For R* in Miserable Days

As a close friend has suffered a particularly difficult miscarriage recently, I want to pause from the usual vocations of life to express solidarity to and love for the many women who have similarly suffered. We are fortunate now, I think, in ways we were not once fortunate, to have ways to communicate about “fetal loss,” “miscarriage,” “spontaneous abortion”—whatever it is that we are trying to describe when a woman’s pregnancy ends without live birth. I would at the beginning remember that there are women who are not profoundly affected by miscarriage. The response to miscarriage will depend heavily on culture and personal factors. A woman who does not mourn a miscarriage should not be forced to do so, just as a woman who needs, existentially, to mourn a lost pregnancy should not be discouraged from doing so. If I know anything, it is that life is complex and we are individuals. We should seek ways to match our rhetoric and our responses to the needs of those we care for and respect rather than our sense of how the world ought to operate.

A Disclaimer

I hope that allowing myself some license to write in this setting will not be seen as suggesting that a male voice should be privileged on this topic. Beyond experiences with my wife and conversations with affected friends, I have no direct authority to speak on this subject. I am writing because I love so many people who have suffered miscarriage, and I want to honor them, to “mourn with those that mourn” as Christ calls me to. I welcome and expect that female voices will join in the comments and will be more potent, authentic, and moving than my own.
This event carries so much more than just the personal grief of an aspiring mother that we should tread carefully in our discussions. Miscarriages and the infertility with which they are often associated have been used culturally to demean and control women and their experiences for millennia. Even the term itself, with only a gentle nudge into etymological misinterpretation, seems somehow to suggest that the womb-bearing woman has failed in her duties to carry a fertilized ovum through to live birth. The stunning and to many inspiring prophet Ann Hutchinson of Massachusetts Bay Colony is only the most memorable example of a time when miscarriage was used to silence a woman—Hutchinson’s stillbirth of a disfigured fetus was all the proof the authorities needed that God wished her voice stilled. Countless women through millennia have been blamed for their (or their partner’s) infertility, and we would do well not to ignore that history when we consider any specific experience with miscarriage. I also do not mean for a moment to disparage the grief of women who never participate, successfully or unsuccessfully, in the cycles of physical reproduction. Their grief can be as real and as brutally unrelenting as that associated with miscarriage. In this moment, though, I have in mind those whose pain derives from lost pregnancy.

An attempt to define terms

As a linguist in recovery I can’t help but peer into the etymology of these words to imagine to myself how other people might have understood them. Miscarry (and in its turn the Latin-derived word “abortion,” which was largely synonymous with miscarriage for centuries) appears to have born the sense we would associate now with a car accident. A sudden and horrible failure of natural events that leads to peril or loss. If the sources I consulted are correct, to miscarry meant to die or be lost for over a century before it came to mean the very specific instance in which pregnancy does not result in live birth. I think I understand this extension of the word from loss generally to the specific instance of a pregnancy that does not proceed to live birth. Motion is such an important part of our mortal experience. It is when a face moves or lips part for respiration that we know for sure, in the tortured logic of a worried parent, that a sleeping child is still alive. Our key experiences of the world—worship, recreation, sexual intimacy, work—all incorporate movement, dynamic contact, exertion. In many cultures a fetus is considered to be alive when it begins to move within the womb, at its “quickening.” But in movement we are also vulnerable. We crash cars, ski into trees, slip from ladders, and fall down the stairs. We are always moving, the world is always moving, history is always moving, and we pray that God is at least aware of this fact. Moments of miscarriage, the wreckage of our physicalness glaring at us in silent agony, are times that this aspiration seems most poorly informed. Where, we might ask with the dying Christ, has God gone at our moment of agonal stillness?

Physical Betrayal: Of Bodies and Afflicting Casualties

There can also be in miscarriage the realization of how fragile we are as humans, how temporarily we tread upon this earth. The hope for future generations so strong within a body that every facet of a woman’s life can be affected by it is one day just gone. The Psalmist famously asked God “what are humans, that you are mindful of them?” and there is nothing quite like miscarriage to focus the impact of that question. We are in some respects all like a fetus, a dimly recognizable conglomeration of physical matter yearning desperately to be something more. Miscarriage can be the fatal frustration of that aspiration.

It is not just that the body has betrayed us. All bodies will do that some day. Knees will give way to osteoarthritis, lungs will slowly deflate, hearts will gradually scar and deform. Though we do not generally welcome its obsolescence, our body can be expected to betray our hopes for persistent good health. In miscarriage the great sadness may derive at least in part from the sense that our body has betrayed another being, a being so defenseless that it cannot even acquire an identity without our treacherous body. A sacred and miraculous capacity to create another human being proves brutally unreliable.

There is also the pain. How a pebble-sized object as smoothly and anciently alien as a coelacanth can cause so much pain is a great mystery to me. But a pregnancy has occurred; it just did not end with a human child. The great transitions of pregnancy leave their mark on the body, with echoes on the mind. Emotions are frayed, cognition sometimes cloudy. The “products of conception,” a collection of fetus and its supporting anatomical structures, must pass, with contractions of the uterus that can be as miserable as successful labor in a full-term pregnancy. If these “products” do not pass, bleeding and infection can threaten the disappointed mother’s health and even life. A “D&C” (dilation and curettage), the procedure we associate with therapeutic abortion, may be necessary to save the life and protect the uterus. There is no epidural anesthetic, no solicitous anesthetist hovering beside you, no hope for an imminent meeting with a new child, just the miserable contortions of a uterus expelling a stilled fetus and its placenta. Surely these pains are a testament to the physical distress that became ours as we sacrificed primeval purity for the strenuous mortality that makes of us divine beings.

An Abortive Grief

The grief of miscarriage can be difficult to categorize for both those who experience it and those who observe it. As opposed to other forms of bereavement, there is no specific identity to which the bereavement is attached. There are no memories by which the visceral love for a child can be moored. In many cases there is only the misery of pregnancy-associated nausea and the pensive contemplation of what this particular combination of our genetic material with another’s might look like, might smell like after a soothing meal of milk or formula, who this potential child might be or have been. There is no name, no funeral, no listing in the records of either church or state, only the occasional notation in a mother’s medical record, “Sp[ontaneous]Ab[ortion].” Such utter obliteration of a life that felt so real in anticipation can be difficult to process, to digest.

Despite, or perhaps because of, the lack of a familiar child to whom the bereavement can be associated, much of this grief may be channeled into self-doubt. Miscarriage can seem to be a failing grade on a test of motherhood, an inability to care for one’s body sufficiently to protect a body within it. However irrational, this self-doubt and self-judgment can be inexorable.

I live daily with the fear that I have failed my children, that my inadequacies or poor decisions will forever wound these wonderful souls in my heart and home. In lost pregnancy these worries can be amplified many-fold. We are obsessed already with our bodies, with the proper care of them and their potential occupants. We are ready to conduct witch-hunts for women who smoke or drink, however little, during their pregnancy. In my experience women after miscarriage often torture themselves with doubts about their too-brief stewardship of a body. They shouldn’t have eaten fish, they didn’t eat enough omega-3 fatty acids, had too many French fries, exercised too little, exercised too much, didn’t sleep well, didn’t hydrate enough when the nausea got bad. That a woman’s choices generally have nothing to do with the miscarriage can be less than reassuring.

An Abortive Condolence

The death of a child is an event so horrible most of us fall speechless in its presence. There can be no doubt that it is real and powerful and soul-wrenching. Though we often retreat as onlookers from such an event, we understand and can respect its tragic majesty. But a miscarriage may be much harder to honor. It could certainly have been worse, the fetus was never a person per se (bracketing for a moment the rancorous debates about therapeutic abortion policies). Most late menstrual periods are miscarriages; 80% of conceptions do not result in birth. Some onlookers will be so embroiled in skirmishes in cultural wars that they cannot see beyond arguments about intentional miscarriage to the sometimes surprising depth of grief that a woman feels when a pregnancy ends without a child. That something could have been worse does not mean that it is itself good.

It is all well and good to suggest that the biological system that assures the integrity of the next generation can only work by the random pairing of parental gametes, that most conceptions do not result in birth. Such observations sometimes serve rhetorical ends in our cultural wars. But we ought not to forget that these kinds of statistical observations describe probabilities of particular types of experiences or encounters but they do not drive how we will respond to them as individuals. Life is lived in details by highly specific people.

Grief, which in many modern Western cultures including our own, can be profoundly isolating, is perhaps even more isolating when what is mourned is something, someone that could have been. Women may worry that they are perceived as self-indulgent, that they should get back about their lives rather than pause to mourn what could have been. I pray that I will always be prepared to mourn with those who mourn the capsizing of the vessel of parenthood. May God bless all whose lives have been touched or changed by such loss during pregnancy.

Comments

  1. Thank you.

  2. Thank you, Sam. This is eloquent and touching, not at all what I expected to find when I turned on my computer this morning. Time dulls the pain but never quite erases it altogether.

  3. KerbearRN says:

    Grief is grief and must be honored. I am a NICU Nurse and meet grief in all it’s stages each shift, though baby lives. This is a grief of a loss of the “expectation”, and it is a huge loss. I think in many ways miscarriages are even more devastating– loss of expectation, without even having a chance to meet and experience this person. For many people there is an associated loss of hope– “what if I can never get pregnant again?”. Especially where infertility is involved, that fear is real. But even where it is not, the fear exists. It is devastating.

  4. Kevin Barney says:

    For about six months pre-mish I worked in a hospital sterilizing surgical instruments. When I first started I would see the notation “D&C” on the schedule, and wondered what that might be (of course I noticed it because I’m Mormon and I was actually studying the standard work D&C at that time). I quickly learned what those little letters really meant.

    This was both beautiful and touching; thanks Sam.

  5. thanks–it’s rare to find a male address the topic so thoughtfully. I think miscarriages are some of the great unacknowledged griefs women carry, too often silently. Funny how it can come up even a decade later like this and still make me weep.

    For me it has helped to think of the difference between sacrifice and consecration–one offering burned at the altar, the other raised as the Lord sees fit, but both given as covenanted.

  6. You’ve written a very thoughtful piece, Sam. Thank you.

  7. Thank you Sam. I was the only one of my mother’s seven pregnancies that went beyond five months. The possible existence of six siblings is one of my most personal and baffling spiritual questions.

    For as maternally-focused as we are as a people, it’s always surprised me there are not more of us who avoid the D&C reference to our standard work. Being hyper-aware of that scriptural term is something I inherited from my mother’s recurring grief in the face of that procedure.

  8. Jennifer in GA says:

    Thank you for this.

    We need to hear more things like this, as opposed to the state senator here in GA who has introduced a bill that would call miscarriage “pre-natal murder” and would require women to PROVE that their miscarriage was absolutely natural, with no “human involvement whatsoever” (and that is a direct quote from the bill.)

  9. Thank you Sam, you did a magnificent job of putting to words the challenges and sorrows that a miscarriage represents.

    The loss of a pregnancy can shatter the illusion for a couple and especially a mother-to-be that every pregnancy leads to a healthy birth. Experience and examining the statistics closely brings the realization that a live birth of a healthy child is truly a miracle in many ways.

    Few people will tell you the dark potential for what is in store if instead of storks and pink or blue balloons what you bring home is an empty car and can only look upon an empty nursery. How do you answer the kind grandmother you encounter at the vending machine in the hospital when she notices your wrist band and queries whether you are the proud father of a son or daughter?

    If, as was the case for my wife and I, the first pregnancy fails, then you don’t have other small children whose needs and laughs can help tug you out of the sorrow. As a husband I found myself grasping for ways to “make it all better.” I was protective of my wife and deeply sensitive to her needs and yet angry with God for allowing such sorrow to enter our lives. That anger was eventually replaced with real peace by spending a great deal of time in the temple.

    My wife wept night after night and it was months before we truly recovered even with therapeutic and spiritual assistance. I suspect given that ours was a near third trimester loss contributed to the overall sense of loss. Nearly 6 months of planning, talking, dreaming, and preparing suddenly come crashing down to reality. To nothingness.

    People do fall speechless at the prospects of how to help. They fail to understand that even though this was never a living child you held this can be specifically why this loss is so painful. Though there were times I wished others would have remained speechless.

    The best manner I have found for helping those who are mourning such a loss is help them find space and time to mourn. Taking children off their hands and trying to lighten their burden in ways that are personally relevant for them – sometimes offering an enjoyable distraction that removes the isolation. I have found it best to be an open ear without saying much unless asked and avoiding any platitudes. Sometimes our own experience is helpful but generally I try not to compare or share unless specifically asked.

    Whatever the biology says and whatever you might believe for when the spirit enters the body, this pregnancy represented a bundle of very real hopes and dreams. One of the most comforting aspects of our personal experience was to realize that:

    1. We could hold a burial if we chose – which we did in the same plot as my grandfather.

    2. That the Church sees stillborn children as potentially part of the family. That while temple ordinances are not performed families may include them in the group record and anticipate that the child may still be part of their family in the eternities.

    Our children know of their older sister as someone who is part of their lives in a small way. We don’t speak of her often but we do keep a small reminder in the form of framed footprints in the home.

    Each loss as you say is incredibly personal and the parents should be treated with care and love.

  10. A friend who knew of my previous losses sent me a link to this post this afternoon, but she did not know that I had suffered another loss just today. I have grieved differently with each successive loss, sometimes publicly and sometimes privately, but grappling with my lack of spiritual understanding of how these children may or may not fit into my family compounds my grief. As a mother, I want to know where to focus my sorrow and my hope. Additionally, knowing the joy my children’s individuality bring into my life can alternately increase the depths of my despair or bring me tremendous comfort.

  11. thank you for this post.

    i think the closing statement hits on the tragedy and heartache the best – miscarriage and grief is profoundly isolating because often we suffer anonymously. for whatever reason, for all it’s commonness – we still seem to suffer silently.

  12. Thank you for this, Sam.

  13. Thank you so much for your comments. You are fulfilling my hope that the comments would be better than the original post.
    #5. I blame my wife and my mother for any sensitivity or understanding I have about the human condition or people individually. They are most excellent teachers, and I thank God for them.

    AnnaJ and Alain, thank you for your poignant reminders of yet another dimension to this question–the complexly fluid and hopeful nature of family within Mormonism. You have increased my understanding.

  14. We lost our first pregnancy. We learned about how Christ feels to offer life and be refuesd, we wondered if I should have played basketball, we learned all sorts of things about my body, we lost a lot of that innocence, we started to realize how little control we have over procreation, we learned all sorts of ways we as a mormon culture ask in our probing “helpful” way so when are you having children? I bonded with the sister in laws and cousins as Grandpa gave me the talk about drinking more water so I could get pregnant. I was congratulated and praised for waiting until my husband graduated.

    Two things helped me the most.

    Madonna got pregnant. really. It was suddenly crystal clear in my mind that some things are biological and not righteousness based.

    My sister got pregnant. I couldn’t help but be so very very happy for her. It helped me be happy for others that I didn’t know as well.

    I only had a very brief recovery and wait-6 months which is the average time to the next preganancy…I can’t fathom what adding additional days and years and months would do.

  15. This is a striking, thoughtful song, Sam, thank you. I have struggled in the past to articulate ways of dealing with grief from a faithful but not clouded perspective–so your post is the sort of thing I have felt but that I may never be able to articulate myself.

  16. Ensign had never occurred to me, but you’re right in terms of advancing the conversation. I will talk to my wife and see whether she would have any interest in coauthoring something like this for that venue.

  17. I really do believe it could be a landmark publication. Based on the limited comments in this thread so far there seems to be a great need for this sort of thing to be disseminated among members of the Church. You have a great ability to incorporate scientific, cultural, and above all, spiritual elements in a way that will ring true and relevant to many people.

  18. Thanks to the commenters who have added their thoughts, too.

  19. My mother’s first four pregnancies ended in three miscarriages and a stillborn baby girl. My father has said more than once that I will never understand the depth of their grief the first few years of their marriage – or, at least, that he prays sincerely that we never do.

    Thanks for this, Sam. It is beautiful – and I second the motion to submit it for publication in the Ensign.

  20. Rosalyn says:

    Thanks for this thoughtful reflection on miscarriage. I miscarried not quite two months ago, and it was a profoundly emotional experience for me (I posted about it at Segullah: http://segullah.org/daily-special/miscarriage-and-miracle/). A friend sent me a copy of Sherri Wittwer’s Gone Too Soon, which I found really helpful, as she writes about miscarriage and stillbirth from an LDS perspective (and might be a useful reference if you’re thinking about extending the conversation here).

  21. JA Benson says:

    Loss of a baby you will never see, hold, or know in this life is a hard thing. Thank you Sam for your eloquent and thoughtful post.

  22. I just want to second BHodges suggestion that you submit this as an article for the Ensign. My wife and I have experienced two miscarriages (that we know of) in the short 2 1/2 years. We were blessed to have family and friends who supported us through this, but this message would have been a wonderfully blessed addition.

  23. My first miscarriage was an awakening of just how many women in my circle had experienced this loss that I had not been aware of until my own. The silence is one of the most baffling elements of this element of birth and death.

    My second miscarriage was a more complex affair. Due to a still undiagnosed complication, my body kept bleeding for months and months afterwards. Then the silence started to make sense. Who wants to talk about blood? And constant sadness? And a sense of grief not only for the child that is no longer but the growing sense of hopelessness that the child will ever have another chance to come to you.

    For the first time, I finally understood, on some minor level the woman with the issue of blood. The woman who had sufficient faith to simply touch His robe. And the clincher, the reminder that in the pressing crowd, the Savior felt, recognized and healed the *one* of the many.

    Unlike dear friends who have had miscarriage after miscarriage, infertility has not been my burden. I have four children, my last who I’d given up on, was conceived after these two losses. But I am grateful for the miniscule insight my miscarriages gave me into how the atonement can function. How healing can come. The metaphor of blood has new meaning for me.

  24. When my wife was laid up in a foreign hospital, deathly ill and heavily pregnant with our first child I thought, hoped, prayed even, that I had come as close as I ever would to losing a child. Luckily, she thrives to this day. Then only 2 years later I received a incomprehensible SMS while at work about the results of the first scan of our second pregnancy who’s words I’ll never forget “Lights are on but nobody home.” I also remember the almost unbearable sorrow and fear I felt that there was a child I would never know, as I sobbed away at my manager (who had miscarried herself several times). My wife outwardly held herself together better than I did but as the days stretched on and likely spontaneous clearance became likely D&C she started to fall apart. So much so that when she fell pregnant again she ignored the signs until there was absolutely no doubt that she was carrying a child, so that we missed the entire first 20 weeks of the pregnancy.
    I’ll never fully understand the pain of losing that you carry, just like I’ll never know the pain of childbirth. i can only hope to be enough a support for the one who carried the child that wouldn’t be.

  25. Thank you for opening up the discussion on such a poignant topic. As someone who has suffered a miscarriage and it now dealing with infertility, I am grateful to know that I am not alone in these struggles.

  26. Sam, Thank you for your post….I believe it will help those who are mourning a loss. Anita, this too brought tears to my eyes…and yes, 11 years later it still hurts. I especially appreciated the section about An Abortive Grief and Condolence. When I found out that our baby didn’t have a heartbeat, I instantly began questioning myself, what did I do? Was it because I ate soft cheeses? Maybe it was because I went in a hot tub or because I fell straight to the floor during fetus implantation on the uterine wall. I actually came up with 10 different reasons or ways I caused this miscarriage. The Dr. tried to assure me that I had done nothing wrong…and that one in 5 pregnancies end this way. I was fortunate enough to give birth to four live children. So, I guess when just looking at my situation, I fit the exact figures.

    One of the things that I found most difficult to manage was that I didn’t know the gender of my baby. I was only 13 weeks along when I learned of the loss. So, like Sam said, no name, no funeral, no momentos of any kind…yes, that to me was the most difficult. Not knowing and also not having anything to hold on to of that child, except for a much ANTICIPATED due date. My heart aches for those who have experienced a loss like this…and even aches more for those who have endured multiple losses. I just know how determined I was that I was going to try again. (My husband had a much different idea about that: he said it was God’s way of telling us we should be finished (we already had 3 living children). He is not LDS and believed differently..I think mostly out of fear since he didn’t want to endure that kind of loss again.) Fortunately for us, we were pregnant again by our “Angel” babies due date…that made some of the pain from that day more bearable for us. Please do not forget the pain that our spouses feel either. Yes, women feel the physical pain, but I think it can even be very difficult for men too…especially since men really don’t talk about these types of things…the man culture doesn’t lend itself to this too easily.

    Thank you for posting this article. My prayers go out to those who have experienced a loss like this,
    Trish

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