Ending a pregnancy after 12 weeks

In their lifetime, up to one in five women will choose to end a pregnancy, for their own unique reason.

“They are mothers, daughters, sisters, nieces, wives, aunties and grandmothers. They are politicians, lawyers, students, teenagers, nurses, police officers, women who ‘don’t believe in abortion’, waitresses, doctors, journalists, and dancers.

They come from many different religious and cultural backgrounds. They can be wealthy, getting by, or struggling financially. They are married, in long term relationships, single, divorced, having casual sex, or victims of sexual assualt. They usually share the belief that while the decision may have been difficult, they made the best choice at the time.”

Source: https://www.childrenbychoice.org.au

In Belgium, it is possible to end a pregnancy after 12 weeks if:

  • the pregnancy endangers the health of the mother; or

  • the baby has been diagnosed with an incurable condition.

If the above criteria are not met, and a woman still wishes to end a pregnancy after 12 weeks, she can go to another EU country where abortion is still possible at her stage of pregnancy.

Choosing to end a pregnancy because of an incurable condition

Being told that your baby has an incurable health problem comes as a huge shock, and you may have trouble believing the news. In the following hours and days you may have a lot of decisions to make, such as whether to end the pregnancy or let nature take its course.

Making a decision to end a much-wanted pregnancy is heartbreaking, and you will have a multi-disciplinary team (doctors, midwives, nurses, psychologists) to support you through this time, and provides comprehensive information on the options available, as well as advice.

In Belgium, a ‘therapeutic termination’ can be carried out at any time until the term of the pregnancy. This gives the mother (and father / partner if relevant) the time they need to decide how to proceed.

What happens when?

Once the decision has been made to end the pregnancy, your doctor will explain your options to you and you will have the opportunity to ask any questions you may have.

Unless there is a reason for a caesarean birth, you will most likely give birth naturally. Hospital staff will be particularly sensitive to your needs, e.g. in terms of pain relief and who you want to be present.

You will have the opportunity to discuss pain relief with an anaesthetist, should you wish to have an epidural during the labour.

Around 36 to 48 hours before the birth, you will be given the drug mifepristone – this stops the hormone that allows the pregnancy to continue working. You will most likely be able to stay at home for this.

Once admitted to the hospital, labour will be induced using prostaglandins, which provoke contractions of the uterus.

If the procedure takes place after 24 weeks of pregnancy, a strong painkiller is injected into the umbilical cord to anaesthetise the baby, and the a second medication is injected directly into the baby’s heart to stop the heart.

Hospital staff will make sure you are well supported during labour, whether by your partner or someone else close to you, or if this is not possible, by the hospital staff.

After the birth, the baby is taken out of the room, but can be brought to the mother / parents a little later if they wish.

There are some ‘full-spectrum’ doulas practicing in Belgium who accompany women / couples when ending a pregnancy. See the directory for more details.

Saying goodbye

The decision of whether or not to see, hold, or photograph your baby is a very personal one, and hospital staff should respect your choice. You may want to ask medical staff about your baby, how he/she looks etc to help you make your decision and to help prepare you to meet your baby, if you wish to do so.

“Meeting your baby after his/her death is not morbid: its a healthy reaction that allows parents to see their baby and to give him/her a real place in their lived. It’s an extremely intimate moment that is full of emotion.”

Dr Milagros Marin-Ponce, Gynaecologist at St Luc hospital (https://www.gynandco.be/fr/linterruption-medicale-de-grossesse-y-faire-face/)

The website of the UK stillbirth and neonatal death charity Sands provides some useful practical information and suggestions about saying goodbye to your baby and ways to remember your baby.

Remember though that this is a UK website, so advice about registration and funeral formalities will not apply in Belgium. See below for further information about procedures and admin in Belgium.

Looking for answers

You will be offered a post mortem examination of your baby, which could help to explain the possible causes of your baby’s condition or abnormality and the chances of whether it could happen in a future pregnancy. A post mortem would only be carried out with your full consent, and after your care provider has explained the kind of tests that you can request to be carried out.

The UK stillbirth charity Sands has compiled a useful document aimed at helping parents make the decision of whether or not to request a post mortem

Registering your baby’s death

The staff looking after you will be able to tell you what you need to do, and in many cases, will offer to liaise with the commune on your behalf.

If the pregnancy was ended:

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Funeral arrangements

The staff looking after you will be able to tell you what you need to do, and may be able to help you start making arrangements, such as contacting a funeral home / undertakers.

If your baby:

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Cremation / burial cannot take place less than 24 hours after the stillbirth / death.

Funeral costs

While Belgian mutuelles will contribute to funeral costs for a baby who was born but died shortly after birth, this is not the case for babies who are stillborn – this is because a stillborn baby has never officially been registered as a ‘dependent’ of either parent. This unfortunate loophole means that parents whose baby is stillborn may be faced with fees of around €1000 for even a simple funeral/cremation.

Some employers have been known to contribute to funeral costs. Your HR department will be able to advise you.

Note that the Crematorium de Bruxelles does not charge for cremation of a baby who was miscarried or stillborn between 106 and 180 days of pregnancy.

Admin – worth knowing

If your baby was stillborn after 180 days of pregnancy, or born but died shortly after birth irrespective of how long the pregnancy lasted, and you are part of the Belgian social security system, you are still entitled to:

  • paid maternity leave and paternity leave (if the father’s name appears on the declaration of stillbirth/death certificate) – for this, you will still have to liaise with your mutuelle(s), and provide a copy of the declaration of the stillbirth / death certificate.

    Note that if you wish to return to work before the end of your maternity leave, you may require a doctor’s certificate.

  • the birth allowance (‘prime de naissance’ / ‘kraamgeld’) from the Belgian state – this is typically paid as of the 7th month of pregnancy, but even if you did not claim it at this time, you are still entitled to it provided the pregnancy lasted at least 180 days. You have five years from the date of the stillbirth / birth to claim the birth allowance.

    Whether or not you applied for this allowance during the pregnancy, you will still have to provide your family allowance agency with a copy of the declaration of stillbirth / death certificate.

  • tax deductions for your baby for the tax year in which he/she was stillborn / died – your baby is still considered as fiscally dependent for that tax year, which will entitle you to some tax deductions.

It is also worth knowing that bills for medical care related to the loss of your baby, e.g. consultations, blood tests and ultrasounds, can continue to come for quite a while after the stillbirth/death, which may feel like insensitive reminders as you are trying to come to terms with your loss.

Physical aspects for mum

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Emotional and psychological support

Local support

  • An independent midwife is a good point of contact for holistic support after ending a pregnancy. This is also covered by the mutuelle.
  • Community Help Services offer a helpline (+32 (0)2 648 40 14) as well as English-speaking psychologists, psychotherapists, bereavement counselors.
  • The Brussels Childbirth Trust (BCT) has an ‘Experiences Register’ – this allows BCT members to be put in touch with other members who have experienced stillbirth, and who can offer support and advice.
  • Waterloo-based mum Joanne Fraser has set up a support group, Pregnancy and Infant Loss Support Belgium, for the loss of a pregnancy, stillbirth, infant death, conceiving or expecting after a loss. 

    “It is a terrible thing to have to go through the loss of a baby in a foreign country away from family and friends. Even worse is not having anyone to speak to about it.” 

    Joanne has been involved in grief support for a while now and – having not really found a group here in Belgium – decided to start one. The group currently has a closed Facebook group, which gives an opportunity to meet and support each other. 

    Email joannefraser_home@hotmail.com for further information or to be added to the Facebook group.

Online resources

This website provides a wealth of information for women who may need to end a pregnancy.

In particular, this page may be of use for women who are struggling emotionally:https://www.childrenbychoice.org.au/forwomen/afteranabortion

Reading other people’s accounts

Three women tell their stories of late-term ending of their pregnancies: https://www.theguardian.com/society/2017/apr/18/late-term-abortion-experience-donald-trump

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