health of women's behavior at the University of Colorado Medical School.
Spontaneous abortion or the loss of a pregnancy before 20 weeks is so common that Americans often remain silent about their pregnancies until the first trimester, when most abortions occur. Improvements in the early detection of pregnancy and the use of fertility treatments also increased the likelihood that couples learn that they did not make their dislike, while once they did not know they were pregnant.
The risks are higher for black women, who are more likely to suffer from pregnancy loss than white women. (Black babies are also very likely to die during the first year of life, according to recent data from the Centers for Disease Control and Prevention).
For such a common occurrence, however, much about involuntary abortion is widely misunderstood. A 2015 investigation found that many people do not understand their causes, with more than one fifth of those interviewed saying they believed that lifestyle choices (such as smoking or drinking alcohol) are the most common cause. In fact, most abortions are caused by genetic problems.
Other factors that the interviewees incorrectly identified as potential causes included lifting heavy objects (we believe in 64 percent); having a sexually transmitted disease (41 percent); and even enter an argument (21 percent).
It is not common to find out the cause of spontaneous abortion and women often blame. The investigation also found that 47 percent of those who experienced an involuntary abortion reported feeling guilty; 41 percent reported feeling alone.
Some women also remain worried that they are infertile, a fear that can cause identity problems for those who are destined for paternity.
Psychologists say it is also important to recognize the sorrow of the partner or spouse, who can process emotions differently, but also has experienced their own loss.
Insulation can aggravate these feelings, including the belief of some of the women that "their body has left us," said Coons of the University of Colorado.
Nancy Molitor, a clinical psychologist and professor at the Faculty of Medicine Feinberg from the Northwestern University, said that the same question was asked by many women when she suffered from her own miscarriage, a trauma that almost killed her: what did I do wrong?
Today, women are more likely to talk with their friends and other loved ones about their spontaneous abortions, said Molitor, helping them realize how common events are and eliminate some of the stigmas. But even in 1996, when she did not pronounce, "nobody spoke of it," he said.
She advises women, some in their 80s or 90s, who present their abortions that arose decades later. "There is a nonsense about the fact that they never talked about that," said Molitor, adding: "It has been said, go ahead, honey. Come on, my dear. I was not meant to be."
Couples who are sad are also faced with a penalty that has no rules or rituals. Stefania Patrizio from Philadelphia and her husband waited until she was 12 weeks old to tell their family and friends that she was pregnant. She was showing for the moment she aborted in about 20 weeks.
"There were many people who did not know how to handle it, because it is a different kind of grief, it is a different type of: I think I'll say death, because it is not someone who has met," he said. "It was a dream penalty."
Creating her daughter – who was born a year after her abortion, almost daily – did not relieve her fears. "I did not want to talk about it. I did not want to get excited," said Patrizio, now 34. "Even with the click, click on the [ultrasound] The machine would give me so much anxiety. "
Psychologists emphasize the importance of women recovering from an involuntary abortion to build a support network.
Coons recommends pregnant women reach at least one or two people close to them to discuss fears they may have. This could mean spreading an early pregnancy to a couple of friends before revealing it publicly, so they can not only talk about their anxieties, but also loved ones are ready to help something go wrong.
Aline Zoldbrod, a Boston-based psychologist, who runs SexSmart.com and has written about infertility, said those who did not do a breakdown can find the comfort of a therapist or support group, which can calm the blame and "inherent sense of defect "women often feel.
Zoldbrod recommends that your loved ones do not use lines like "you will have another one" to console those who have lost a pregnancy, which can be as legitimizing their loss. She said she might be enough to simply tell them: "I'm sorry".
In the absence of established ceremonies, many found peace in their own rituals or memories. After losing her pregnancy, Patrizio and her husband camped together on a couch called "our island" – eating, sleeping, visiting with friends and crying.
They also traveled to Scotland, where they spent time walking. One day, finding themselves alone by a lake, they performed their own ceremony, reading a poem before taking some memories from pregnancy to water.
Shaw said after finding out that his baby was a girl, she and her husband called it: Cecelia.
She maintains a magazine about her feelings for Cecelia, and sometimes, around the anniversary of her involuntary abortion, Shaw removes a letter box, images of sonograms and one who bought by whim while shopping with a friend, shortly after learning who was pregnant
"I do not mean that you are moving forward," said Shaw. "It's something like your new normal".
KHN coverage of these topics is supported by the David Foundation and Lucile Packard and the Heising-Simons Foundation.
Kaiser Health News is a non-profit news service that covers health issues. It is an independent program from the Kaiser Family Foundation, which is not affiliated with Kaiser Permanente.