As a psychologist who specializes in women's reproductive and maternal mental health, I sat with women for nearly a decade listening to stories of heartbreak and hope, before experiencing my own 16-week miscarriage in 2012.
Nothing could have prepared me for the confounding pain that followed. All the books I had read, my half-a-decade of clinical training, my years prior working in public health: none of this knowledge could buffer the cataclysmic emotional toll my miscarriage took. I was home alone on that October afternoon when my baby fell from me. I proceeded to cut the umbilical cord (coached by phone by my obstetrician) and promptly began to hemorrhage. Upon arriving at my doctor's office, I underwent an emergency unmedicated D&C (dilation and curettage). It was a stunted hello and a goodbye that continues still; I think about this trauma and the loss of my daughter almost daily.
No less complicated was the experience of learning I was pregnant again several months later, while still processing my loss: How should I share the exciting, albeit tenuous, news? How do other survivors of pregnancy loss see me? Do I still have a right to my grief?
I was reminded of these quandaries—ones I experienced myself and counseled patients through—when I read Leandra Medine’s post on Manrepeller today, carefully sharing her long-awaited news of a healthy pregnancy after writing about her fertility struggles and pregnancy loss candidly. In it, she acknowledges just how complex it was to be awash with envy, sadness, even hopelessness amid a sea of burgeoning baby bumps, wondering if she would ever be "happy again," before her healthy pregnancy. She reflects on her circuitous course and wonders how her pregnancy announcement will land on those who are still struggling. And most of all, she captures the painful ambivalence about sharing "good" news after opening up about "bad" news, due to the associated guilt and worry.
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After my miscarriage, I was acutely aware of how other people might internalize it. Rendered more apt to understand my patients' experiences now more than ever, I worried about how my loss would affect them. On the one hand, my patients reported feeling like I probably could understood their pain all the more. On the other, my loss—the fact that it could happen to me (the proverbial untouchable psychologist) and in the second trimester—scared the wits out of many of them. They wondered aloud: "If this can happen to you, this can happen to me," and "Did this happen to you because it happened to me?"
A handful of months later, when I became pregnant again, my petite frame made it impossible to miss even an 8-week bump, and they didn't. They knew, and we talked openly about the myriad feelings that emerged. We acknowledged that my pregnant state could in fact change at any time. I shared with my patients about my fears and about my longings to have this pregnancy last. Thoughtfully, I aimed to model for them that no amount of vulnerability can steal joy. In other words, opening up about our hopes doesn't make us more apt to losing them. I vacillated between terror and joy in that subsequent pregnancy, aware that being "out of the woods" is merely a construct.
I remember how concerned I was about my patients' resulting feelings of this new life growing inside of me. It ran the gamut from momentary guilt to wanting to protect them from my ongoing grief and newfound excitement to wanting to remain that solid tome of empathy in their lives. They had come to appreciate my empathy, knowing that I felt a similar pain. But was my grief now somehow less than theirs? I certainly didn't feel that way.
Here's what I know now that I wish I knew then: My pregnancy loss will always be a part of my story. Giving birth to my healthy daughter was, without doubt, life-changing. And yet, the swells of suffering I experienced after my miscarriage didn't exit my body when I gave birth to my daughter. The anxiety, the PTSD even, took hold and didn't simply dissipate when happiness returned.
Nor should it. Death, I learned, is as big a part of life as birth. My joy was laced with grief, and vice versa. Research has found that a majority of women report feeling a sense of shame, self-blame, and guilt following pregnancy and infant loss. And in 2014, in effort to create a culture in which loss can be dealt with more candidly and compassionately, I became an activist. I wrote my first New York Times piece about my miscarriage and launched the #IHadAMiscarriage campaign, and I have continued to encourage myself and others to replace silence with storytelling.
I found a sense of support and belonging in raising my voice and shedding the shame. And I now understand that I can rejoice in the birth of my daughter—without letting go of the deep hurt that became a part of me when I had a miscarriage. I try to actively challenge the pressure to arrive at a "happy ending." Grief can color our world completely. We might see things differently and, sometimes, no less beautifully. We needn't compare or contrast losses because there is no hierarchy of grief.
It takes unabashed courage to walk the vulnerable line of publicly sharing the experience of pregnancy loss. But upon opening up about our nascent experiences of grief, we often find our tribe.
Jessica Zucker, Ph.D., is a psychologist, writer, and activist based in Los Angeles.