By Tendai Makaripe
When Elias* and Nobuhle* married on September 11, 2016, they looked forward to a joyful union.
Like many couples, they hoped to be blessed with children they would cherish deeply.
Soon after their wedding, Nobuhle became pregnant. The couple was overjoyed and began preparations for their new baby.
They regularly visited the doctor for check-ups, with all seeming well until the fifth month.
One Tuesday morning, a call from his wife as Elias arrived at work altered everything.
“She said she wasn’t feeling well and was heading to the hospital with a relative,” he recalled.
Upon entering, Elias heard her cries and soon learned she had miscarried. It was a girl. From that time until 2021, Nobuhle experienced four pregnancies, each ending in loss: three miscarriages and one stillbirth.
“For the second pregnancy, the doctor recommended a cervical cerclage, a procedure, usually done in the second trimester which involves stitching the cervix to prevent preterm birth. However, by the fifth month, complications arose, and the stitch was removed, indicating my cervix wasn’t the issue as initially thought,” she added.
The couple lost another girl.
Driven by their faith, the couple tried for a third pregnancy. Their doctor closely monitored them for any potential complications. However, no issues were detected. In the sixth month, Nobuhle unexpectedly went into labor and was quickly taken to the hospital. Upon arrival, the familiar receptionist recognized them due to their previous visits.
“She said ko madzoka futi, chii chaitika iye zvino (you are back again, what is it this time?). I was heartbroken. My spirits lifted when the scan indicated the baby had a strong heartbeat,” said Nobuhle. “Yet, the scan also showed a complete absence of amniotic fluid in my womb, a situation specialist deemed highly unusual.”
She was given an injection to assist the baby’s breathing during birth.
After delivery, the baby was put in an incubator, with a paediatrician overseeing care.
“The paediatrician informed us our baby didn’t survive. Facing the procedures of a stillbirth was devastating,” Elias lamented.
Following this ordeal, the couple sought counselling alongside another couple undergoing similar challenges, seeking solace and mental relief through shared prayers.
For the fourth pregnancy, specialists from South Africa consulted with them in Zimbabwe. These experts assured the couple of their ability to care for even four-month preterm babies.
At six months pregnant, Nobuhle travelled to South Africa, where she unexpectedly went into labour.
“Just before delivery, she called saying the baby’s heartbeat was strong. Yet, moments later, I was told our baby, a boy, hadn’t survived,” Elias recounted.
This ordeal underscores the struggles couples endure with recurrent miscarriages. Generally, a loss before 28 weeks is termed a miscarriage, while after 28 weeks, it’s considered a stillbirth.
Annually, almost 2 million babies are stillborn, with many of these deaths being preventable.
Yet, even in developed countries, miscarriages and stillbirths often go unrecorded, hinting at potentially higher figures.
263 Chat investigated the psychological impact of recurrent miscarriages on mothers.
In some cases, miscarriages can even result in maternal deaths, particularly where healthcare systems are inadequate.
United Nations Population Fund (UNFPA) communications specialist Bertha Shoko attributes some maternal deaths to: “Human resources attrition caused by a number of health workers leaving the country for economic reasons.”
However, some mothers survive after miscarriages and have to deal with psychological impacts of the problem.
Doctors shared with this publication that recurrent miscarriages can result from various factors, including genetic abnormalities in the foetus leading to developmental challenges.
“Issues like an abnormally shaped uterus or uterine fibroids can hinder pregnancy,” said a doctor from Parirenyatwa Hospital in Harare.
She added: “Conditions such as diabetes, autoimmune disorders, or thyroid problems in the mother can be culprits. Hormonal imbalances, especially involving progesterone, and lifestyle habits like smoking or heavy alcohol use can increase risks. Often, though, the exact cause is unknown.”
Losing a child is painful, and enduring the consecutive loss of four newborns can deeply affect a woman’s psyche.
“The intense grief, guilt, and loss can be overwhelming,” noted psychologist Ivy Mukombachoto.
“She might wrestle with the question, ‘Why me?’, which can spiral into depression, anxiety, or post-traumatic stress. Such repeated losses can also shake her maternal identity and amplify fears about future pregnancies.”
Mukombachoto added that social isolation, strained ties, and potential self-stigmatization can deepen the emotional turmoil, complicating the healing journey.
Research indicates that the repeated cycle of hope and despair amplifies mental strain. With each attempt, the eagerness for a new beginning and the heightened emotional expectations can further weigh on one’s well-being.
“Each loss isn’t an isolated sorrow, but a buildup of past heartbreaks. Trusting experts and then meeting repeated disappointments can diminish trust in the very systems meant to help,” said social worker Lisa Samupita William.
“This emotional turmoil, swinging between hope and despair, deeply impacts a woman’s mental resilience, testing her capacity to hope anew.”
In an interview, Alice*, a nurse from Budiriro who endured five miscarriages after her firstborn, expressed the anguish of seeing others with similar challenges find success with treatments that failed for her.
“Each success feels like a reflection of my own unfulfilled hopes, intensifying the feeling of ‘why not me?’,” It creates a sense of isolation, as if I’m the only outlier in a world with solutions.
This silent battle involves questioning one’s value and the constant fear of always lagging in the collective path to healing and joy.”
If not addressed, such feelings can escalate to suicide.
The World Health Organization states that suicide accounts for approximately 20% of postpartum deaths. While Nobuhle received support from her husband and in-laws, some women grapple with mental health challenges due to societal pressures.
In many cultures, they face accusations of having a “weak womb”, being labelled as witches, or enduring insinuations that their losses benefit family members’ fortunes.
Such accusations can fracture relationships, fueling familial tensions and exacerbating the wife’s mental health challenges. Rodwell Kufandada Musonza, the village head of Musonza kraal, suggests that traditionally, repeated miscarriages are not only viewed physically but carry deeper significance.
“Our ancestors saw repetitive patterns, such as consecutive miscarriages, as potential spiritual signals. They might interpret it as ancestral communication pointing to an imbalance,” he said.
“Consulting spiritual leaders or healers can help decipher these patterns and guide us towards realignment with our ancestral spirits, ensuring harmony.”
Dr. Watson Mbiriri, a Seventh Day Adventist Church pastor said: “In marriage, the commitment to ‘in sickness and in health’ is crucial. Instead of looking elsewhere, one should stay true to their faith.”
Repeated miscarriages not only inflict emotional pain but also bring substantial financial stress, intensifying mental health challenges.
Nobuhle faced both the anguish of loss and the burden of costs from multiple scans, hospital bills, flights to South Africa, and specialist fees.
“The weight of significant expenses without the hoped-for result can deepen feelings of despair,” said Mukombachoto.
Many nationwide share Nobuhle’s financial strain from recurrent miscarriages, pushing them further into depression. Supporting those facing repeated miscarriages requires a comprehensive approach with diverse stakeholders.
Academic Lazarus Sauti said: “Society is pivotal in promoting understanding and empathy, addressing miscarriage stigmas, and breaking the silence. Immediate families serve as primary emotional pillars, offering love and comfort during these challenging times.”
He emphasized the government’s role in providing quality healthcare, financial aid, and policies focusing on mental and maternal health.
Developmental analyst, Gideon Madzikatidze noted that “NGOs provide crucial services, including specialized counselling, awareness initiatives, and community support groups. Together, they form a vital support network for healing.”
The combined empathy of society, reinforced by strong support structures, paves the way for healing and hope amid the agony of recurrent miscarriages.
*Names were changed to protect the identity of the interviewees.