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30 March 2013

For everyone’s sake, we need to talk openly about miscarriage

Anger, shame, responsibility, guilt - these are all feelings we need to have a way of expressing when a pregnancy ends in an early tragedy.

By Glosswitch

When someone suffers a miscarriage, it’s hard to know what to say. All the same, there are some obvious things to avoid, such as:

  • You must be relieved.
  • So was it just like heavy period?
  • I blame early pregnancy tests. That’s the whole reason you’re upset.
  • Do you think it’s food additives? Maybe you should go organic.

I say “obvious “, of course, but these are all things that were said to me. I suppose people were taking a punt on none of it really mattering too much. After all, you can always “try again”.

For something that is so common – NHS Local estimates that “at least one in six clinically recognised pregnancies end this way” – miscarriage can be a desperately lonely experience. It happens often enough for those who suffer to feel their grief is self-indulgent, not often enough – and, perhaps more pertinently, not openly enough – for it to be part of everyday conversation. In TV programmes and novels, a positive pregnancy test can be greeted with joy or horror, but either way it is taken to mean “you are having a baby”. We maintain this pretence in real life, with pregnant women routinely spending the first trimester hiding their condition lest it all go wrong and shatter the illusion (and besides, who would want to be deprived of the chance to suffer in silence?).  

Experiencing a miscarriage changed my attitude to pregnancy itself. I’d never been pregnant before and while I knew the risks they hadn’t felt real. Indeed, all around me there was evidence that plenty of pregnancies didn’t end badly at all; every living, breathing person was testimony to that. When I miscarried, I felt strangely cursed (and yes, I know how self-absorbed that sounds). For a time, I felt as though I was the only one.

I wanted to make sense of it but couldn’t. I spent hours on the internet, poring over “the statistics”, well aware that knowing the likelihood of experiencing another miscarriage wasn’t going to make it any more or less likely. I still hoped I’d find some magic nugget of information. I hated the lack of control I’d had over my body and refused to give up on knowledge alone offering some mysterious way out. When I did become pregnant again, I attempted avoid future hurt by reframing the experience for myself. A positive pregnancy test does not mean that you are having a baby; it means, if anything, that you’ve been longlisted for the baby prize. Get past the first trimester with a fetal heartbeat and you’ve made the shortlist. Third trimester and you’re in the final, but even then it can still go wrong. You can reach the finish line and still the judges might change their minds. At that point you’ll realise it would have been far better to drop out early on. I told myself all of this but I didn’t believe it. The difference between having a baby and not having a baby – between being pregnant and not being pregnant – is too great to allow for nuance and hesitation.

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Saying Goodbye is a charity which organises memorial services for those who have been affected by miscarriage, stillbirth or neonatal death (or in their words “people who have suffered the loss of a baby at any stage of pregnancy, at birth or in infancy). I think what they offer is incredibly valuable. What some people need, badly, is some form of formal acknowledgement that their experience was real and that their loss is keenly felt. It is difficult to articulate what it is like to lose something which, according to outside appearances, you never really had. Difficult, too, to explain why this loss of a future relationship isn’t the same as not getting a dream job or not meeting someone you think you’d have really liked. It is more than that. The weight of physical responsibility you feel for the loss can be tremendous. You don’t trust your body anymore; it feels alien, a thing that rebels against you and those you want to protect. Saying Goodbye say they offer the chance to “stand with other people ‘who know’”. You are, in all probability, surrounded by people “who know” on a daily basis, but it’s rare that this ever comes to light and clearly requires some outside impetus. I’m glad a charity like this now exists, although not so sure that it’s really enough.

I don’t think I would ever have attended a Saying Goodbye ceremony. The fact that they are held in Christian places of worship (but welcome other faiths – although I myself have none) wouldn’t bother me, but the particular position they take on what pregnancy loss can mean doesn’t always correspond with my own. Some parts of this are, I think, very personal. I am uncomfortable with the idea that an early miscarriage really is the loss of a baby (while the dismissive attitude of people who’ve never been there infuriates me, I don’t feel I could ever compare my loss to a stillbirth or a death in early infancy). The pro-choicer in me is reluctant to bestow personhood on whatever it was that failed to thrive inside me (I hate terms such as “unborn baby”; if pregnancy has shown me anything, it’s that the difference between a fetus and a baby is based on a hell of a lot more than one of them not having “been born”). Person or not, my feelings towards what did get lost are mixed; far from love, I’ve felt anger at its “rejection” of me. By contrast, when my eldest child’s heartbeat first flickered on the ultrasound scan, I felt a huge sense of gratitude, as though my future child was being unfathomably generous by not yet dying on me. In all this I don’t think my responses are particularly normal or abnormal. Miscarriage is a strange kind of loss; you have nothing to show for it so you construct your own stories.

Throughout my recovery, my GP was fantastic. She had three children but had been through nine pregnancies to get them. Even so I didn’t have much time for her story. She had children and I had none, so wasn’t I worse off? I look at it differently now. It’s not a competition (and if it was, I barely skimmed the surface of suffering). There’s always someone worse off, someone who can’t conceive, someone who’s been trying for years, someone who’s on their tenth or eleventh miscarriage. It feels as though you’re alone because you can’t identify these other people. We need to talk about it more openly and recognise that however diverse people’s responses, their pain is unquestionably real.



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