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May 31, 2023 11:28 pm

Miscarriages In Kashmir: Burden Of Tragic Losses & Unheard Woes

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In the centre of a petite room, bathed in a faint glow that filtered through the curtains, casting patterned shadows on the walls, Shaista Gulzar, 34, laid curled up in a blanket. Her eyes wide open, staring at the ceiling and her breaths coming in short, uneven gasps, unveiled the silent turmoil within her. Shaista had recently miscarried a child and the emotions were still raw and fresh. She felt like a part of her had been ripped away, leaving a void that would never be filled.

Every once in a while, her mother would come in, sit next to her bed and make an effort to console her, “but no amount of words can ease the pain I am feeling,” she said. The mere mention of the loss gnawed at her soul, a constant reminder of the precious connection that was abruptly severed.

The day that Shaista found out that she was pregnant was one of the happiest in her life. She and her husband had been trying to conceive for three years and the news of a baby on the way was a pinnacle of unbridled bliss. What followed were tearful phone calls made to close friends and family, as she sought support and solace in sharing the long-awaited news. However, things took an unforeseen turn, when she started having cramps and spotting in the tenth week of her pregnancy. She was taken to her gynaecologist, who told her that she was having a miscarriage. After undergoing a Dilation and curettage (D&C) – a surgical procedure used to remove any remaining tissue from the uterus after a miscarriage or abortion, Shaista experienced immense physical pain. The soreness even persisted for days after the operation, but it was the psychological trauma that affected her the most.

“It was devastating. One minute we were planning and dreaming of the arrival of the baby and the next I was lying in a hospital bed.  I couldn’t understand what went wrong, why did my body fail us,” she said in a despondent tone.

After informing about her pregnancy, Shaista was showered with congratulations, visits, and well-wishes, “but after my miscarriage, the support and attention from friends and family quickly dried up.” she said. “Nobody asked me how I felt. Instead, I was told that I broke the news of my pregnancy too quickly and invited bad luck.”

It isn’t a woman’s fault!

When an unborn baby dies, society often reacts differently than the loss of a healthy baby, remarked Nelofar (name changed), who has had two miscarriages in a span of five years. “The thing with miscarriage is that most people don’t realise what we have actually lost. They don’t understand the intensity of our grief,” she said, adding that people think  the loss is not significant since the baby was not a ‘real’ person.

For Nelofar, the burden of being unjustly accused and blamed for the loss added to her agony. Her sister’s marriage was scheduled shortly after she conceived for the first time, and she couldn’t help but notice the insinuations made by her in-laws, implying that her miscarriage was due to her involvement in the wedding preparations. “I was labelled as careless for not being able to take care of my pregnancy,” she said.  She confessed lingering on the bathroom floor for hours and crying freely without any judgement or interruption, as she was often told, “tchea osuy ne zyad time gomut, thaw wani aith seith bihun (you weren’t pregnant long enough, stop holding on to the grief too much).”

The data from the National Family Health Survey for 2019-21 reveals that 8% of foetuses are lost due to abortion, miscarriage, or stillbirth, whereas 92 percent of pregnancies result in a live birth in Jammu and Kashmir. The most prevalent type of foetal wastage is a miscarriage, which accounts for 5% of all pregnancies, and abortions, which account for 2%. Globally, about 1 in 10 women will have a miscarriage over a lifetime. According to a series of articles in The Lancet, an estimated 23 million miscarriages occur every year, translating to 44 pregnancy losses each minute.

In a simple yes or no poll on Yakjut – a facebook group exclusively for Kashmiri women, out of 23 women who participated, 18 reported to have suffered from a miscarriage or an abortion due to medical needs. Despite the high incidence, miscarriage is still a hushed topic in Kashmir that is often associated with secrecy, taboo and shame. The stigmatisation, where the mother is largely held responsible for miscarrying leads to emotional distress and anxiety among the women.

Waseem Ahmad Kakroo, a clinical psychologist based in Kashmir believes that miscarriage is a deeply personal and emotional experience for women and their partners. The loss of a pregnancy can bring about a range of intense emotions such as grief, sadness, guilt, and even feelings of failure, “however, societal attitudes and cultural beliefs often contribute to the perception that miscarriage is a private matter and should not be openly discussed. This can create an atmosphere of shame and silence surrounding the topic,” he said.

He added that it can be challenging for a woman when those around her fail to recognize the depth of  pain. “This lack of empathy can leave her further isolated and misunderstood. It makes it more difficult for women to open up and seek the support they need.”

The myths persist

“This must have been a son,” Filory Jan, recalled being told after her medically advised abortion following a non-viable pregnancy in the first trimester. “The insensitive remarks and the false beliefs in Kashmir make it worse for us. I was told that I would never be able to conceive again and I had started to feel hopeless,” until she gave birth to a healthy baby girl two years later.

It is not limited to this, as some women also reported encountering dietary myths that suggest certain foods or eating habits can cause miscarriages. “People who visited me during those days frequently enquired if I had eaten bananas or tomatoes. Had that been the case, my doctor would have advised me to avoid consuming certain things,” Filory said. In her view, misinformation about pregnancy could be more harmful than helpful. She did her own research and talked with her healthcare provider, and learned that the vast majority of miscarriages are caused by genetic or developmental issues, and that no single food or behaviour can completely prevent or cause a miscarriage.

The confluence of infertility, stress and miscarriages

According to the National Family Health Survey for 2019-21, Jammu and Kashmir has the lowest fertility rate in the country, with a 0.6 percent decrease in the fertility rate from the last survey in 2015-16. This only compounds the challenges that women who experience miscarriage face. Miscarriage can be an isolating experience under any circumstances, but in a society where childbearing is viewed as central to women’s roles and identities, the emotional impact of miscarrying a baby can be especially difficult to navigate.

“Because of the high infertility, women may feel pressured to carry pregnancies to term, which can heighten their disappointment and frustration when a miscarriage happens,” another woman who has experienced recurrent miscarriages and is trying for a child, said.

According to Dr. Munaza Farooq, an Obstetrician and Gynecologist working at Sher-i-Kashmir Institute of Medical Sciences, health factors such PolyCystic Ovarian Syndrome (PCOD), obesity, torch infections and sedentary lifestyle are associated with the risk for miscarriages.  “These factors can give rise to certain metabolic disorders like diabetes and thyroid which in turn can contribute to miscarriages,” she said.

“Not just biological and medical reasons, social factors also play a role,” she told Kashmir Observer, adding that high levels of stress, anxiety, or emotional distress can potentially affect hormone levels, disrupt the normal functioning of the reproductive system, and potentially contribute to complications in pregnancy. “Society keeps on forcing a woman to have kids, but they must know that it is very important for a woman to be mentally fit to be able to conceive again after a miscarriage. ”

Waseem Kakroo also emphasized on the need to provide a non-judgmental space to women. He suggested promoting open conversations and educating people about the emotional impact of pregnancy loss as a way to assist them in finding healing and resilience.

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