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be getting a call from my doctor in a couple of weeks, after she’d obtained the chromosomal testing results, but otherwise, I didn’t even consider thinking about anything I might get to have or hold. Something tactile. Something sacred. Something that signified that this experience really happened. Honoring my loss or getting some semblance of closure around it was the furthest thing from my mind. I was still back in the bathroom, with the blood and the echoes of my primal scream and that godforsaken plastic bag. I was still just trying to survive.

Once my mind was able to focus on more than the sheer need to persevere, I contemplated things I’d heard and read about on the topic of honoring a loss. In my own Jewish culture, loss is seen as a normative, albeit challenging, outcome of pregnancy. For example, traditionally, many Jewish families don’t give gifts meant for unborn children (including abstaining from having baby showers) because these items could be a painful reminder if the pregnancy is lost. Despite customs that acknowledge the very prominent possibility of loss, Judaism’s position that life begins at birth leaves grieving families without standardized rites and rituals to honor a pregnancy loss. As I ruminated on my own culture’s traditions, I thought back to patients like Opal, whose faith was a consistent, guiding presence in her life, even when her belief in God resulted in feelings of inadequacy and guilt. I felt, in a strange way, almost envious that the role faith played in Opal’s life gave her, at the very least, a framework for processing her feelings; her questions about motherhood and fertility were, ultimately, a part of her relationship with God. It seemed that she, and others of similar convictions, believed that if they continued to focus on that relationship, healing through and from grief would come as a reward. While I’m not expressly adherent to the religious tenets of Judaism, I do find value in the customs. Knowing then that culturally, Judaism had little to offer in terms of schema and guidance, added to my already-frequent feelings of isolation in the wake of my loss. I yearned for comfort—and wondered if faith could provide some, like it did for Opal—but when it became clear it could not, I looked further afield.

And so, as I began to search for ritual, I let this be a moment to meditate on the nature of theological perspectives and reflect on how other spiritual codes choose to interpret and memorialize loss. For some, like Opal, there is an idea that loss, like everything, is part of “God’s plan.” This sentiment and its theological underpinnings didn’t resonate with me—why make something so heartbreaking into an experience God would have a hand in? “Everything happens for a reason” is another phrase that gets repeated in some spiritual circles. To this statement, my retort is a diplomatic “does it?” It’s a natural question, of course—one I had myself and that I parsed through after I read Rabbi Harold Kushner’s seminal book When Bad Things Happen to Good People. When Kushner’s three-year-old was diagnosed with a degenerative disease, he was faced with one of life’s most difficult questions: “Why, God?” As a result, Rabbi Kushner penned an elegant contemplation of the doubts and fears that arise when tragedy strikes. This text is a profound offering for those examining these philosophical dilemmas.

I’ve witnessed the many ways in which this question—“Why, God?”—can both aid and impede a person’s healing process after a pregnancy loss. Opal, for example, felt like she was “playing God” by utilizing IVF, the underlying message being that this experience—pregnancy and whether it was successful, the number of children her family was destined to have, when she would become a mother—wasn’t hers to determine. A higher power (the Christian God, in her case) was in charge of these reproductive outcomes, so seeking these medical options felt like an act of defiance, a deviation from God’s plan.

In Judeo-Christian scripture, God rewards the unwavering faith of a follower by granting her the ability to have children despite her being barren. “And by faith even Sarah, who was past childbearing age, was enabled to bear children because she considered him faithful who had made the promise,” reads Hebrews 11:11. Such messages can evoke feelings of inadequacy in people who are unable to get and/or remain pregnant. If God grants conception to those who are faithful, what does that say about religious women who are infertile? Who experience pregnancy loss? Who give birth to a stillborn? Religion and religious teachings can perpetuate the idea of “worthiness”—of who is, in the eyes of God, deserving of parenthood.

These edicts can also lead to a rift in one’s relationship with religion. Instead of being a source of comfort, it becomes a source of uncertainty. If God “causes” miscarriages, or at the very least allows them to occur, is this otherwordly being worthy of devotion? If our chosen faith is unable to carry us through grief, should we continue to live a life in service of that religion?

Of course, religion can also be an important way to help make sense of things that don’t make sense. The promise of an eternal afterlife in which parents are reunited with those they miscarried or delivered without breath can act as a beacon for those adrift in a sea of mourning. They are fueled by the knowledge that they will be able to love on the babies they lost once again. And in cultures steeped in specific religious teachings, the relationship with death and how the dead are honored can also provide comfort and hope. One can look at Mexican culture, for example, as a way in which death is not considered final, but an inevitable transformation of sorts. Practices such as Día de Los Muertos—the Day of the Dead—encourage and honor the constant contact between the living and the deceased. There’s a palpable relationship with those that have passed, one that is cultivated with great intention

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