Pregnancy and infant loss: breaking the silence to better support

Lightning doesn’t strike twice. We’ve all heard the saying before, taken to mean an extreme event won’t occur a second time after it’s been endured once. 

But the saying is a myth. In some cases, lightning does strike twice. And again. The Empire State Building is actually struck about 25 times every year1

Until this month, I didn’t think twice about whether or not lightning struck twice. 

My family is in the process of moving from Cleveland to Tampa and my husband and I spent the last two months house hunting. Before we started our home search, in what was the surprise of our lives, we found out we were pregnant. We have a 5-year-old, a 3-year-old, and after over a year of trying for a third child, we lost a baby this past Christmas after an ultrasound had confirmed a strong heartbeat. 

With the knowledge we were now expecting for a fourth time, we cautiously navigated the home-finding process. Do we look for a home with space for our family to grow into? A room for a nursery? An area for a basinet in our future bedroom? We wanted to be hopeful and plan for the best, but were reluctant after enduring the loss of a baby just nine months earlier.

I also hesitated to share the news of our latest pregnancy. As the days and weeks passed, we grew more confident in the idea we would get to bring this baby home and I started to let a few in on the secret. They met our news with excitement and well-intentioned sentiments: 

This is a different pregnancy, a different baby, and it will have a different outcome.”

Many women have healthy and successful pregnancies after a loss.

Lightning doesn’t strike twice.

Except for us, lightning did strike twice. The first time it struck sudden and violent, the second time it struck slow and silent. The day finally arrived for my husband and I to go in for an ultrasound of our fourth baby. The baby looked perfect but did not have a heartbeat. 

We had another miscarriage. 

A Future Dashed

When you have a miscarriage, you don’t just lose a pregnancy, you lose a baby. You lose a future you expected and planned for. A framework you had built up—dates earmarked, plans made, a specific house bought.

When you are suddenly looking at a future with one less person, the scaffolding is dismantled. A room planned for a nursery will not hold a crib or changing table. Plans are cancelled. Dates loom on the calendar—once filled with anticipation and excitement are now filled with dread and heartbreak. 

Losing these babies has been unexpected and disorienting. Their losses have upset our sense of balance, knocked us off our feet, and changed the course of our future. Our hearts and home expanded in anticipation of their arrival and now hold voids in their absence. The losses of these babies have been lightning strikes to our lives.

The first time you lose a baby, you don’t know how you will get through the shock and pain. The second time you lose a baby, the shock and pain are the same. It’s still just as devastating. But you’ve lived through it once. You know your heart will keep beating even though your baby’s heart stopped. You know life will go on even though your baby’s life will not. 

I no longer carry these babies inside of me and I will not get to carry them in my arms. Instead, I carry the grief of a stolen present and future. And I am not the only one who carries this. Approximately 1 In 4 pregnancies end in miscarriage2. 1 in 100 women will experience repeated miscarriages3. 1 in 160 women will live through the tragedy of stillbirth4. Chances are, you know someone who has lost a baby or have lost one yourself. And I am so sorry for your loss. 

More Than a Medical Event

Despite pregnancy and infant loss affecting so many, it remains largely undiscussed. According to a poll of 6,000 women conducted by the miscarriage-research nonprofit, Tommy’s, two-thirds of women who have miscarried say the feel like they can’t even talk to their best friend about it5. Women and their partners feel like they have to endure the physical and emotional tolls of losing a baby in silence, further compounding the grief, emotional, and physical distress they are experiencing.  

Rayna Markin, Ph.D is a licensed psychologist and leading researcher on the psychological experience of pregnancy and perinatal loss who partially attributes the pressure to not talk about the loss of a baby to the modern world view of seeing a pregnancy loss as not a psychological, emotional, or mental process, but as a medical event. 

Losing a pregnancy—losing a baby—has profound and far-reaching impacts on parents6, which Dr. Markin summarizes in her introduction for a special section of the journal Psychotherapy (Psychotherapy, Vol. 54, No. 4, 2017)7.

“Numerous studies have documented the devastating effects of pregnancy loss on parents, particularly on the mother, including chronic and severe grief that may extend for years, beyond the birth of a healthy baby, and does not follow the typical linear decline found with other types of grief, as well as symptoms of depression, anxiety, and trauma,” writes Dr. Markin. “Furthermore, after a pregnancy loss, women tend to report feelings of guilt, self-blame, a yearning for the lost baby, low self-esteem, and an increase in suicidal thoughts and obsessive–compulsive symptoms. Women have lost faith in their bodies, in the world as a fair and predictable place, and in others as a source of support and comfort.”

When society views miscarriage strictly through the lens of a biological process, it dismisses a parent’s deep grief and denies support for the myriad of potential health implications associated with pregnancy loss. Classifying a miscarriage solely as a medical event fails to see the mother as someone whose life has been irrevocably changed, further stigmatizes pregnancy loss, and silences the grieving. In these oversights, we are failing to support bereaved parents. 

A Call for Support

October is Pregnancy and Infant Loss Awareness Month, initiated in 1988 to cast light on the women, their partners, and the families who have lost babies and shared futures. 

Despite Pregnancy and Infant Loss Awareness Month first being recognized more than 20 years ago, drastic discrepancies still exist between patient needs following a miscarriage and current clinical practices. Women are responsible for seeking medical attention and coordinating care after the loss of a pregnancy while handling fluctuating hormones, grief, trauma, and the feeling that they can’t talk about their loss. Systems need to be created so women do not have to shoulder this burden in its entirety. 

The timing of care following the loss of a pregnancy has been shown to influence the degree of adverse physical and emotional health effects women experience8. With the knowledge that miscarriage is a significant source of psychiatric morbidity, mental health screening should be standard following the loss of a pregnancy. 

Counseling programs after a pregnancy loss are shown to reduce depression, anxiety, and stress in women with recurrent miscarriage9. Following a miscarriage, patients should be provided with resources to connect with licensed professionals who can offer appropriate treatment. 

Employers should allot paid leave for women and their partners who are experiencing the loss of a baby, which often requires a trip to the hospital, general anesthesia, and surgery. 

Finally, society should not shy away from parents who are navigating pregnancy or infant loss. We need to learn to sit with the broken-hearted, even if its uncomfortable. 

To change current practices and create better systems of support—both medically and socially—we must continue to raise awareness. 

How do we raise awareness of pregnancy and infant loss? By talking about it. We cannot create networks of support in silence. We cannot create healing environments in isolation. Which is why I am sharing my story of repeated miscarriages.

While my losses have left me empty in more ways than one, they have also made me who I am today: more compassionate and discerning. I find myself looking around rooms and counting heads. I wonder which women and their partners have endured the same losses my husband and I have. I know if a couple misses a holiday dinner, they may be recovering from a miscarriage. I know if a woman sends an email saying she won’t be calling in to a meeting due to unexpected surgery, she may be preparing for a D&C. I know a man who suddenly cancels work travel may be taking his wife to the hospital for surgery and grieving the loss of a baby. 

As we pack the belongings of our home in Ohio, I wish some of our future neighbors in Florida may know that the family moving during a global pandemic, also just lost their second baby in less than one year. 

Sharing stories of pregnancy and infant loss can be difficult, but it is necessary if we want to shape a society that supports grieving parents. Lifting up the voices of parents who have endured pregnancy and infant loss during the month of October is one place to start. 

Pregnancy and Infant Loss Awareness Month is punctuated by Wave of Light, a global event where everyone is invited to light a candle on October 15 at 7 p.m. to acknowledge all the babies who are not carried in the arms, but in the hearts of their parents. Please join me in lighting a candle to recognize the babies we have lost and all the others who are loved and missed. 

Sources:

1. https://www.noaa.gov/stories/5-striking-facts-versus-myths-about-lightning-you-should-know

2. https://www.who.int/news-room/spotlight/why-we-need-to-talk-about-losing-a-baby/unacceptable-stigma-and-shame 

3. https://www.acog.org/womens-health/faqs/repeated-miscarriages

4. https://www.cdc.gov/ncbddd/stillbirth/facts.html

5. https://www.parents.com/pregnancy/complications/miscarriage/why-its-important-to-talk-about-miscarriage/

6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4468887/

7. https://psycnet.apa.org/fulltext/2017-55835-005.html

8https://pubmed.ncbi.nlm.nih.gov/32550017/

9. https://pubmed.ncbi.nlm.nih.gov/33688267/

Spring Snow

I listened to the coffee percolate as I looked out the window at the wet snow that hung heavy on branches of spring blooms. Nine days until May and we woke up to nearly half a foot of snow. I wondered if the rose bushes that had started to bud or the clematis vine that had turned green would survive this late blanket of winter. Snow a month into spring isn’t unusual in Ohio, but a deep snow is. Two weeks ago, I sunbathed on my back patio in my swimsuit. Today, the same chair I had sat in with a book was buried under fresh powder.

My kids were moments from waking and my husband already gone to work. I sipped my hot coffee and took in the blue hue that washes everything moments before dawn on a snowy morning. A quick check of text messages and Instagram stories and it was easy to most were lamenting this late snow. And yet, I couldn’t help but feel a sense of peace about it.

I lost my third baby on the first day of winter and although it’s officially been spring for a month, the snow this morning felt like a reminder that while life will keep moving forward, the life of that baby will not be forgotten.

Miscarriage is such a deep well. It’s not easy to see what it entails and you often don’t know unless you’re right in it.

I’ve started and stopped writing about miscarriage many times since mine. I think this start and stop is rooted in a feeling that I need to have a complete and polished thought on what happened. A desire to write from scars instead of wounds. I’m realizing that miscarriage isn’t the kind of thing that has a final thought. It can’t be bundled up and contained into a neat package. I now recognize that miscarriage may be the kind of thing that ripples through the rest of a mother’s life.

My kids ate their breakfasts and begged to play in the snow. As much as I did not want to go outside in freezing temperatures at the crack of dawn, I also knew it may be the last chance I’d have to play in the snow with my kids at these ages. The last time I’d get to pull boots and hats and mittens on my 3- and 5-year-old. See them catch flakes on their tongues and lay on their backs with arms and legs outstretched, making angels.  

I felt peace about this unseasonably late snow because it seemed like some kind of poetic reassurance that things were going to be alright, but also because it felt like a mirror to parenthood, and life. You can plan and anticipate and set expectations, but life throws curveballs. And then the only thing you can do is pull on your boots and hats and mittens and embrace it. Things may not go as you planned or anticipated or expected, but they can still be beautiful.

A call to the creatives

Constant Moyaux. View of Rome from the Artist’s Room at the Villa Medici, 1863. Watercolour on paper, 11⅝ x 9 in. Musée des Beaux-Arts, Valenciennes. Réunion des Musées Nationaux/Art Resource, NY.

Creativity begins from a place of need—a desire to communicate an idea. Whether the realization of that idea is shared with others is at the discretion of the creator. Maybe they create only for themselves or maybe they create with the intent to share. A painting, an essay, a project made, music played or plans built—they’re all iterations of a response to a pull to see a thought in a tactile presentation. Brush strokes layered, words arranged, thread needled and stitched, materials sawed and bound together. Creativity is important because it is often these makings that look at a norm in a different light. Turn an idea on its head. Challenge patterned acceptances. Take something ordinary and make something extraordinary from it. It is this magic equation of transforming a feeling or idea into a proposal, if not a reality. And two things are necessary for it happen: time and space. These two things are really hard to come by as a work-from-home parent of young kids during a pandemic. 

I used to slip out to a coffee shop a couple times a month and had the time and space to sip a cup of hot coffee and write what I wanted—uninterrupted. I could step out of my regular space—the house where I’m mom and the home office where I’m a freelance writer—and into another where I could write what was on my mind. 

This need for dedicated space is why artists have studios. Carpenters have shops. It’s why a lot of writers write best early in the morning or late at night—when the demands of the ordinary aren’t immediate.

I worry that the pandemic is muffling the creatives. People who do not have any space from their ordinaries also do not have any space to create. 

A lot of creatives also need a transition time—a window where they can shift from the ordinary and into the making. 2020 has made it difficult to shift from the ordinary. A global pandemic, a much-overdue racial reckoning, social unrest, an election year—there is so much in the world that needs our attention right now, I feel guilty putting any time I can carve out into creative pursuits. 

But, I also believe now is the time creative thinking could be the most important. Art, music, words and design–all can bring us together. They all can connect us at the most basic level: as humans.

Maybe it is the creatives who are going to take the norms and force people to see them in different lights. Turn ideas on their heads. Challenge patterned acceptances. Take the ordinary and make something extraordinary. 

A call to the creatives: do not stop. Find the time and space. Even when it feels hard–or impossible—or you feel guilty to be putting pen to paper, brush to canvas, fingers to keys, needle to thread, saw to wood. Explore the feelings, communicate the ideas, do whatever it is you do to create the magic that could connect us all once again. 

I’m a mom, feminist, and fan of J. Lo and Shakira’s Super Bowl halftime show

The Super Bowl is broadcast in over 130 countries in 30 languages. Viewership estimates for the 2020 game range between 99.9 and 102 million, making it the tenth most watched game in Super Bowl history. With that many people tuning in around the globe and so many brands using it as a platform to promote their products and services, it is undeniably a cultural touchpoint.

Fox reports that 103 million tuned in for the 2020 halftime show—over a million more than actually watched the game.

My husband and I recorded the game with plans to start watching as soon as we got our two-year-old and three-year-old to bed for the night. We finally turned it on around 8 p.m. but by 9 p.m. I was so tired, I went to bed. 

When I woke up the next day I immediately saw online chatter of the halftime show and as the morning went on I heard more from parents in our community. 

Parents who watched with their kids or hosted watch parties for their children and their friends were left flabbergasted during the performance. Do we turn it off? Let it play? Valid questions for any parent to have, especially if children other than their own were in the house.

I finally got a chance late Monday afternoon to watch the show. Initial takeaway? I liked it. As the day and week went on, I read articles pushing for a parental warning for future halftime shows, listened to Alt.Latino radio unpack the show, and discussed it with friends and family. 

While a warning or rating can, of course, help a parent decide whether or not to let their children watch the halftime show in their own home, it won’t prevent school-aged kids from hearing about it the next morning at school, at a practice the next afternoon, or seeing it on YouTube or news loops for the next week. With 103 million people seeing the show in real time, it’s going to be talked about. 

When Janet Jackson’s “wardrobe malfunction” occurred in 2004 I remember it being the talk of the high school halls the next day. I did not watch the halftime show that year (I’d, once again, gone to bed early). But, in 2004 our high school selves didn’t even have our Motorola Razrs yet (they didn’t hit the market until the third quarter of that year). So, the wardrobe malfunction was largely contained. It wasn’t at our fingertips to search, pull up, and watch and discuss among our peers. Today, the average age at which a child receives their first internet-enabled cell phone is 10. Even if your child does not have a cell phone, they likely have a peer in a class or practice who does. The halftime show is accessible long after the game is over and when parents won’t be there to police it.

As a parent, I would rather have my children watch the halftime show with me. Where I can guide the conversation, provide context, and answer questions they might have.

Sure, there were elements of the show I wouldn’t have chosen to have performed exactly as-is, but it wasn’t my show to choreograph. And that is a lesson in and of itself: the artist gets to decide the scope of a performance, not the audience. 

Ultimately, J.Lo and Shakira’s halftime show was a performance of empowerment. It was a celebration of culture and women. A championing of career. A call to be who you are, unapologetically.

Songs from across their decades-long careers were included in the mash-up and cultural nods were peppered throughout the performance. Shakira’s widely-memed tongue-flicking is an act of celebration in Lebanese culture called zaghrouta. Their clothing and dancing echoed carnival celebrations throughout Latin America (also already seen by and introduced to any kid who has watched the animated children’s movie Rio). This attire also was not new or atypical for Shakira and J. Lo performances. A concerned parent can do a quick search on announced performers and see previous shows. And as far as a “family-friendly” expectation for the Super Bowl goes, I’d be curious as to know whether parents are discussing the rap sheets of some of the athletes competing in the NFL (past and present). And bottom-line? Women can wear what they want. 

Shakira and J. Lo are two of the most-recognized Latinas in the U.S. and yet xenophobic Americans still only want to view them through a specific lens—a belief that J. Lo and Shakira should only perform in ways that Americans deem to be “appropriate” or “acceptable.”

When J. Lo brought her daughter on stage, started with Springsteen’s Born in the USA, and launched into Let’s Get Loud, I got chills. Jennifer Lopez and Shakira’s performance is ushering in the next-generation of Americans to a more accepting society. A place where what you wear, where you come from, and what your gender or sexuality is, does not dictate what you accomplish or who you become. 

This was a performance about being you–with pride, of not forcing yourself to fit into someone else’s prescribed notions or expectations for their comfort. All things I want to teach my children (along with discussing the elements of the show I could’ve done without) when they’re old enough to stay up for the halftime show, and I can stay awake long enough for it too.

So, yes. Let’s get loud. 

Not now doesn’t mean not ever

Raising a two-year-old and three-year-old, we talk a lot about patience in our house. Usually hourly. They want a juice box, the toy the other one is playing with, to watch a show. It’s not the commonplace things they have trouble waiting for, but those that are special, exciting. A treat.  

We talk about waiting our turn: “you will get it, but not yet.” We talk about asking nicely and not whining. And we expect that one day this will all click and we will no longer need to have these conversations. 

But last night I realized I probably need to be having these conversations with myself. 

Why do we expect toddlers to wait patiently when we still haven’t seemed to have mastered this skill as adults?

Sure, by the time we’re adults we’ve learned to wait for our food at restaurants, for our turn in line at the BMV, and even for the weekend–all of which are commonplace things. But what about the bigger items? Those that are special, exciting. A treat.

An essay I wrote was accepted for publication last month. Which was exciting at first but the longer I’ve had to wait to see it in print, the more restless I’ve become.  

This kind of impatience isn’t just contained to career. Some of us could be waiting on friendships, test results, perceived milestones for ourselves or our children, a home. 

In the face of rejection and silence it can be easy to believe that this is how it will always be—especially when the disappointments stack up. We forget, just because something isn’t happening right now, doesn’t mean it will never happen.

It’s usually the things that are special, the ones we want the most, that are the hardest to wait for. 

So, when the weight of another let down, missed opportunity, or heartbreak hits, do not be fooled. This is not how it will always be. Not now doesn’t mean not ever. There are more tomorrows ahead. Plenty will be filled with disappointments and rejections but plenty will also be filled with victories. 

Our turn is coming. It may not look how we initially thought it would, it may not come when we want it to. But it will come. We just have to be patient.