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In late 2014, I read about the Human Placenta Project, an initiative launched by the National Institutes of Health to study the human placenta. It took me months to get my head around the import of this project. I pondered the what-ifs of my own story. I remembered the heartache of many parents I have known over the course of the last decade.
In 2005, my second son was stillborn as the result of placental abruption. My subsequent healthy pregnancies were treated as high risk, and I was fortunate indeed to receive excellent medical care. Adverse outcomes as a result of placental problems range from low birth weight to prematurity and stillbirth. While placental problems certainly do not always end in loss, they do generally add stress to pregnancy and/or to early infancy. The psychological ramifications of this fact are profound, lasting, and rarely discussed.
I live with the reality of the worst-case scenarios for placental problems. Since my son’s stillbirth, I have forged a complex peace and even built a happy life. But I cannot even begin to express how uncomfortably I sit with that statement. Because there is always, of course, the ache - the wish that the missing child be present. I am not a doctor, and so I cannot even begin to fathom all we do not know. I am a bereaved mother who lives with the psychological effects of loss. I am the human face of clinical terms such as “fetal demise,” “poor outcome,” and “placental abruption.”
According to Dr. Alan E. Guttmacher of the Human Placenta Project, “[A] chief goal of this initiative is to develop tools for studying the placenta in real time, so we can learn how it develops normally. With that knowledge, we could do a better job of monitoring pregnancies and detecting placental problems earlier. Ultimately, we may be able to identify markers that may predict many adverse pregnancy outcomes and take steps to prevent them.” [Emphasis added]. http://www.nichd.nih.gov/research/HPP/Pages/default.aspx
Says Dr. Diana Bianchi of the Tufts Medical Center, “[T]he placenta is really the Rodney Dangerfield of organs. It just doesn’t get respect. It gets thrown out at the end of the pregnancy. I mean, when you think about it, what other organ does its job effectively, grows when it’s supposed to grow, provides the nutrients it’s supposed to provide and yet knows when its job is over?”
Dr. Guttmacher speaks to the need for experts in various fields to lend information to the Human Placenta Project. I humbly join the chorus of voices asking that his call for support be answered.
The wealth of actionable information that the Human Placenta Project could potentially deliver means those who might otherwise have suffered may be spared. At present, most standard pre-natal monitoring tools have critical limitations - they are reassuring of the past and present more than they are predictive of the future. Writes Michael Ravitch about his observation of a prenatal ultrasound appointment and the mysteries it casts:
“A prenatal ultrasound early in pregnancy gives us a glimpse of a world we’re not supposed to see. Like the surface of the moon or the bottom of the ocean. A place we know is real, but beyond our earthly existence. A place so far, or so close, no one can see inside. Let there be light, but not everywhere, not until now, and now these distant dark inside spaces can be seen … [A] circle at the core, the destination, the vantage point. And then expanding outwards, up and down, forward and back, shifting sands, waves of sound, motion, time and perception … [T]hink of it like a storm – a doppler map of a hurricane – and in the middle of that storm, think of this tiny sleeping creature, oblivious to the gale force winds, the blinding rains, the constantly shifting surface on which it sleeps. … [E]ven when someone explains to me that the growing fetus is in fact held close by the folds of the uterus, snug, burrowed deeply, I still cannot shake the sense of how vulnerable it is, … alone on the difficult road to be born. And now we all have a window on this struggle, we can watch it, noses pressed to glass, an impermeable barrier. Soon it will come into our world, where it will rely upon us for everything, and yet now there is nothing we can do to help it, no way for it to hear us.” http://reconceivingloss.com/the-neverknown-by-michael-ravitch/
As a bereaved mother, I hope that medical professionals, including psychiatrists, and others support the work of the Human Placenta Project. Those in the medical field who work with women and families are well placed to add to the information sought by this project. This is equally true for a pediatrician following a low-birth-weight baby, as it is for a therapist helping a parent following pregnancy or infant loss. The information that can be culled has always been apparent – but at last, here is an opportunity to digest and analyze the same. It is a comfort to me that others might be spared what so many have endured – the stress or trauma of placental problems whose effects range from the less-than-optimal to the tragic. Here is human progress: slow, hard-won, and worth the effort.
