At the start of a new pregnancy, many dreams begin to be nurtured in the heart of the family. Every family gives positive vibrations to the new human being that will be part of the pathways of parents, grandparents, brothers and sisters… But what to do when an illness is detected while the baby is still in the uterus? How to proceed? How can healthcare professionals provide information and look after that family? 

Cristiane Assis (photo), a gynecologist specialised in Foetal Medicine, has published a book called Gestação: Um Encontro de Almas (Gestation: A Meeting between Souls). She also gives talks and lectures about the pregnancy period and the surprises that may come up during those months when the family is expecting a baby. That is the main object of the following interview: 

Tell us about your book, Gestação: Um Encontro de Almas (Gestation: A Meeting between Souls). 

The material I gathered through the years was based on my daily experience with ultrasound. I followed the life explosion that happens when you have a new pregnancy and studied the importance of the emotional connection between the parents and the baby for the future of that human being in formation.  

After 10 years, more experienced as a doctor and with the soul blessed by the experience of being the mother of Alexandre and Maya, I have edited the book and added new texts. The book aims to celebrate, inform, share and welcome the experiences of the process involving the birth of a child.  

To look after each detail at that most precious moment means offering parents and relatives better opportunities and better tools for them in their search for their dreams and goals. In each page of the book readers will find useful tips to help them in this process.  

How can you identify any malformation when the baby is still in the mother’s uterus? 

I must say that as much as I may study, seek information about and live that situation, there isn’t an easy of simple way of giving such news to the parents. Not when with every new word you will be destroying the dream of a perfect son and a peaceful future. 

Such a diagnosis will initiate a huge journey for those parents. They begin looking not only for more information to help deal with the problem, but also for someone who can empathise with their suffering. It is huge the pain of parents who, even before they can hold their son or daughter in their aims, already see the baby suffering so much.  

Do the health professionals in that area also give the support required by the parents? 

There is a great conflict in that area between two approaches. On one side we have professionals being trained in Foetal Medicine who generally follow the bio-ethical pragmatic utilitarian method, which only values individuals if they can produce something for society. On the other side, we have 90% of the Brazilian population, which according to the 2010 census follows one or more religions. For these parents, the bioethical model that would better meets its demands when facing a diagnosis of malformation of the foetus is the personalist one, which ensures the dignity of all human beings.  

The difference will be in the capacity that professionals have to show empathy. Until the bad news arrived, what we had was a desired baby. Often, already with a name, surrounded by dreams and plans. How can we transform that baby in a simple group of cells in a matter of seconds? How can we transform it in something that must be interrupted or erased? It may be easier, perhaps, for people trained to think that way. Or for those who prefer not to think about what they cannot comprehend or control! Doctors and demigods may be able to do that in an easier way; not parents who love their children.  

I understand that during an ultrasound session we don’t have time for extended conversation with patients dealing with a diagnosis of malformation. But the minimum we can do is, through empathy, treat that patient with the respect and care we would like to get if we were facing a similar situation, offering them access to other professionals able to help them in the next steps concerning diagnosis and/or treatment. 

What can the doctor and the parents learn in such situations from emotional, psychological and even spiritual terms? 

In a situation concerning foetal malformation, all the parts involved – parents, other family member and other professionals – face a unique learning opportunity. If we practice noble feelings such as love, patience, resignation, determination and faith, something that apparently cannot be explained makes sense. For that, we they need to be willing to relinquish something they cannot control and that does not concern them: HUMAN LIFE. It can be observed, supported and protected by us. But the reason of its existence, even if you believe that life never ends, goes much beyond what our yet limited scientific knowledge can understand.  

What else would you like to add on that issue? 

A foetal malformation diagnosis is something extremely unpleasant. For many, the first feeling is that a dream is being destroyed… the dream of a healthy son or daughter, with a perfect future ahead of them. Each one will deal with the news in a different way, according to their own life experiences. The only thing they can be sure of in their hearts is that they are being helped towards the best possible outcome.  

The spiritual benefactors are fully aware of the sacrifices involved in the gestation of a child with a malformation. In my experience, I have seen mothers tired for looking after their disabled children, but grateful for the opportunity that has provided them to learn.  

I have seen sad mothers because their baby had a malformation and they lost it, sometimes even a few days after giving birth. But their hearts were relieved for having offered all the love they could during the time they were together.