Why don’t we talk more about miscarriage? Why don’t we have these conversations with our friends over lunch or after our spin class? Why don’t we have honest conversations about the grief of pregnancy loss in the office staff room with our male friends and colleagues or with our mothers and sisters on the living room sofa?
It doesn’t make sense when so many women have experienced a miscarriage. 1 in 4 of us, to be exact. 1 in 4 of us have experienced when the ecstatic joy from a positive pregnancy test is replaced with the heart wrenching low, as we hear the confirmation that the new life growing within us is no more. This often comes with a crushing and life changing sentence, “Sorry X.....There is no heartbeat....I am very sorry.” If we haven’t experienced it ourselves, we surely all know of someone who has, and yet, we just do not talk about it. Why not?
We also all know of someone who has been touched by the horrible scourge that is cancer but we all talk about that and rightly so. We talk, we commiserate, we get angry and we rally against the disease. We run marathons and we raise money. Through all of this we increase awareness, make new medical discoveries and we push the boundaries for treatment and care. We change lives. We achieve this through open discussions about how cancer touches and impacts our lives and by making individual pain, society’s pain.
This just doesn’t happen to the same degree for miscarriage. It is always interesting to see that fertility issues primarily affecting women tend to be among the least discussed medical concerns in the general sphere. This is particularly true for miscarriage and ectopic pregnancy. For a nation that likes to talk about everything from our latest obsessions on Netflix to the cute contestant and their dog on Britain’s Got Talent, we can be deafeningly silent on this issue.
Could it be that we have a collective shame about what we continue to perceive as a “failure’ of women’s bodies? Maybe it is because society subconsciously still subscribes to the idea of a women’s role being solely that of life giver that we find it hard to imagine an alternative. Could it be that we believe open discussions may leave us vulnerable to being the next victim of a scenario that we never want to experience ourselves, like catching the flu? Most likely we just do not know what to say. The silence betrays our feelings of inadequacy and helplessness. Those of us working in early pregnancy understand the severe impact that miscarriage also has on a woman’s partner - for men in particular, there are even less resources and support for dealing with their grief - but for so long when a woman has been unable to conceive, the burden of responsibility has been placed squarely on her shoulders. With miscarriage, individual pain is not wider society’s pain.
Thankfully, medicine has progressed a great deal and there are many in the world of fertility, recurrent miscarriage and early pregnancy that are working tirelessly to improve the outcomes for women and their partners who are struggling to conceive and to give women a voice. An example of this is the excellent #misCOURAGE campaign by Tommy’s, that encourages women to share their stories of miscarriage and in doing so, shines a welcome light on a common but traumatic experience for many.
But where are we as general society? In maintaining the silence, we perpetuate the wrongful feeling of shame. We celebrate new life with our pink and blue balloons and ever elaborate baby showers. We admire and attempt to copy the new fad that is the ‘gender reveal’ posts for our Instagram feeds. We openly acknowledge the “Baby on Board” badge with a congratulatory smile and an offered seat; but we are slow to acknowledge those coping with miscarriage and an as yet, unrealised dream.
When so many of us will experience a miscarriage in our lifetime, it always seems crazy to me as a gynaecologist, that knowledge and awareness surrounding miscarriage is severely lacking. Often, the first time anyone hears of miscarriage, is when they unfortunately experience it firsthand for themselves. I am always astounded to hear women incorrectly take the onus of blame upon themselves. “Maybe it was the curry I had last night, the yoga class or my stressful work deadlines....” None of these assertions are true but by keeping the silence we may never rid ourselves of these false beliefs and learn the truth.
By limiting our discussions on miscarriage, we allow women and their partners to carry their pain in silence whilst the rest of us continue to remain in ignorance. Through our lack of open discussion we fail to be frustrated at the slow pace of medical research and development in this area and the status quo remains. This is a shame because there is still so much to talk about. Despite its commonality, we are still far from understanding why miscarriages occur and even further away from effectively preventing them. Maybe if we talked more about miscarriage, we may stop seeing it only as a problem for the affected women and more as a collective dilemma to be solved. Only then, we may finally get to a place where we fully understand why so many couples experience miscarriage and more importantly, be able to do something about it.