I Had a Miscarriage Read online

  “Get a plastic bag!” I shouted. “Put her in it so we can bring her to Dr. Schneider’s office.” Anything but grounded, reeling from his own experience of this trauma, he shot back, “Why are you calling it ‘her’?!” before descending the three flights down to our kitchen, where leftover grocery bags were stored.

  The last thing I needed was to hear him call the baby—our baby—“it.” I don’t know what I expected his reaction to be, but even in the very initial moments of my grief, I knew it wasn’t that.

  • • •

  We numbly sped to the doctor’s office, mute.

  When we arrived, I urged him to leave me on the corner and go find parking. Blood was spilling down my legs as I stood there, on the bustling corner of West Third Street and Willaman Drive, across from the Cedars-Sinai towers. Waiting for the light to change, holding the unimaginable bag, shouting into the phone to my sister: “The baby FELL. OUT. She is IN A BAG.” She couldn’t believe that had possibly happened. I couldn’t either. I still can’t, all these years later.

  With increasingly soaked towels still stuffed down my baggy sweatpants, I knew I wasn’t going to stop bleeding until I delivered the placenta. In an effort to push the details of what was to come out of my mind, I recounted every detail of my miscarriage (thus far) to my sister while I shared a street with oblivious strangers.

  “Wait, go back!” she said. “The baby came out while you were home alone?!”

  “Yes,” I replied. “She did. And I had to cut the umbilical cord. I have her in a bag right now so the doctor can do testing!” I wailed, the unfolding events unimaginable to me at sixteen weeks along. But what was even more unimaginable is that, on that busy street and as my life felt as though it was unraveling, people around me continued to live theirs. As I held the remains of my daughter in a bag, blood collecting in pools around my ankles, people were rushing past me to work or day care, a coffee date with a friend or a mundane errand. The contrast was nothing short of jarring.

  As I started to disassociate from the duality of it all, I watched my life from a distance. And in the safety provided by that distance, I let the dread take hold. I felt suspended in midair, floating in the liminal space between life and death; a simultaneous place of trauma and disbelief, where the certainty that all life ends clashes with the sheer cruelty of an unexpected loss. I remember that, for a moment, I was terrified for my future self. Now there’s a dead baby. A hollow womb. What will come next? How will I mother, work, put one foot in front of the other, and grieve? Amazing, the places our minds go.

  I was bleeding incessantly, and I couldn’t fathom how I’d take my pants off when I arrived at the doctor’s office. But when she ushered me in, I heeded her orders to do so, and a blood clot the size of a boulder splattered across the floor. A nurse muttered that it looked like a “murder scene.” She wasn’t wrong—a death had occurred, and it had felt violent and cruel. The only way to make the bleeding stop was to extract the placenta, and that meant proceeding with a dilation and curettage (D&C), a procedure to remove it and any remaining tissue inside my uterus.

  Before the procedure began, a nurse removed her from the plastic bag for testing, then placed her on the kind of tray you’d see surgical tools prepped on, where she stayed for the duration of my D&C. Her peaceful body was within eyeshot as mine continued to writhe.

  I was faced with two options: wait for anesthesiology—numbing me for the painful mechanic extraction—and continue to bleed, then undergo a blood transfusion; or just get on with it unmedicated, pain, bloodlessness, and all. While I wanted desperately to not be in physical pain anymore, I was told that it could take the anesthesiologist up to an hour to arrive and administer the medication. If I chose to simply get it over with, the whole ordeal would be over in another ten or fifteen minutes, max. So, desperate for it all to end, I elected to press on without anesthesia. I couldn’t imagine the fleeting pain would be any worse than the agony I already felt, emotionally and physically.

  At some point, Jason entered the room. To this day I cannot recall from where or how, at what time or in what state. I can’t tell you how he looked—was his face distraught with worry?—or if he asked my doctor for clarity on the next steps. I do, however, remember the rhythmic sound of his labored breath. He had been running. He ran to me. Now by my side, I asked Jason to turn some music on to help drown out the near-savage sound of the machine—to drown out the thoughts that accompanied those sounds.

  Jason obliged and put on Alexi Murdoch’s “All My Days,” but the usually calming rhythm was woefully incapable of shielding me from the sounds that will always signify the final moments of my pregnancy. As the machine roared, I stared at the ceiling and felt everything I had prepared for—the sleepless nights breastfeeding my infant, the anxiety-ridden moments in which I would stare at my sleeping baby’s chest rising and falling, the moment my son held his baby sister for the first time, the extra place setting at the dinner table—tugged from my body. As I clenched the nurse’s hand and tears streamed down my face, I shifted my gaze to her—my stare piercing her soulful, almond-shaped eyes. And in her eyes I remained, until it was over. It took the full estimate—a brutal fifteen minutes—to ensure nothing had been left behind, save the part of me that still resides in that kind nurse’s deep-brown eyes. The part of me desperate for a future I never had, a life I have never known. The part I knew I had to learn to live without.

  At some point, my midwife friend, who had come over just the night before with her reassuring fetal doppler, also arrived. Like my husband, I cannot recall when or how. The only proof of her presence were the snapshots of the fetus she had the presence of mind to take. She just knew—an outcome of her education in birth and pregnancy loss, no doubt—that these pictures would prove useful in the future. That I would need them. That, eventually, I would want them.

  After a few inhales of smelling salts and bites of salted crackers, and with nothing but those snapshots, my husband and I returned home. Assaulted by this new reality, I went blank.

  • • •

  The furthest thing from my mind following this incomprehensible trauma was to feel ashamed of it, as if I had done something wrong or like I should keep it secret. But I quickly found—both in my memory of so many of my patients’ experiences, and prevalent in the research on women’s feelings after pregnancy loss—that somehow shame is expected. It doesn’t exactly make sense: One in four pregnancies ends in miscarriage—and that’s just of the pregnancies that are known. (The number is probably much higher, due to chemical pregnancies, for example, where the expectant person may not have been aware a pregnancy even existed, much less that a miscarriage occurred.) Approximately one in one hundred pregnancies results in stillbirth. Others learn their developing babies are ill or won’t make it to term, and therefore terminate for medical reasons. Still others must terminate based on health risk—in lieu of their own demise. One in eight couples struggles with conceiving a baby at all.

  The medical facts are clear: A majority of miscarriages are due to chromosomal abnormalities, fetal complications, or other genetic issues. There are reportedly more than three million cases of miscarriage in the United States per year. This common occurrence is therefore a normative, albeit often difficult, outcome of pregnancy. But here’s the thing: We are not in charge of chromosomes. And we ultimately have no control over genetics either.

  Still, research has shown that more than half of people who have been through these ordeals feel guilty. More than a quarter feel shame.1 And indeed, these concepts somehow have been ingrained in the psyches of countless people who’ve lost pregnancies—that their bodies were defective, that they failed, that they somehow did something bad, something wrong. Our culture literally adds insult to injury.

  I couldn’t tell you exactly why I didn’t feel this way. I just didn’t. Maybe it was because of my career, talking formerly pregnant people away from this very line of thinking, even though I had not yet experienced it firsthand. Maybe i
t was because I’d never believed miscarriage was the fault of any person. Regardless of the reasons why I was able to sidestep this self-destructive line of thought, I never once considered that I did something to prompt this traumatic loss.

  But I also kept thinking, through the maze of grief and despair, how much worse it would be to also feel ashamed, guilty, or self-blaming. Amazing, the places our minds go. How much more agonizing it would be if I subscribed to the stigma, bought into society’s expectations of women, and considered myself some kind of a defunct model solely because I couldn’t carry this specific pregnancy to term. I shuddered to think how exponentially worse my suffering would be if I chose to stay silent.

  I didn’t want that for myself. And I didn’t want it for anyone else either.

  In time, I realized I wanted to make a dent in this taboo topic. I wanted to inspire women to question why they would turn this excruciating experience in on themselves. And I wanted to educate those who would blame women and other people capable of becoming pregnant for a reproductive outcome that was and is beyond their control. The best way I could think to reach the masses and provoke societal change was through words. Starting with my own.

  I wasn’t ready to share my story immediately after my loss. I had told countless patients prior to my own pregnancy loss experience that grief doesn’t adhere to a timeline, and that healing from any traumatic experience is a cyclical event with no beginning or definitive end. So in the days, weeks, and months that followed, I tried to practice what I preached. Sometimes I felt like I was ready, only to sit in front of a computer and become excruciatingly aware that I was not. Other times, I simply knew it was too soon, and in those moments I had to remind myself that sharing my loss with anyone should be a choice, not a requirement. I wanted to eventually divulge this information publicly, yes, but on my own terms and when it felt “right” for me and me alone.

  Eventually, in early October 2014, two years after my loss, I plopped down at my desk and began writing what turned out to be a searing piece detailing what I’d lived through. Once completed, I sent it into the largest, most influential outlet I could think of, with the hope of not only sharing my experience but sparking a much-needed reproductive revolution of sorts. As soon as the New York Times accepted my essay to run on Pregnancy and Infant Loss Awareness Day, October 15, I reached out to a talented calligrapher to see if she would be willing to make some signs I could hold for a photo that would accompany the essay. The sign would read “#IHadaMiscarriage” but I would be faceless in it, so that anyone and everyone could picture themselves holding the very same sign. I wanted to send an unabashed message into the world, and this seemed like the best way I could think of to get conversations rolling about this all-too-common, albeit all-too-neglected, topic. The hashtag hearkened back to my frenzied early text messages to my friends and family, when I’d searched for a feeling of community and the grounding presence, even if it was via the phone, of those who would support me. I wanted to create a national discussion that, in some way, would do the same for those who had experienced the same type of loss. #IHadaMiscarriage would be more than a transference of information. It was meant as a call to action. It was meant as an invitation. It was meant to incite an influx of silenced stories. It was meant to normalize grief and invite those who have felt shamed into silence to share theirs as they find comfort and solidarity in others.

  And almost two years to the day after my miscarriage, my piece ran, with the image boldly alongside it. I logged on to my Twitter account and watched as people around the world chimed in with their reproductive hopes and hardships, and shared feelings they no longer wanted to keep silent. It was clear: women worldwide were yearning for a cultural shift, one that would allow these stories to flow freely rather than remain shrouded. A simultaneous sense of relief and overwhelm washed over me as I received emails from people who had survived pregnancy and infant loss and continued putting one foot in front of the other in the aftermath.

  I vowed that this was just the beginning. I kept writing. It was as if I couldn’t get myself to stop. I put pen to paper and dove into various aspects of pregnancy loss and life after, as it was clear this was not only helping me process my feelings, but also inspiring others to do the same.

  To spread the message further, I started an Instagram account: @IHadaMiscarriage. The followers came in by the thousands. It was clear there was not only a willingness, but a burning desire and a pressing need to shift the cultural landscape by opening a dialogue for all who have experienced these painful losses. And as the number of followers continued to increase, it also became apparent that a primal need to be in communion with others, in both grief and hope, was driving the collective demand for the silence surrounding miscarriage and infant loss to end. Women no longer wanted to do this alone. These women wanted their voices to be heard. These women wanted to step out of the shadows.

  My Instagram page became a hub where people could share their loss stories, find fellowship, and receive support. The page grew into a place for people to talk candidly about grief and their complex feelings of failure, fear, indifference, relief, desperation, and isolation. A place to share openly about their seedlings of hope, their crushing disappointment, the messiness of moving “forward,” and, in some cases, the freedom of letting their reproductive dreams go entirely. They would meet in the comments and become real-life friends. They’d support one another through both subsequent losses and successful pregnancies. They’d share parenting hacks, relationship advice, lament about quirky in-laws, and discuss the inconsequential moments of their lives that, in the midst of a loss, can feel overwhelming. For many, they found an online home.

  What emerged from a simple hashtag and a personal essay was far from what I had initially planned, but the #IHadaMiscarriage campaign took on a life of its own. What began as a social media endeavor quickly evolved into a robust multiplatform effort. It was even the subject of an academic study exploring the shared experience of miscarriage and how it’s discussed online.2 To this day, on an annual basis, I use the movement to highlight various aspects of pregnancy and infant loss worthy of further investigation.

  As my voice in this space grew, national media outlets reached out to me to speak on the topic. I inadvertently became one of the go-to psychologists in the media on the topic of pregnancy and infant loss. It was clear: the world seemed more poised than ever to shine light on a dark subject.

  Today, I have an eager and robust community on Instagram joining me in rethinking why there’s trepidation and stigma around saying, “I had a miscarriage.” There isn’t a day that goes by that I don’t receive a message or see a comment along the lines of “I refuse to silence my pain any longer. This community has helped me see that I am not alone,” and I am further reminded of the power of replacing the silence, stigma, and shame with the truth of our experiences. I’ve collected more stories than I ever thought possible, communicating with people across the world as they navigate their own reproductive roller coasters. People tell me that the @IHadaMiscarriage Instagram account is one of the first places they turned to after experiencing a pregnancy loss, especially since the relative anonymity of the social media world can shield people from the stigma of miscarriage that is far too often perpetuated by even the most well-intended family members, friends, partners, and loved ones.

  My role borne out of the #IHadaMiscarrige movement is one I take seriously, and I’m forever honored to be even a small part of people’s journeys toward sharing their experiences. In turn, some of the community members have graciously allowed me to share the words they’ve given me—in direct-message conversations, in comments, in email threads—here in this very book. They, along with the women I see in my practice, have taught me so much about the extensive power of words and the necessity of vulnerability. Sharing inspires me—and, I hope, others—to dig deeper into aspects of grief and loss and life after.

  Galvanizing a community in this way has been transformative beyond m
easure, but still—I am not without grief. I’m not sure I believe in grief disappearing altogether as a possibility. I don’t see healing as finite. I’m still in my grief on occasion, and that’s okay. My loss ultimately gave birth to a movement. And now I’ve got to raise it up.

  2

  “I failed to give myself the space to fall apart.”

  Early in my training en route to becoming a psychologist, I learned that a common reaction to traumatic events is a kind of “perseverance approach.” Referred to in the Diagnostic and Statistical Manual (the go-to guide for mental health) as the “acute stress response,” this is a prime example of the “fight” part of the fight-flight-or-freeze response, which can accompany perceived danger or harmful situations. This physiological reaction to stress is an adaptive mechanism employed with the hopes of shirking danger. I. Must. Survive. In day-to-day life, this response can take many forms. Sometimes people try on an “I can handle this, I’m okay” attitude in order to push ahead. This is a sincere (and often unconscious) attempt at “moving forward” so as not to sink into the wretched, lonely pit of mourning that so often accompanies trauma. With the loss of a would-be pregnancy, this acute stress response can manifest as anxiety, difficulty concentrating, a sense of impending doom, and/or denial, among other things. We so desperately want to hold on to the life we knew before, untouched by this particular heartache. And so we claw at the walls of our past—comforting walls we knew so well once upon a time. But for so many of us, unavoidably, the profundity of this remarkable experience eventually sets in. And how could it not? We can only stave off pain so long before it comes careening in and shoves its way smack-dab front and center. Trauma has that way about it.

  Ready or not, here it comes.

  • • •

  Even as a psychologist, despite knowing what I know from all my years of completing doctoral hoops, barreling through piles of trauma-related textbooks, and talking with other individuals in the midst of their own traumas’ far-reaching reverberations, my post-loss journey was filled with a complicated mix of haphazard attempts at honing that innate survival instinct. Beleaguered and besieged by losing the pregnancy, I focused on putting one foot in front of the other. Day by day. I did my best to continue on. I showed up. I stayed busy. I chimed in. I replied. And on occasion, I smiled, even.