Ecuadorian lawyer Pablo Proaño questioned the lack of empathy for families who lose a child during pregnancy and called for protocols to support them.
His remarks followed the death due to a pregnancy complication of Stefano, the son of Ecuadorian President Daniel Noboa and his wife, Lavinia Valbonesi.
On Aug. 15, Interior Minister Nataly Morillo announced the news and offered her condolences to the presidential family.
Many comments appeared on social media questioning the characterization of the loss as the death of a “child” rather than an embryo or fetus, or arguing that the matter should have remained private.
For Proaño, a lawyer with the firm Dignidad y Derecho (Dignity and Law), these reactions reveal “a lack of understanding regarding pregnancy loss and a lack of empathy that goes beyond the political debate over the way the president is running the country.”
“Many people approached this topic by first claiming it’s a ‘fake news’ story — arguing that it’s not a child, but rather an embryo or a fetus — and secondly, by insisting that it’s a matter that should remain private. And this reveals, as I said, a profound lack of empathy,” he noted in an interview with ACI Prensa, the Spanish-language sister service of EWTN News.
‘There’s already an expectation’ of welcoming the child
The lawyer explained that regardless of gestational age, “parents who already know, long for, and look forward to welcoming this baby are already forming an expectation, both on the psychological and social level.”
He said there can be “severe psychological impact following the loss” but also “long-term effects when the time comes to decide whether or not to try for another child.”
The lawyer also noted that this suffering can arise in everyday situations, particularly when the mother encounters other women with babies.
Proaño said he believes the scale of the phenomenon makes it important for society to learn how to support those going through this type of grief. “According to the World Health Organization, 1 in 4 women has experienced pregnancy loss at some point in her life,” he stated.
The lawyer noted that while the circumstances of a miscarriage or an abortion may differ, both situations can involve suffering and grief.
“Induced abortion often entails a greater sense of guilt,” he said.
Regarding miscarriage, he said there is also “a great deal of suffering regarding why the pregnancy could not be carried to term.”
“Many questions remain unanswered, and this creates a great deal of anxiety and can even lead to cases of severe depression in women and families going through this grief,” he continued.
The need for protocols regarding pregnancy loss
Proaño said he believes healthcare systems should have protocols in place to care for women who lose their babies during pregnancy.
“The first and most important aspect is institutional support from a medical standpoint. In many Latin American countries, there are protocols known as ‘butterfly protocols’ for the care of women experiencing pregnancy loss,” he explained.
In this practice, the silhouette of a butterfly is placed on the headboard of the patient’s bed, alerting the hospital staff to be particularly sensitive to her emotional state. The butterfly symbolizes a brief life, fragility, and transformation.
Ecuador does not currently have an official protocol from the Ministry of Health. “There are foundations promoting these types of protocols, and individual hospitals may implement them, but it largely depends on whether the hospital authorities choose to adopt them,” Proaño stated.
These protocols, he explained, aim to prevent situations that could increase the suffering of a woman who has just lost her child.
“What do these ‘butterfly protocols’ mean? It means healthcare staff are sensitized that they don’t say things like, ‘Oh, right. Well, it would have been better if you’d done this or that, and then you wouldn’t have lost the baby,’” he explained.
He also emphasized the need to avoid placing a woman who has just suffered a loss “in the maternity ward, where you can hear and see other women with their babies.”
Proaño even proposes identifying these patients: “They should be given a separate room and identified by a symbol or a sign on the door, so that when a nurse or doctor walks by, no one makes the mistake of asking, ‘And where is your baby? Why haven’t they brought your baby to you?’” he said.
In addition, the woman should receive psychological care, he noted.
Employers should also have to make allowances
According to Proaño, families also need “social recognition that extends to the workplace.”
“In Ecuador, these cases often only qualify for three days of leave for a family emergency, and three days is not enough,” he maintained.
“Many of these people go through episodes of severe depression, return to work, and are then fired because the enhanced job protection afforded to pregnant women because they are carrying a child does not apply. But if the baby dies, they don’t benefit from this leave,” he added.
Parents' right to say goodbye to their child
Another aspect the lawyer deems necessary to review is what happens to the babyʼs remains following a pregnancy loss.
Measures should be in place “to ensure the baby can be given a proper burial," he stated.
Proaño explained that, according to Ecuadorian regulations, there is a distinction regarding the release of remains based on whether the pregnancy has reached 22 weeks of gestation.
“In Ecuador, up to the 22nd week of pregnancy, hospitals are not required to hand over the child — the body or remains of the fetus — and may simply dispose of it, donate it for research, or even sell it to institutions,” he stated.
He said this situation can deprive parents of a step that is important for the grieving process.
“This baby is the child of a family that deserves and needs, for the sake of their grieving process, to bury him and have a place to go to mourn his death,” he noted.
In his view, families should receive clear information about their rights and be able to decide what happens to their childʼs remains.
“Parents should be provided with informed consent that explains this possibility and their rights, so they can make a decision. And if they ultimately decide not to take the fetus, they should also be able to decide on its final disposition,” he explained.
‘An unborn child is a child’
Beyond the legal and medical aspects, Proaño said he believes there is a cultural challenge: “A great deal of work to raise awareness and foster understanding” needs to be done, he noted.
“Because an unborn child is a child; it’s not merely a fetus,” he emphasized.
The lawyer lamented that many families do not even receive condolences after losing a child during pregnancy. He also questioned certain responses that may seem well-intentioned but ultimately minimize the pain.
For example, he said, “there are many doctors who say, ‘You can get pregnant again; there’s no problem.’ As if that loss could simply be erased from a mother’s heart.”
An issue that also involves the state
Proaño maintained that the response should include public policies focused on prevention, support, and family protection.
“At the state level, there are these three points: promoting the implementation of support protocols; ensuring proper informed consent when the disposition of the fetuses is to be decided; and enacting workplace reforms to grant parents more time to grieve the loss of their child in accordance with the law,” he explained.
“And also, having awareness-raising campaigns. Furthermore — taking it a step further — it would be very important for the state to take up this issue as a public policy necessity,” he added.
Proaño said he also believes that proper preventive care during pregnancy can help reduce some pregnancy losses. He cited, among other factors, medical monitoring during pregnancy and the detection of potential vitamin or hormonal deficiencies.
This story was first published by ACI Prensa, the Spanish-language sister service of EWTN News. It has been translated and adapted by EWTN News English.