The loss of a pregnancy, through miscarriage or stillbirth, can be one of the most traumatic events that a woman can experience, on par with going to war.
Recent studies by Danny Horesh, a psychologist and researcher from Israel’s Bar-Ilan University, found that between 33.3% and 42% of Israeli women who experienced pregnancy loss from the second trimester had probable post-traumatic stress disorder. In contrast, a study by the U.S. Department of Veterans Affairs found that 29% of combat veterans of the Iraq War were diagnosed with PTSD at some point in their lives.
Couples who experience pregnancy loss have also been found to break up or divorce at far higher rates than those who have live births.
There are nearly 900 stillbirths a year in Israel — roughly five for every 1,000 births, according to a 2016 study by the Jerusalem Institute for Policy Research. (Under most definitions, stillbirths are pregnancies that are lost after approximately 20 weeks, as opposed to miscarriages, which occur before.)
Israel’s Yad Sarah medical nonprofit launched a new initiative this week to help these hundreds of Israeli women who experience pregnancy loss, creating a specially designed recuperation hotel for them in Jerusalem where they can find support, relaxation and –- most critically –- validation that they’ve been through a traumatic event.
On Sunday, the organization began spreading information about this new initiative, without a press release or an ad campaign, solely through word of mouth: a WhatsApp message, offering “physical and mental rehabilitation,” personal and group support systems, as well as spa and pool facilities, all of which were offered at a subsidized rate of NIS 350 per night ($96).
“Within an hour, the number of people who responded — I don’t remember a thing like that in the 30 years that I’ve been at Yad Sarah,” the nonprofit’s CEO Moshe Cohen told eJewishPhilanthropy.
Rivka Benedict, a Yad Sarah volunteer who is running the hotel, said the organization did not realize how desperately this type of initiative was needed. “We didn’t know how important it was until we started. The phone doesn’t stop ringing. It’s a flood,” she said.
Cohen said the organization planned to host 100 women a year at the hotel. Within three days of the WhatsApp message going out, more than 30 people had contacted Yad Sarah about staying at the center. Two days after opening, there are already seven women staying there, with more expected to arrive in the coming days and full occupancy within the next few weeks. (Out of sensitivity, it was not possible to speak with the women currently at the hotel.)
“This is a solution that doesn’t exist anywhere else in Israel,” he said.
In general, Yad Sarah is known in Israel as the organization that provides people with free or deeply discounted medical equipment. If you need crutches, a wheelchair or a bassinet for a newborn, you can go to one of Yad Sarah’s franchises – which are mostly located inside hospitals – and pay a small deposit, which is returned after you no longer need the equipment.
Cohen said the cost of running the hotel is not particularly high — it costs roughly $200 per night per woman and each woman is expected to stay for a few days, so the total is in the tens of thousands of dollars — but that Yad Sarah was looking for outside funders to keep it going.
“We want this initiative to continue. We don’t want to say after six months that we have to shut it down,” he said.
The idea for the initiative — along with a portion of the funding — comes from an organization known as Nitzotzot Inbar, Sparks of Inbar, which is named for the founder’s daughter, who died in utero at nine months.
The CEO of the organization, Yael Binenfeld, told eJP that this type of recuperation facility had long been a goal for the organization, which until now mostly provided training to hospital staff about pregnancy loss and distributed kits of written materials and other items to women and couples who experience it.
“We wanted to provide a place that recognizes their loss,” Binenfeld said. “Many don’t want to stay in the hospital, surrounded by the sounds of babies and other couples, but going home is also not easy.”
She said Nitzotzot Inbar approached Yad Sarah about the idea in May and the organization “took the idea and ran with it.”
Horesh, one of the top Israeli researchers looking into the psychological effects of stillbirth on the mothers, told eJP this week the fact that such an initiative exists is itself an important achievement and a boon to women who have experienced pregnancy loss.
“The first condition for recovering from trauma is someone telling you, ‘I know you’ve had a traumatic experience,’” said Horesh, who was not involved in the creation of the hotel.
“Stillbirth is still the kind of traumatic event that is not discussed enough. It’s considered taboo. We call it ‘disenfranchised grief’ — suffering that goes unrecognized,” he said. “Opening a center that helps women who have had pregnancy loss that itself gives recognition, and that is something therapeutic in its own right. It gives them that acknowledgment and validation, which general society doesn’t always offer.”
In some cases, the women come directly from the hospital once they are able to be discharged, and in others, they come from home, Benedict said.
“Women who have a stillbirth can return home to an environment that doesn’t really know how to treat them. They don’t know what to say, what to do,” Horesh said.
The women are allowed to bring a guest with them, often their husband or partner, a relative or a close friend.
Women are eligible to stay in the hotel up to six months after they experience pregnancy loss. Binenfeld explained that this is because women and couples may only realize they need this type of support later on.
“We see in research that two months later people can be the most susceptible to depression. You think that everything is OK, and then it can hit you,” she said.
In some cases, it can be more immediate. Benedict recalled getting a phone call from the husband of one of the women who is currently at the hotel.
“He called me and said, ‘I see that my wife is just not ready to go home after what happened to us. We have three boys at home. We just lost a daughter. It was only at the end of the pregnancy that they said she wouldn’t survive. And we had to deal with the labor and the burial, and it was so painful,’” she said.
“They came to us and I hugged her and told her how brave she was and how incredible she was,” said Benedict, who worked in special education and has volunteered with Yad Sarah for several years.
While the hotel is only available to women up to half a year after their pregnancy loss, the need for help can last decades. Benedict said she received a call from a woman who had a stillbirth inquiring about staying at the hotel. When she asked when the pregnancy loss had occurred, the woman told her: 25 years ago.
According to Binenfeld, this is not uncommon. “I get those calls all the time too,” she said.
This post-birth hotel was set up on one floor of a larger hotel that was established by Yad Sarah on Jerusalem’s Yirmiyahu Street. The hotel, which is due to fully open later this year, is meant to serve as both a standard hotel for tourists and visitors, as well as a rehabilitation hotel for people who have recently undergone surgery or are otherwise recuperating from a medical event, Cohen said.
“This is a place where a woman who has had a stillbirth can come to rest for a day or two or three, where she can get the help she needs,” Cohen said.
As the initiative is only just getting on its feet, Benedict said they were still working out its exact schedule and what services it would offer. She said there were already support groups being held for the women and she hoped to soon offer such groups for their partners as well.
Everyone involved in the creation of the hotel, as well as Horesh, stressed the profound effect that pregnancy loss has not only on the woman carrying the child but on her partner as well.
“The couple feels that to the world, it was a fetus who [other people] didn’t know. For everyone else, it didn’t really live. But for the couple, there was someone there. They ‘meet’ the baby for months, especially now that there’s ultrasound and you see pictures,” Binenfeld said, adding that her organization considers the partners to “not just be supporting the woman through this, but to be part of it themselves.”
Horesh stressed that since women who experience pregnancy loss are a heterogenous group — some may already have children, while for others this is a first pregnancy; some may not have a partner; some may be older or younger, rich and poor, of all races and creeds — it makes it difficult to prescribe a single course of action to help them cope with their traumatic experience, as all of these factors can influence the type of care needed.
Support groups, for instance, can be a hugely beneficial resource for one person and hurt another. “There are those whom it helps to be with others who have been through what they’ve been through, and there are those whom it can frighten,” he said.
Horesh said that made it critical to evaluate the person upon entry in order to gauge their condition so they can get this type of personalized care.
Benedict said the staff try to be aware of the individual needs of each of the women, asking how they are and what they need. “That kind of reception is so important,” she said.
She said that so far the seven women currently in the hotel have sought group settings, opting to eat together in a shared dining hall.
In addition to this type of emotional evaluation, a Yad Sarah doctor — Dr. Chana Katan — reviews the discharge documents that every woman who comes to the hotel receives from the hospital in order to understand their medical condition. Cohen stressed that while the hotel has a nurse on staff and some medical equipment, it is not a hospital or clinic.
While Horesh said the type of therapy and support that a place like this hotel can help a woman cope with the immediate, acute stress from pregnancy loss, that will not necessarily prevent PTSD, which can come months or even years later.
Binenfeld acknowledged the limitations of this initiative as well.
“We saw that there was a need for a place where they can rest their head, where they can recuperate, breathe, talk and cry and just not be home for a little while,” she said. “It’s not going to solve everything, but I truly believe that when a person knows that someone sees them and wants to help them, it helps alleviate some of the pain and the loneliness that is so common in times of crisis.”
While Horesh emphasized the need for individualized care and refrained from making sweeping generalizations about the potential long-term ramifications of this kind of hotel, he stressed that this type of project is a positive development for women who experience pregnancy loss.
“At the end of the day, I have to say — because I’ve equivocated a lot — this is a praiseworthy thing to offer a place like this. I have to say that. Stillbirth is not discussed enough. It is a trauma that still goes unmentioned. Women need validation, they need a place to go to. The opening of any place with professionals — a clinic or a hotel like this — is praiseworthy in my eyes,” he said.
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