Celebrities have begun going public with their miscarriages. In this case their ability to say things that get way more attention than when they are said by you or me actually serves us, since ordinary people might keep private matters private. Beyoncé, Gwyneth Paltrow, Michelle Obama, and Meghan, Duchess of Sussex, are some who have opened up about loss. Their plaint is pretty consistent: miscarriage happens all the time, but sufferers are isolated in their sorrow. In 2020 the Duchess tried to explain: “Losing a child means carrying an almost unbearable grief. . . . Despite the staggering commonality of this pain, the conversation remains taboo, riddled with (unwarranted) shame, and perpetuating a cycle of solitary mourning.”
Mourning is too often solitary because miscarriage comes by surprise, women unaware how frequent it is until it happens to them. Then they discover it happened to lots of their friends too. Shame would seem the last thing a grieving woman should feel, but prenatal care designed to help mom help baby can leave women thinking that it must be their fault when anything goes wrong. Miscarriage may not be exactly taboo, but bifurcations in American culture around pregnancy make it harder to talk about.
I fall within the staggering commonality the Duchess identifies. Decades ago I had two miscarriages. Maybe if they happened now I would have shared the news, as social media encourages women to do. Psychologist Jessica Zucker’s book and hashtag campaign, #IHadaMiscarriage, aims to offer solidarity among fellow sufferers and to reassure them there is “no ‘one way’ to feel about these specific losses.” That might be true. But this permission to feel what you feel may not be as kind as it sounds. The midst of a miscarriage is not a great time to invent an interpretation of it for yourself. Interpreting your miscarriage in your own way means that others often can’t or won’t grieve alongside.
Public ambiguity about pregnancy doesn’t well prepare one in advance to process this kind of loss.
About one in five pregnancies ends in miscarriage. Accurate numbers are hard to fix and are probably higher since pregnancy can be over before anyone knows it is there. Like other common and grievous parts of human life—illness, injury, death in the family—miscarriage deserves a set of accepted manners to help comfort those who experience it. But for Americans, communal ways of handling this grief are inadequate, not only because our time has thinned communal ways of doing many things, but also because of distortions wrought by abortion polemics. Public ambiguity about pregnancy doesn’t well prepare one in advance to process this kind of loss.
Without communal recognition that there is something to be sad about, grief can be dismissed as just personal choice. Some women, after all, either choose not to grieve or see little worth grieving over in what a pregnancy loses. Ardent though she is to offer solace to those who want it, Zucker also determines to “make space for the people who feel indifferent toward their pregnancy losses or even relieved,” regretting that women “who do not experience sorrow or anger . . . are made to feel defective.”
In the years following my miscarriages I wanted to write about them. But when I said I was thinking through pregnancy, wanted to write about miscarriage, people asked what my angle was on abortion. I didn’t want to write about abortion. I lamented that this part of a woman’s life failed to hold interest unless the conversation was going to swing to abortion somehow. I still would rather not make that my conversation. But I concede. Talking about miscarriage can add something to the often bitter, often wounding conversation about abortion.
The distance between different ways of seeing pregnancy may cause tension when all goes smoothly up through birth. But when pregnancy doesn’t go smoothly, the distance breeds even bigger problems.
Medical assumptions and infant-gear marketing encourage women to care very early for their pregnancies. Special diets, beauty regimes, clothing, furniture, and parenting advice constitute the nine months as a world unto itself. The rites of passage of American pregnancy—vitamins and prenatal appointments, due dates and baby showers—usher a woman through a whole new mental world. That plastic stick with its telltale lines is her entry ticket to this fair. The woman comes out of the bazaar transformed: mom-to-be.
But a woman left holding a telltale plastic stick also might not choose this carnival. Not interested or not able to take up the prize promised at the end of the nine-month program, she might use the entry ticket as admission to a different pavilion. Fewer booths and gift bags appear in this one, where she is moved more swiftly from entrance to exit so that she can emerge into life appearing to be roughly the same as when she went in.
The choice is hers. She can choose either tent, but there’s a catch: providers in both tents are usually emphatic that, for the duration of her stay in one, the woman suspend belief in the alternate reality altogether. This may not seem like a problem. But miscarriage drops women into the crash space in between.
American handling of pregnancy prioritizes choice. But the choice a pregnant woman faces is not just about the possible decision to enter the second tent. A woman has the choice of how to imagine the fetal presence within her. Pregnancy, society tells us, is a condition that requires her to decide what the condition is. If she wants a child, she might describe the creature in utero as a baby, but if she does not want a child, she will describe it as something else. The difference is not in the fetus; it is denominational—that is, a matter of names. By our words we can bring a child into being by choosing to call it one.
If a woman miscarries, she may think, What just happened? What did I lose? Did I bleed out my baby? Perhaps nothing happened because this was a nothing? The parallel presence of mutually exclusive narratives of pregnancy, treating the fetus either as someone’s peach-sized baby or as nothing, is a lousy space in which to have a miscarriage.
The Crash Space Between
Having laid minefields around conversations about pregnancy, abortion controversies unfortunately make it harder to build frameworks for comforting women in miscarriage. Remarkably, though, the influence has begun to move in the other direction. In the wake of Dobbs, opponents of the decision have trained their focus on miscarriage to point out the unintended harms abortion bans could impose on women who miscarry. Pro-choice groups worry that mothers and doctors could be intimidated away from necessary medical response when a pregnancy ends accidentally and, worse, that women could be blamed or even prosecuted for the loss they grieve.
That is a horrid prospect. Abortion opponents should feel urgency to make that prospect unlikely, even as they maintain that bans do not intend such outcomes. It might be that abortion-ban opponents concentrate concern on these cases for rhetorical effect. Still, fear that miscarrying a pregnancy could be mistaken for an abortion is not unreasonable. The two can look much the same once they present in a hospital, where a miscarriage is in fact called a spontaneous abortion. The two situations might be addressed with the same kind of surgery. In practical terms, treatment for miscarriage falls between health-care models designed for other outcomes.
Living the loss was made worse by the blurred and contradictory handling of reproductive realities.
That institutional reality framed my own miscarriages. The first happened during a family Shakespeare trip, when I doubled over in Stratford-upon-Avon and my husband drove me to the nearest hospital, where I had a D&C, the surgical procedure used for abortions. I was further along in the second when an ultrasound found no heartbeat, so I was scheduled for a room on the labour-and-delivery floor of another hospital. Nurses rigged my belly with the fetal heart monitor, as was then standard practice, even though there was no beat to monitor, and I spent a day in surroundings I knew well from previous deliveries, overhearing other women in contractions while I waited for stillbirth. I regret that in neither case could doctors do anything to avert the loss, but living the loss was made worse by the blurred and contradictory handling of reproductive realities.
If it is not unrealistic to imagine a miscarriage being mistaken for an abortion, it is not unrealistic to imagine women being blamed for their own loss. In the 1950s American psychiatrists sometimes attributed morning sickness or miscarriage to women’s secret wish to be rid of the baby. In the 1990s media attention and criminal law in some American states targeted women whose drug use threatened to harm or kill their “crack babies.” Though it might be hoped that Christians have addressed these sorrows in more merciful ways, their history is not altogether edifying either. There are some exceptions. Martin Luther wrote a frequently circulated “Consolation” for women after childbearing loss. Dispiritingly, however, much of the premodern stuff written about pregnancy loss seems mostly interested in sniffing out sin, as authors were prone to entertain suspicions that women who got pregnant at the wrong time or with the wrong person were attempting to cover it up by eliminating the evidence. In early modern Europe miscarried or stillborn children could be investigated as physical testimony of a woman’s sin and would not be buried in consecrated ground unless the baby had received emergency baptism. This suspicion of guilt nags not only the Western church. An Orthodox invocation still in “The Book of Needs” pairs miscarriage and abortion in one prayer about both and asks God’s mercy on the “handmaid who today is in sin, having fallen into the killing of a person, whether voluntary or involuntary, and has cast out that conceived in her.” (The italics are in the original.)
Miscarriage merits consolation, whether or not consolation comes, but it might seem like a strange place to discover hope. Even so, hope could come from the present scrutiny paid by contending parties in abortion battles, who might find common ground through reflection on miscarriage.
Presupposing that pro-choice interest in miscarriage is more than strategic but carries concern for women going through it, the unwantedness of the experience can be instructive. Foremost, miscarriage tests the idiom of choice. Even when a woman was hoping not to be pregnant, she can’t be said to have chosen miscarriage. A birth culture authorizing women to have only the pregnancies they choose needs something different to say when a pregnancy fails. Unplanned and unchosen, miscarriage demands that more be offered in support of women’s reproductive health. Second, miscarriage frames individual choice within a network of social relations and limits. The sorrow of “solitary mourning” reminds us that pregnancy, while experienced uniquely by the one in it, does and should affect other people. People hope or hope not to be pregnant for a whole range of reasons, worth hearing with respect. Pregnancy and birth can be intimate and personal but are not best lived all by ourselves. When something happens, we want to be supported in our private pain by beloved others who recognize that the loss is worth crying over. Finally, miscarriage prompts confrontation with what I called the denominational problem, a gut check asking to what degree the being of the fetus in our purview is determined by our bestowal of a name.
Miscarriage merits consolation, whether or not consolation comes, but it might seem like a strange place to discover hope.
If miscarriage might prompt such deliberation for pro-choice thinkers, it also provokes challenging reconsiderations from those with opposite views. All along, the project of defending life in the womb could have fostered perceptive attention to pregnancy, appreciation of the moral work involved in gestating a new person. Campaigns to protect the fetus have not always been innocent of the charge that their enthusiasm extends more to the life inside a woman than to the woman herself. Pro-life efforts to “love them both” may show a positive shift. Still, that love tends to emphasize aid for general welfare or childrearing rather than grasping what is essential about pregnancy. When pro-choice voices point out that pregnancy can be riskier for the (woman’s) body than abortion can, those on the other side need not fear conceding too much if they, too, take to heart pregnancy’s risk and hardship. It should not surprise anyone, least of all defenders of the unborn, that the process of bearing life can be difficult or dangerous. Giving life is a big deal. Thinking well about pregnancy equips thinking better about pregnancy loss. There again, those who think carefully about fetal life might have been of all people the most equipped to speak comforting words into loss. I looked for some when I needed them and found few.
It is wonderful to be able to confirm pregnancy early by a quick test, to see the hidden fetus through sonogram print, to get body and house ready for a coming child. But too much premature festivity anticipating the baby can mislead, overpromising good outcomes and masking the gravitas of the process. Women can’t make their babies live or be born soundly just by following rules and healthy living. It’s a serious business, opening your body to the possibility of a new life. It’s serious when everything goes well for nine months that end in a happy birth. It’s serious when women have to take bedrest, or when the doctor detects fetal abnormalities, or when the baby does not survive. Bearing and birthing a new person is a big deal that can hurt a lot. That built-in pain demonstrates continuity between pregnancy-all-good and pregnancy loss. The fact of loss should make us aware that all pregnancies, including easy ones, tower with significance, weight, and freight. Loss is part of the experience of childbearing, even for women whose maternity is marvellous.
Christians who speak beautiful and true words about God creating each unique child should find resources to allay grief, if not answer all questions.
Those motivated by the gospel to reject abortion could—should—find words for those in need. Some churches devise special healing services or prayers for pregnancy loss. These practices can be nurturing but tend to be ad hoc, unusual to discover rather than integrated within liturgy. Christian response to this loss is not just a counselling problem but a theological one. Did God fearfully and wonderfully make this child—then stop? Was it a mistake or a change of mind? Whose sin, this one’s or another’s? Did God want to spare mother or child? Does Limbo accept visitors?
Christians who speak beautiful and true words about God creating each unique child should find resources to allay grief, if not answer all questions. Given the staggering commonality of pregnancy loss, those who really need consolation probably are not hard to find. The needs around childbearing sorrow are not just a ministry for moms but deserve a regular place in the family life of the church. Christianity centres on a pregnancy, if an extraordinary one. The incarnation touches on every aspect of human life, but it touches this one not incidentally. Pregnancies that go wrong or are out of the ordinary tend to fall through the cracks, between arrangements set up to welcome something else. Communities and churches can supply some of what is lacking. That supply is an expectation consistent with the call of the One who, as the carol tells, abhorred not the womb.