Features of obtaining and implementing parental rights on maternal capital with the death of one or more children for a long time were the subject of lively disputes. First of all, because additional measures to support families with children within the framework of the Matchekipal program are formally intended for providing a worthy level of the family's living standards in the presence of several children!
However, the death of children does not cancel the fact of their birth - and the right to the mat. Capital is established precisely in connection with the birth (or adoption) second or subsequent child!
Therefore, in the first years of implementation, which started in 2007, when legislatively individual special cases have not yet been settled, many parents were forced contact the court after employees Pension Fund It was wrong with the issuance of a certificate for Matkapital, if the first or second child from one mother died at the time of treatment.
Recall the following highlights:
In the absence of a birth certificate, at least one of the born children, the territorial bodies of the FIU will be forced to refuse mothers who have applied to receive certificate!
In this case, the question arises about the principal opportunities for obtaining a document (or his duplicate) confirming the fact of the birth of a child, in the registry office, which is most difficult:
- at the birth of a dead child;
- in the event of the child's death in the first week of his life.
Matkapital on a stillborn baby
Unfortunately, a woman who gave birth to a second or subsequent child since January 1, 2007, if at least one of them was born dead (due to perinatal death), does not have legal right To receive maternal capital!
The fact is that in accordance with the provisions of Art. 20 of the Law of November 15, 1997 No. 143-FZ "On Acts civil status»On a child born dead, birth certificate not issued.
In this case also:
- state registration of the death of a child And the issuance of the corresponding certificate is also not produced (at the time of birth, the fruit is already dead - the case of perinatal death).
- at the request of parents, the registry offices can only be issued by document confirming the state registration of the birth of a dead child.
The right to maternity capital when the child's death is in the first week of life
Until August 2, 2010 by law "On the acts of civil status" The ability to receive a birth certificate for a child who has deceased during the first week of life, also not envisaged.
On the death of the baby in the city hospital number 2, the prosecutor's office opened a criminal case
When I learned that Natalia was pregnant, began to treat her, as a child, - tells Natalia Bartholomeva's husband Volodya
Gifts bought, in the refrigerator there was always a complete range of fruit. Then you immediately bought a fur coat about which she dreamed so long. Repair began to make capital. Prepared nursery, pasted her with wallpaper pink with bear. On that day, when Natalia gave birth, she already agreed to buy a baby carriage. And I had to buy a globe.
At the end of February, a child died in the city hospital during childbirth. His mother Natalia Varfolomeev passed all pregnancy without complications, and the child was also healthy. The woman could not give birth to independently, as the kid's shoulders were greater than the head. Due to lack of oxygen, the baby died. Doctors say that the female has a rare complication, and believe that they did everything possible. Parents of the infant Vladimir and Natalia Varfolomeyev are blamed by doctors. The father of the child filed an application to the prosecutor's office of the Oktyabrsky district.
A criminal case was initiated under Article 109 part 2, "Leonid Kharyshev said Zambedoor.
Natalia Varfolomeva could not get pregnant for eight years. Applying to doctors who did not reveal the pathologies and said that she would have children. And so the miracle happened. On that day, Natalia asked her husband Volodya to buy her a pregnancy test in the hope that he could, he had easy hand. In the evening, Volodya from the threshold immediately asked how the result. Smiling, Natalia said :. Volodya from surprise stood for a few minutes silently. Then he ran up to Natalia, grabbed her in his arms and kissed. From this day he began to work for ten, trying to the wife and their future child did not need anything. When it was time to give birth, Natalia went to the doctor who watched her and received a certificate of hospitalization in the hospital.
From the beginning of the receipt in the hospital, nothing foreshadowed troubles, "remembers Natalia, with difficulty holding back tears. In conversation she does big pauses, deeply inhales and tries to restore the voice that all the time trembles. - I was taken to the maternity hospital. I gave birth to the head, but then the cough stopped, and seven minutes the child lived, and the doctor who took the childhood and midwives did not take anything to save his life.
Natalia believes that the doctors did not make the main - dissection. This operation, I am sure the woman would help to be born a large child, whose weight was 4100 and the growth of 55 cm.
The chief doctor of the Roddoma Anatoly Dmitriev says that the full amount of work with such a complication, which is called, was rendered to the crotch dissection. This complication is very difficult to diagnose, and you can only learn about it at the time of the completion of childbirth. According to statistics in such cases, 50 percent of children dying. The head of the child was born, he should begin to breathe independently, and his chest and shoulders are in the narrowest part of the pelvis. The baby cannot make respiratory movements and dies from suffocation, the doctor explained.
The head physician claims that during childbirth, the entire team of the brigade was attended: one doctor, two obstetrician-gynecologist, two neonatologists.
That is, no one stood folded hands, the doctors tried to do everything possible, "says Anatoly Valerevich.
After recognizing the fact that the child died, the doctors began to argue that in any case the outcome would be inevitable, says Natalia. In order to find out the cause of death, the placenta was sent to the republican pathoanatomy bureau, which is engaged in the study. According to Anatoly Dmitriev, the result of the analysis showed that the child died of hypoxia (that is, the lack of oxygen).
Investigative actions are now being taken, the necessary examinations under the initiated criminal case are being held, "comments Leonid Kharyshev, Deputy Oktyro-district of the Oktyabrsky district.
The case that happened to Natalia, disassembered by all medical team. The doctor who took these births passed the course on the situation with which she faced and which was not able to take control.
I want to say that the doctor is not God, not a car. The percentage of medical error was, there will be. Of course, it is necessary to strive to ensure that they are not, - says the head doctor.
In the city maternity hospital, the percentage of death mortality in childbirth is low compared to all-Russian indicators. According to 2004, it is equal to 1.4 ppm (PROMILL - the number of children who died during childbirth, for a thousand born, living and dead).
The first days after the birth, Natalia lived with a deep sense of guilt for what happened, remembering the abnormally abandoned phrase of medical staff. Only then, restoring events with relatives, I realized that it accused of what had happened in vain.
The doctors of the female consultation, where the course of treatment Natalya Varfolomeyev is now being passed, they assure that she is all right and children will still be. And Natalia is looking for a response, why the tragedy occurred with her child, in the books and believes that she will definitely become a mother.
According to statistical data, the fulbirth during childbirth is more than half of all stillbirths.
Due to the fact that in our country, the birth is at the proper height, with forensic disrespects, most of the trumpets of newborns refers to the clauses that took place without obstetric care, secretly, in the situation where the newborn remains without help, such as in the forest, in the field and t. d.
The causes of the death of a baby during childbirth are much more diverse than before childbirth and more often are the object of forensic medical examination. They can be combined into two main groups, namely: premature cessation of placental respiration - pressed, infringement, campus of umbilical cord, etc. - and squeezing the head of the generic paths.
Placental blood circulation in conditions of normal genera continues within a few minutes after a complete expansion of the fetus from the uterus. If placental respiration ends earlier than a pulmonary breath begins, a fetus will come, which can lead to his death during the act of childbirth or after childbirth, if the pulmonary breathing does not begin.
Placental blood circulation may cease earlier due to the following reasons: 1) the pressing of the umbilical cord, which contributes to the elongation of it and the hiding around the neck of the child or around the limbs, and sometimes so much that suffocation occurs. This happens with anhydrous protracted birth; 2) short umbilical cord, resulting in a premature detachment of the last; 3) central presence of the last; 4) excessive time of the uterus;
5) convulsive cuts of the uterus with the coverage of the cervix, especially during the passage of the subsequent head with a berry or foot preview. In such rare cases, the neck of a dead baby was a pressure in the form of a furrow in 1-2 cm wide, reddish color with a bluish tint.
In all the cases described in the presence of one of the above reasons, the supply of oxygen over the placenta, which is why there is still an unbounded baby to accumulate carbon dioxide, irritating the oblongable brain and thus determining the offensive of premature respiratory movements; The baby aspiries in the trachea, large and small bronchi mucus, particles of primary grease, hairs, Mekonia. Asphyxia due to the pressing of the umbilical cord is most often observed when the latter is falling out, which contributes to its elongation and the position of the fetus. With a cross position and a pelvic preview during the expulsion of the fetus, conditions contributing to the fallout of the umbilical cord is created, which is also favored by a narrow pelvis, multi-way and early breakdown bubble.
I. A. Arshavsky distinguishes three groups of asphyxia depending on the causes and conditions of their occurrence: 1) asphyxia of toxic nature, mainly during pregnancy (eclampsia, toxicosis, etc.), 2) asphyxia as a result and 3) asphyxia due to the aspiration of mucus and spindle water in the respiratory tract.
There are observations that the development of blue asphyxia is the result of a suddenly emerging obstacle in the blood circulation of the fetus, the white asphyxia is the result of a slowly active harmful factor.
The above classification is somewhat schematic, does not cover all factors important for forensic studies of the causes of asphyxia of newborns, it requires further development.
Application of operations, i.e., the so-called operational childbirth give a rather significant percentage of asphyxes. Prof. I. F. Jordania leads a table that demonstrates the influence of various operations on the fulbirth during pelvic previews.
The death of the fetus during childbirth may also come in cases where the uterobs and its vessels are attached not to the placenta, but to the shells, and sometimes at a considerable distance from the edge of the placenta.
With such pathology, the basic vessels from the place of attachment to the placenta pass between the water and chorial shells are completely naked and not protected by warrtonic jelly. The risk of cord attachment is already in the process of pregnancy due to the nutritional disorders, which may in some cases lead to death. With the onset of childbirth, the presses of the vessels heading for the next may occur, and even rupture them, as a result of which the bleeding occurs.
Such an anomaly attachment attachments are particularly unfavorable if the place of breaking the bubble coincides with the place of exposure of cord vessels. Thus, as a result of pressed naked vessels, the fetus asphyxia may occur in the intrauterine life, and the bleeding as a result of the vessels is mostly occurring during childbirth.
When opening a newborn's corpse, whose death came from asphyxia, with an external inspection, various degree of blue skin and face, ekchimosis of eye conjunctivations, full-blooded, presence in the respiratory tract of the oily fluid, mucus, primoric lubrication, hairs, blood and mixonia are found. In the cavities of the nose, mouth, larynx, the respiratory throat and bronchi find mucus and Mekonia, which histologically can be identified even in small bronchops.
Death from compression head. The compression or compression of the head in the known borders occurs at every kind. Passing the fetus generic paths It becomes possible with a normal location of the fetus, which lies so as to occupy the smallest volume, for which it takes an ovoid shape corresponding to the uterine cavity. Some Selheim, the plug believes that for the smallest volume when passing through the generic pathways, the fruit takes the form that approaches the cylinder is the so-called "fruit cylinder".
When passing through the generic paths, the fetal skull must change its configuration and decrease in size.
The bones of the fetus skull are interconnected by a fibrous militant tissue forming the seams, so the bones of the skull during the generation due to compression they come one over the other, since the presence of seams allows them to mutual mobility.
With the change in the shape and volume of the skull, the dark bones of the sweat-shaped seam are made on one to another, the frontal and occipital bones at the level of the temporal and the frontal-occurring seams are coming one to another and are suitable for dark bones. As a result of compression of the head bones, a temporary decrease in the brain occurs. This brain compression during the head pass causes a slowdown of heartbeat.
The adaptable head configuration refers to the physiological conditions of the generic process, but these conditions can sometimes switch the border of physiology and become pathological, with the arising adverse effects for the fetus: severe damage and death may occur.
Depending clans can cause damage to the bones of the skull in the form of presses and cracks, also under the well-known conditions leading to the fetus death. Such cracks are almost always localized in dark bones, sometimes on both sides, and go radially from the center of the bone of the bone to the periphery. The appearance of such cracks is associated not only with the characteristics of the generic process, but also with the configuration of bones, with defects of ossification.
The heads on the bones of the head are located on the frontal and dark bones: the formation of them is associated with the pressure of the promonator or bones of the Lonatic articulation during protracted births, with large degrees of the escape pelvis, with a large fruit. Hemorrhages in the course of the crack or for references serve as evidence of their lifetime origin.
With a long standing head in the pelvis cavity, especially if part of it is outside the neck, a test tumor of the test consistency may form on it due to edema and impregnation of lymph tissues.
As a result of long genera, the head tumor becomes a blood, so-called cheefalohematoma. Kefalohematoma is a fluctuating tumor with a chicken egg and more, which is hemorrhage under periost of dark bones, mostly one-sided. The blood tumor due to the displacement of the soft parts, in which the intake of the vessels of the vessels coming from the peristole to the bone. Unlike a vague head tumor, it is sharply deliberate and never passes the line of seams or through the spring.
It is important to know that the head tumor disappears after 2-3 days, and the blood tumor, on the contrary, is increasing during the first days. On one head, two or three kefalohematomas may form. Kefalohematoma may be the result of a long and difficult expulsion of the head or operational delivery. Its resorption continues within 2-3 months. From the deliberate damage to the cheefalohematoma, it is distinguished by the presence of a circular bone shaft, which is formed as a result of the neoplasm of bone tissue, which there is no damage to a violent nature.
With a narrow pelvis, with protracted and heavy breeding, with a large fruit, as well as during the pathological flow of labor or operational intervention, intracranial or brain hemorrhages are detected. Hemorrhage among stillborn occur on average at 25-30%. The frequency of intracranial hemorrhages during childbirth with pelvic preview is especially large. According to P. M. Bukhiko,
S. V. Kisina, intracranial hemorrhages in pelvic prediction are much more frequent than when head.
Zatetz (Seitz) distinguishes three types of hemorrhages.
Hemorrhage from Sinus Sagitalis or from one of the veins in it. At the same time, Tentorium Cerebelli is not affected.
During childbirth, favored conditions for the occurrence of hemorrhage occur: when the head configurations, there is a different bone with one and the other, which creates the difficulty of the outflow from the main discharge trunk of Sinus Longitudinalis. In this case, the edema of the brain with extravasates, and with prolonged squeezing, due to stricture of the uterus, and hemorrhage.
When you add the scales of the occipital bone to the dark, squeezing sinus transversus or rectus and the sinus break. The main mass of blood is detected under Tentorium Cerebelli. The hemorrhage sometimes spreads through the cerebellum to the oblongable brain.
The third option is relatively rare, it is hemorrhage into the ventricles, from where the blood can get into the oblongable brain.
In most cases, hemorrhage occurs as a result of the tentorium cerebelli gap. Such ruptures occur from squeezing the head towards the temple to the temple. These hemorrhages are divided into supra- and infrattorial. Experience shows that changing the position of the head and the elongation of its size, for example, in case of extensive previews, is dangerous, as they can lead to a break of the thin-walled brain shell veins. Soaring in the opening of macroscopic hemorrhages in the brain still does not decide the question of the absence of injury in this case. In this regard, for the final conclusion, a subtle histological study is required, in which the fat accumulation is discovered in gliose cells, which indicates regressive changes as a result of a skull injury with hemorrhage. Single authors consider these finds by physiological phenomenon, referring to them to millegenesis.
Not all cases of hemorrhage into the brain depend only on the spatial relations between the baby's head and the pelvis of the mother or the duration of childbirth. A large number of Intricultural hemorrhages are observed in premature, there is a considerable role at the same time playing vessels and a large permeability of capillaries. An important role, in addition to injury, is owned by asphyxia, closely related to the disorder of blood circulation from the numerous above reasons. The poet (Roes) explains the mechanism of hemorrhage on asphycia soil as follows. Cordhouse compression, the detachment of the last and other complications lead to the accumulation of carbon dioxide in the blood of a baby and the annoyance of his vascular center, the heart of the baby begins to work stronger, the delicate brain vessels do not stand the heightened blood pressure and burst. However, many authors believe that this hypothesis does not have sufficient grounds.
It is important to keep in mind that hemorrhage into the brain can occur as a result of the difference in intrauterine and atmospheric pressure; The pole of the head outstanding from the cervix is \u200b\u200batmospheric, i.e., the pressure of less power than a part of the head in the uterine cavity under strong intrauterine pressure, which creates stasis in vessels with subsequent hemorrhage [STERN (STERN), Schwartz (Schwarz), Raitz (Reiz), Zaitz, etc.
During childbirth, hemorrhages may occur and in the spinal channel, which, according to Dodon's research (1954), refers to one of the signs of generic injury. The emergence of such hemorrhages favors the following factors: asphyxia caused by stagnation and increased permeability of the vascular wall, long delivery, a long anhydrous period, insufficient development in the vascular wall in premature foods of elastic fibers. These hemorrhages do not occur immediately, the cells of the fiber is formed, then under the influence of blood stagnation - with long pathological types - the blood flow of the epidural tissue vessels increases, which leads to the breaking of vessels and bleeding from them. Epidural hemorrhages Dodonov observed in 93 cases, subdural - in 10 cases, and the combination of subdural and epidural hemorrhages took place in 7 cases. Subdural hemorrhages occur due to a rack of blood from the skull cavity in the spinal cord.
An important circumstance is that on the bones of the skull of a completely developed newborn there are defects of ossification. In shape, they are holes of a small diameter with uneven edges having a shallow excavation. Defects of ossification are often found in combination with bone cracks; Mostly, they are located in the field of dark bones, less often - on the frontal bone. The bone in the circumference of the holes is thinned, shines. In forensic terms, it is important that these holes are never indulged, they are never found in the circumference of hemorrhages, which distinguishes them from damage during childbirth and from violent damage.
Opening the skull of stillborn must be very careful to not only find hemorrhage, but also to detect its source. In the presence of damage to the bones of the skull, both during childbirth with the pre-head head, and during the buttocks, it is necessary to decide whether they are related to generic injuries or are the result of violent damage caused later.
For the giving conclusion about the cause of the death of a child during childbirth, it is necessary to subjected to forensic medical examination and the mother of the stillborn, if it is known. From it, it is possible to get information, how the birth was taken whether they were first or repeated, to know their characteristic features (protracted, fast, dry, heavy); In addition, it is possible to check the container and features of the structure of its pelvis and internal genital, organs.
Comparison of this data with the results of the opening of the stillborn may resolve the issue of the mechanism of fracture bones of the skull, the origin of cracks and other damage. We give examples possible options When conclusion:
- In the absence of damage to the soft cover of the skull and the presence of damage in the field, the most injured, generic actEspecially on parietal bones, you can make a conclusion with a greater or lesser accuracy that the case is about generic injury.
- In the presence of significant damage, sometimes with traces on the skin of the head, neck, etc., and at the same time signs of the extrietic life of the fetus should be concluded that these damage occurred after the generic act.
- If the fractures and cracks of the skull, such as the fracture of the skull base, are accompanied by damage to the skin, places in places that are not typical for generic injury, then at. The presence of signs of extrietic life of the fetus should be concluded that they are not related to the generic act.
It should be remembered that in some cases the childbirth occur in such conditions when the head hits the floor or some other solid item - a stump (during childbirth in the forest), stoolchat, which can cause heavy and fatal damage, while biological ( Pulmonary, gastric, etc.) Samples can be positive or unclear. The question in these cases is solved on the basis of the analysis of the circumstances of the case.
Loss of pregnancy, the death of a child intrauterine or after childbirth is a terrible test for parents. But it is the doctors who have to say that pregnancy can end early, declare that the baby does not fight with hearts ... How physicians are experiencing perinatal losses of their patients, tell those who work in women's consultation, take birth and fights for life in resuscitation of newborns.
We must respect the decision of a woman
Lilia Afanasyev, Head of Women's Consultation, Surgut
For women who survived perinatal loss, a psychologist and a special office preparation for pregnancy are working in consultation. Pregnancy loss by early timing Not accepted from specialists to regard the perinatal losses. We have psychological advice and for these women, because pregnancy, even if it ended up to 12 weeks, was, and often - the long-awaited, and her loss is experiencing in any case not easy.
And in the office of premeditant training there are women who have faced the problem of non-banking pregnancy or her hard flow. They go to the examination before new pregnancy. But they are sent to a consultation to a psychologist, because the fear of repeating unsuccessful pregnancy remains with a woman for a long time. And if it is two and more loss, then rarely a woman leaves this fear itself, without help. Moreover, about 50 percent of such women, the threats of pregnancy interrupt are caused by precisely fear.
And I see a positive effect from working with psychologists from this group of women, where perinatal losses were in history, heavy pregnancy. Moreover, if the doctor who leads the patient, strongly recommends it to visit a psychologist, he sees in practice that pregnancy is favorable, it is easier to find contact with a woman, she is more responsive to the recommendations of the doctor.
The psychologist in the consultation works with doctors, and with nurses on the classic Azam communication with patients.
Each loss - heavily, and especially recall those that were recently remembered. Here is a relatively recently - a young woman with an unfavorable predictions by pregnancy. According to the first screening it was clear that something is wrong. On the second ultrasound there was a mass of manifestations of chromosomal pathologies. The forecast was either overseas premature birthOr the birth of a heavy child. The patient decided to continue pregnancy, and childbirth began almost 24 weeks. The child lived six days.
A woman worked for a long time with a psychologist, and in the framework of group therapy. Now she is preparing for pregnancy, surveys. From the family of the husband's husband, the situation was then met in the bayonets: why did you allow us to be born, with defects, did not persuade the abortion. But Mom is an adult adult man and we must respect her decision.
This year, we had a woman: the third child she had hatched is a severe chromosomal pathology, and she also refused to interrupt pregnancy. With her, after she accepted such a decision, a psychologist worked throughout her pregnancy, who was talking to the family, where there were still children to prepare them. We invited your husband to jointly with your wife and in the Cabinet Ultrasound to show and tell that there is such how it can develop and how to deal with it.
As for the further - palliative care for women who made the choice to give birth to a deliberately unviable child, in the country only begins to develop, but it is important that it is and a woman has a choice.
So far, we communicate with Mom, her son is three years. In 19 weeks of pregnancy, she was proposed to interrupt pregnancy, "the child had an extremely severe heart disease.
She came to us from another plot with the words: "I can't kill my child."
I said that it was a great risk that the child would die in the first two months, and maybe even in the first one, as soon as I lose touch with my mother. Again, at a conversation a psychologist was present. She made his contribution and children's cardiac surgery, which honestly said: "That's up after the birth of a child, I will do everything I can. And then you will need to look for a specialist and a clinic where the following operations will be able to do. "
She refused to interrupt, and we began to fight for a child. While he was sitting in the intrauterine and in the first month after birth, everything was compensated, and then the operation began. Almost up to one and a half years. At first, the child was operated on several times here, in Surgut. Then she traveled to Germany at the expense of a charity foundation. Now the boy is fairly cheerful, goes to kindergarten, restrictions actually does not have. Mom is happy, plans the second pregnancy, she has no fear. Maybe including because there was such joint work and gynecologists, and cardiac surgeons, and our psychologist. The woman was not desperate, and - important moment - The family is preserved. It often happens that the family collapses if the problem of the birth of a child is in serious condition arises.
Now I see that more and more often, women refuse to interrupt, especially if these are some small flavors, with which they previously offered to interrupt - with Down syndrome, refuse other chromosomal pathologies. But even if in this case the woman is configured quite positively, she needs psychological support.
We had a woman, whose son revealed to Chaninfelter syndrome - speaking simplifier when the boy turns out to be a carrier of the chromosome of another sex. She was offered interruption - she refused. She was interested in how the child would develop, with what external signs. The psychologist talked with her, told what to prepare for.
There are also categorical women who insist on interruption where the defects are minimal. It is necessary to work for a long time, talking that this is subject to operating, to be observed, rehabilitation. Unfortunately, there are such patients who still say direct text: no, I don't need such a child. But, as a rule, there is always some kind of problem in the family, if in such a situation the child becomes unnecessary.
When the baby is born non-living, we are still his shoe
Lyudmila Khaluhaeva, obstetrician gynecologist of the perinatal center of Ingushetia
For the first time with loss, I encountered when I studied in the ordinature in Astrakhan. Woman entered the fights on a diligent period. But she had antenatal, that is, the death of the child came back in the womb, and when she did, there were no heartbeat. For a woman, it was a shock, she claimed that he feels stirring. She was shown on the ultrasound, called another ultrasound, and only after that a woman believed.
It happens that this is happening through the fault of the doctor. Here recently there was a situation in the republic: a woman comes to give birth on his legs, with her husband, fourth births, do ultrasound, everything is fine. And in the end - a dead child, detachment of the placenta, the removal of the uterus ... Woman blames all the doctor, and does it right, I as a doctor say. If a woman itself comes on his legs as soon as she crosses the threshold of medical institutions, the responsibility completely falls on the obstetrician-gynecologist, which woman leads. I am now in maternity leave, I observe from the side, and still shocked from this situation.
When the baby is born inhabited, we are still his shoe - the same man. Some women categorically do not want to look at him. And some women, on the contrary, say: "Attach it to me, I need to see it." I have been working since 2005 and see how even a woman who refuses the baby to see, in a day or two begins to regret that he did not look, did not say goodbye. Therefore, based on my practice, when it happens, I speak Mother: "You look at him. He is not terrible, he is nothing as if sleeping. " Let it pay in the rhodtle, let him hold it, presses to himself. And then an understanding comes - there is no baby. Otherwise, there may be some illusions that interfere with living on.
Soothing words often do not help. Sometimes a woman just need to say: "I don't know what to tell you, my good."
Sometimes a believer woman can be said something about hope for the Most High, helps. And so, of course, much depends on the psyche of a woman. With some need to cry together. It happens differently.
I had a situation, a woman, a huge belly, a multi-way, and she arrived with the dead in the womb. Baby big, 5 kg, she diabetesHow hard I pulled it out! Ten times regretted that I did not check out, and she asked to make cesarean her. And after childbirth, she says: "It's good that you did not make me an operation and I went this way."
When a woman comes, a child has a heart in the womb, he is heavier than everyone, but it is much more than relatives, can perceive information, understand. It is more difficult to calm the relatives in this regard, they begin to put pressure, sometimes aggressively, to demand operation, although sometimes it is better to be natural childbirth.
Such women should not be in the wards together with the births of living and healthy children with women. Here is the purely organizational issue. I started my obstetric activity in the hospital of Kazakhstan, and if a woman had a child died, we didn't put it into a common chamber if there were difficulties with a separate chamber, translated into the gynecology department. What otherwise to see her nursing moms, hear children's cries? And when I was the head of the hospital in the hospital, we were protected by such women. There must still be an early statement. If in the hospital there is no possibility of a woman to isolate, on a day or two you can find a single ward, you will watch these a couple of days - and let go home.
We must learn easy humanity. Do not be afraid of sanitary disorders, he is not disturbed because of this. The purity of the building and in the wards we want to maintain, and the humanity and purity of the souls maintain for some reason do not want. Before going to the obstetrician-gynecologist, you still need to take a man's exam. As in all medical specialties.
Before we did a lot of mistakes and did not give parents to burn
Tatyana Maslova, head of the resuscitation department and intensive therapy of newborns in the Tula regional perinatal center
"Have you ever talked to relatives about the patient's death? Not? Let's go to learn, "the head of the department told me when I only came to intensive care after specialization. The woman has a second or third eco, twins, childbirth in 26-27 weeks, one died at once, and the second one after a while. He led the conversation, and I listened, realizing that someday would have to say to me.
And I remembered the first child's name for a very long time, which went already during my independent work. Now the surname was erased, many years have passed, but I remember his weight, the period of gestation - the child was more than 2 kilograms, 35 weeks seemed to be not to die. But he left, and somehow lightning. At that time I myself was pregnant, on large deadlinesI stayed a couple of duty before the decree ... it was very hard: after all, it still fits the feeling of what you did not all, even when you understand that the case is non-develop. Then I called the head of the department - it was five in the morning, he came and let me go, the relatives said himself, because I understood - I am in such a state that I myself can prematurely give birth.
Over the years, I still understand what we, doctors, are very lacking the right communication skills. Even just for conversations with parents, whose children are in intensive care. You have to deal with samples and mistakes to talk to them. It's good that trainings have now appeared, lectures for health workers, although it is necessary to teach talking to patients in universities ...
For three years, I am headed by resuscitation of newborns, and report news to parents, including tragic - my task. You have to constantly learn, read, listen. Last year, the Medical Congress was a whole symposium dedicated to precisely neonatal losses and communications with parents. After I invited lecturers to us so that they spent training for doctors of our center. A psychologist from the Foundation "Light in Hands" came to us.
Now I see what we did wrong, communicating with the parents. For example, trying to calm down, support their phrases, on the contrary, depreciated their feelings, did not let them throw out emotions. In order for, as we thought to hurt less, distract, tried to quickly report and translate the conversation to organizational moments: the burial, the process of paperwork - what you need to bring where to call. That is, we did not give them time to come to ourselves, to burn.
Another error: We, especially if we are talking about children who have had some time with us, began to apologize to moms: "Sorry, we tried." Psychologists explained that it is also not correct here - we really do that we can.
Two years ago, we had a child who came to our department for observation, we were transferred to the second stage of the healing, he had to be written in the morning. At night, he again entered us in extremely serious condition, practically with a single heartbeat. An hour and a half we spent resuscitation, but I could not save. Mom, when she found out, a terrible tantrum began - she closed her eyes and just screamed, it seemed eternity. This is now I understand that such a reaction, on the contrary, helps to cope with pain.
It is much more dangerous to the quiet reaction, without emotions, when a person can lish to calmly, and then leave and do something irreparable with him.
Several times I had periods, you can say burnout. What begins burning, I understand when I can not think about anything, besides work, stop sleeping. Constantly feeling fatigue, questions appear - why all this, who I am trying to prove something. They arise when you are trying to save the child, but there is no return on any of the parents or from the administration. The administration says: you are the most expensive branch, why we spend money on you when they are needed on that and that. Or you need to buy something for a child, and we do not have it, we can buy, we cannot, but we cannot ask for parents - we have a free treatment - such a vicious circle. You get tired of fighting with windmills, and since at home in such a state, it is not at all possible to switch to family matters, problems begin.
In such situations, I turned to a crisis psychologist, and the conversations with him helped to return to a normal state, because I love my job.
Mama, whose children are in resuscitation, we suggest chatting with a psychologist, but more often refuse: "No, I'm not, abnormal!"
If we understand that everything will end badly, we invite Mom to say goodbye. Basically, they refuse: they are scary. But after the training of BF "Light in the hands", I suggest thinking a little more, so that then I didn't have to regret the messenger. I already had a case when my mother came, changed his mind.
Similarly, with burial, especially children weighing less than 1 kilogram. Parents often refuse him, they want to forget everything, as if there were no this pregnancy and these birth. But I explain: "To get buried - does not mean that you have to put monuments, crosses and then constantly go to the grave. Psychologically, it is important for you to close this topic. Not lived internally and not experienced emotions will still look for exit. " And there were several cases when the parents first wrote a refusal of burial, and then, thinking, called back the next morning with the words: "We changed my mind, we will bury the child."
My husband is far from medicine, tries to listen and maintain. Another thing is that we all did not teach to support and empathize. I understand that the husband wants to calm down, saying: "You can't save everyone, you don't need to take everything so much", but my pain does not go from it. It happens, children get tired, angry, say: "Only work is important to you." Of course, this is not the case, but I really have such a thing that you will not turn off, you will not forget everything that was there, until the next duty.
But our work is, first of all, about life. And what a joy when you manage to pull out the child and when he goes to the fill, and then in good condition Disposable home!
Thank you foundation "Light in Hands" For help in preparing the material.
Aliya M., Moscow
I lost a child at 31 a week of pregnancy. Gave birth to him already dead.
Pregnancy up to 28 weeks leaked well, I went to the planned ultrasound, and it was discovered that I had a violation of the uterine-placental blood flow, no nutrient arrive to the childsubstances and it is twice as fewer than it was supposed to be. At 28 weeks weigh about 600 grams instead of the last one and a half kilograms.
I was urgently laid in the hospital, in the department of pathology of pregnant women, where in the end I spent three weeks. Put droppers, pricks, the child even grown up with 200 grams. We are happy with doctors. And then the next ultrasound showed that he already dies the brain.
Then there was stimulation. Three days I passed with him, dead, because the childhood did not begin. I also continued to go to the dining room with pregnant women. When they came to me, asked what my term I was answered: "31 weeks." No one said what happened. Saved the state of shock in which I was then stayed.
I remember a wonderful duty sister. On one night I had a lot of pressure and my head was sick. I walked to her asked if I could drink some tablet. She said: Yes, everything is already possible. And then added: "I sit all night, come to me at any time, you want, just chat." I did not come to her, but it was grateful for these words: she found those that I needed in this minute.
Three days later I myself gave birth to a son. I was sure that these are such a childbirth, when you give birth to a no longer child, - special, occur in a special place where only the doctor and me. But the husband said: "I will definitely be on your childbirth. This is our child. " From the moment I was transferred to the generic department, he was near and supported me.
When the active period of childbirth began, I did not think about what the end would be. I gave birth without anesthesia, because I could not have been done on medical testimony.
When the childbirth is over, we left us together with my husband for two hours. I had an euphoria, apparently, hormones still covered. I understood, on the one hand, what happened that I had no living child, and on the other hand I just gave birth, became my mother ...
The pain from the loss aware has become rolling on the second day, I started crying.
In the postpartum, everyone was lying with the children, they shouted all the time. I remember the moment: I am lying at night and - silence, no one cries. And I understand that I want to hear this sound that I calm down from him.
While I was lying in the postpartum department, my husband learned how to bury the son. No one specially explained what to do. It seemed that no one knows. Can you bury? Can not bury? We first thought that we would not give it away. As a result, he was given, and we managed to bury him. It is very important, and now we often go to it.
I saw that the doctors in the hospital sympathize with me, but they could not, did not know how to support correctly. I heard: "In six months, you will give birth. After half a year you can already. " "How good that there is no scar on the uterus." "All the same if he was born, would be a deep disabled person."
I. important words They spoke friends. My girlfriend said: "Tell me about him." And for me it was so right and necessary. Still helped me phrases: "You are the most best Mom"," I'm with you "," You can tell me everything you want, I'm ready to listen, "I can, am I hugging you?", "Who did he look like?". I hear it, I understood that people admit that this is my child, that he existed that he was.
The first week after the discharge, the husband took the ran away and was with me around the clock. Our mothers came and in turn prepared to us food, helped with life, for which I am very grateful to them. Because some familiar things that we do without thinking - feed the cat, wrapping underwear, cook lunch - become completely unbearable at such moments.
In a strong depression, I was a year. At first I tried to cope myself, without drugs. Found new job, tried to do sports. I started absolutely me not peculiar activity. I look around and understand, it was all the consequence of shock. When the child had to be fulfilled half a year, it became very bad for me, I went to the psychiatrist, and she prescribed me pills.
When the son turned a year, we made a birthday, called our parents, close friends. Baked cake, put a candle, ordered balls. I wanted it to be not a day of grief, but a real birthday, a holiday. And it turned out. We let the balls in the sky, blended the candle, remembered, said toast, as far as this child has changed our lives. After that, I was easier for me. Of course, I can't say that the grief passes: it does not pass. Inside there will always be a hole, but you start learning to live with her. Learning re-laughing, rejoice.
We are grateful to Solomon for how much love he brought us, we opened so much parental feelings. I think I have changed very much. This love we feel to him, she is now with us all the time. If someone asks if we have a child, answer that yes, there is. If questions follow, how old he is, we are already saying that he died. Well, how else answer? Is it possible to say that we have no children if it is?
When it happened to us, the Foundation "Light in Hands" was not yet. He appeared only in a year. No information, how to experience what happened, in Russian practically was not, I took all the information on Western sites. In the same instagram there is a whole world where the English-speaking mothers who have lost children create individual accounts, write about it. And very all each other support. A whole network of support. We did not have this, I did not know where to turn. I am very glad that finally it appeared in our country.
"Mom does not cry, let me go, please"
Diana Fomina, Naberezhnye Chelny
Four months after the wedding, I learned that I was pregnant. All the next five months felt well, with the tests everything was in order. And suddenly swelling began at 19 weeks, went to the reception to the Acusus-Gynecologist in female consultationAnd it turned out that in the week I added four kilograms.
"You probably eat a lot of macaroni, luggage on potatoes. Go home, and if you have a lot, I will put in the hospital. " He came to the next reception, it turned out that she added three kilograms. On the May holidays, another doctor accepted me - the former was on vacation. She looked, let go, did not say anything. But I still felt that something was wrong, although the first pregnancy, I don't know anything, everyone soothes that it happens - in pregnant swelling.
In the evening, the head chaired (it was Friday) and said that, most likely, I had guests and need to come on Monday to the doctor.
On the eve I dreamed of a dream, as the newly deceased grandfather husband takes a small child with him. In the morning I went to the clinic, the pressure began to climb - 130-140, they checked the vision and - they said to come tomorrow ... I've already know for sure that I had a serious problem, I waited for her husband, we went to the head of the head, and only after that they were paying attention to me. They called "ambulance", which took me to the perinatal center. There was already quite another, attentive attitude.
There they tried to bring down the pressure, somehow correct the situation. And then the doctors said that my condition was severe, the protein rose sharply, and it is necessary to manage childbirth. I thought it would be able to save it, go after childbirth. But I was given to understand that it was impossible. I started hysteria, I refused cesarean section: "Look for what is wrong with me, but do not touch the child."
At this point, doctors have conversations with her mother and with her husband, so that they persuade me to give birth. The pressure was 220, and the doctors said that another hour, and either I die, or - paralysis or stroke. The head of the head and began to swear (now I understand that she was right), said that they would not save the child in any case, but if I would die with him, then what would be my loved ones?
Mom and the husband also persuaded, said how I was the road.
But I still refused, because I thought about the child. When I was brought to the signature paper with a refusal of the operation, I have already started twitching my hand. Doctors said that I had very little time. Then I gave up.
Made an emergency Cesarean, a 250 gram girl was born, 23 centimeters. I was told about this only next morning. I still hoped in the first moment that she was alive. Not! We have only a tag and a photo with an ultrasound.
When I woke up in the morning - there were gueaments after Cesarean, and they all asked me who was born, what growth, what weight. Well, the doctors fell good in the perinatal center, they immediately ran up to them, asked not to ask me questions. The nurses were suitable, soothered, they were encouraged. I even made a pigtail.
But I cried all day.
And then transferred from resuscitation to the common chamber, where the girl was lying with me, who premature baby It was in serious condition, it is not clear, survive - will not survive. We both talked to her on one topic, every with her grief, every cry.
When I was discharged, it was necessary to go through the hall of the statement, there were people with balloons In the hands, waited for when those who had prosperous childbirth. And I walked one ...
Two months on the hospital crying continuously.
Very supported husband, parents.
Two months later, they offered a new job in a mad pace, which could not even think about something, I went to her with my head and seemed to have coped. But, as soon as the pace slept, I began to dive with depressions again.
It was especially bad somewhere in six months, a day, when they put a preliminary date of birth.
Certain, in fact, helped dreams. The day after surgery, I had a man like God, in all of the White, who took the child's hand. It was a girl who turned and said: "Let me go mom, please." And later I dreamed of a dream, as if my daughter plays and says: "Mom does not cry, let me go, please, I feel good." After this sleep, I woke up and realized that God was on the work itself, and I gave myself a word to stop crying, take yourself in hand. She left his head in a survey of his own health, which showed that I was fine.
It is important that the husband was able to bury her daughter. He buried her in one grave with his grandfather. I could come there only six months: it was easier for me to understand that she was in heaven. But now I calmly treat the fact that her body is there, and come together with her husband.
Helping another ...
Julia Karaseva, Lyubertsy
My daughter is 16 years old. A few years after her birth, I had spontaneous miscarriage, then - a frozen pregnancy.
I didn't have something to be ready for such sad development of events, but because I was already a psychologist, I knew how to dig up from this situation
I knew how widely the perinatal losses were widespread and how much they were silent in society. I think it is unfair, wrong, because many women are then in serious condition, there are suicides, and divorce, collapse of families ...
After me, I had a prosperous pregnancy, I was constantly the threat to her interrupt, but, with the help of doctors, I managed to save, and my son was born.
After I had another miscarriage.
In fact, to cope with this pain, not only the support of loved ones helped me and let me go, including the daughter with which we are very close, but also what I began to help other women (free) to experience what happened.
All pregnancy is a fact of a woman's biography, even if they ended tragic. It is only important to understand this, to accept, perhaps - to work ...
Charitable Foundation"Light in hand" Provides psychological and informational support to everyone who collided with the death of a child before, during and after childbirth.Someone is important to just hear about the experience of others, someone needs psychological assistance.If you encountered this trouble, be sure to contact support.
