I Had a Miscarriage by Jessica Zucker (classic books to read .TXT) 📗

In fact, given the rates of loss, newborns aren’t recognized as true members of society until they’ve surpassed infancy. And in Brazil, where infant survival rates are low, researchers have observed that maternal attachment and bonding are a far more gradual process than the one we observe in the United States. In Bijnor District, located in northern India, pregnancy itself is considered a “matter of shame,” and is therefore not widely discussed or celebrated. Being proud of pregnancy is frowned upon. The loss of a pregnancy is rendered a nonevent, with no rituals or communal support to accompany it.8

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For as long as I’ve been researching, thinking, and writing about miscarriage, I’ve been aware of a strident trifecta that accompanies the topic: silence, stigma, and shame. These three concepts are responsible for so many of the challenges we face when it comes to pregnancy and infant loss. They work in concert at nearly all times, obstructing conversations and connection around this all-too-common topic, and isolating those who experience it. While they’re inextricably linked, they are part of a vicious cycle that actually has a starting point. And culturally speaking, a relatively easy one to trace.

In the Western world, there have been periods where we actually weren’t nearly as hesitant to talk about the experience as we are today. For one thing, at a time when methods of birth control were virtually nonexistent, and abortion was illegal and therefore dangerous, some women welcomed miscarriage as a relief—financially, physically—from carrying and caring for more children.9 There was no reason not to put voice to that feeling. It was described in articles in the 1800s as a blessing, nature doing its job. But miscarriage and pregnancy loss could also be very dangerous for women; infection and even death were possible outcomes. It was imperative to not stay completely silent, lest you jeopardize your own life.10

There have been glimpses of this more vocal approach in recent decades, like in the 1970s, when the modern wellness trend was really born, and miscarriage became a public health issue. Women began demanding answers when they noticed pregnancy losses corresponding with safety issues like pesticide use and hazardous living conditions. We were shouting, begging to be noticed and taken seriously.11 But by and large, silence has been the norm. Especially as the twentieth century drew to a close, and access to safe, legal abortion care became constitutional law due to the passage of Roe v. Wade and birth control became more attainable than it had ever been before, things started changing. The prevailing narrative, especially among white, middle- and upper-class women, became that, essentially, all “kept” pregnancies are wanted pregnancies.

Advances in modern medicine have also been both a help and a hindrance. We can now know we are pregnant sooner than ever: tests can catch a pregnancy days before a missed period, and at just six weeks, before women may even know they’re pregnant, fetal heart tones—more commonly known as the “heartbeat”—can be detected. Advances in sonography and the introduction of 3-D ultrasounds magnify fetuses so they appear as large, and as fully formed, as infants. And so, the gestational lengths of our pregnancies rarely dictate our emotional response to them—for so many of us, they seem real the moment they begin and the connection only strengthens from there. And while the medical gains of these scientific feats cannot be understated, they have both expanded and complicated our collective reaction to pregnancy loss. Instead of being a blessing or a medical necessity, a public-health concern or a consequence of a past misdeed, miscarriage is now often associated with just one word: “grief.” And for the generations that came before us, grief was often considered a private emotion. Our mothers and grandmothers didn’t grow up in a culture where openness and dialogue about pregnancy and infant loss was encouraged, and they did not have the language to pass along to us. We have been kept underground.12

Silence has even become encoded in medical recommendations. It’s common practice in the medical community to suggest women wait to share their pregnancy news until they are “out of the woods.” In obstetric terms, that generally means waiting until after the first trimester, or around twelve weeks, when the likelihood of miscarriage is statistically lower and screenings that help determine the chance of a fetal abnormality have been conducted. Once the first trimester passes, the conventional wisdom goes, you’ve reached an ostensible safe zone—a time to celebrate and let your baby bump show. When you begin to unpack the messaging of “wait until the second trimester,” the logic goes something like this: “Don’t share your good news until you are in the clear. This way, if your good news becomes bad news, then you won’t have to share your bad news.”

Stop and think about this—really think. By suggesting that women stay mum during these preliminary weeks and in the event of an early miscarriage, we essentially remove from the conversation—and in so doing, stigmatize—any woman who doesn’t experience multiple trimesters of pregnancy. It implies that you probably won’t want to or shouldn’t share news of a miscarriage, so you shouldn’t say anything until the risk of that happening is lower.

To be clear, it’s completely understandable if you’d like to keep news of your pregnancy to yourself for however long, and for whatever reason. Miscarriages are undoubtedly hard and, for some women, they can be difficult to discuss. But it’s worth reflecting on whether you’re consciously choosing not to share the details of your personal medical history or reflexively avoiding these conversations because it’s so ingrained in us not to talk about loss. Not to talk about grief. Or worse, if you are going underground with your feelings based on self-blame or guilt.

The reality is, a miscarriage at any stage might require support, and when we encourage women to be hush-hush in the early weeks of pregnancy, we’re potentially robbing them of that support should they need it. Opening up about loss and expressing