Making Room for Miscarriage
After I miscarried my first pregnancy, I quickly realized that I needed a historical perspective to make sense of this shockingly unexpected and distressing event. Before I got pregnant, I had no idea that around 20% of confirmed pregnancies miscarry, mostly in their early months, and that miscarriages are a normal part of childbearing for healthy women. Once I understood the statistics, I was appalled by how many pregnancy “experts,” from pregnancy manual authors to pregnancy website marketers to my midwife, had encouraged me to bond immediately with a pregnancy they knew might not last. How did such a misleading and damaging expectation of perfect pregnancies, in the face of statistical reality, come to be?
In my new book The Myth of the Perfect Pregnancy: A History of Miscarriage in America, I set out to write the history of our modern culture of childbearing in the US, and how it has produced our expectation of perfect pregnancies. I explored everything from the history of birth control, to changing parenting ideals, to the rise of prenatal care, to increasingly savvy marketing, to the abortion debates. In each of these aspects of American culture, I saw a steady trajectory over more than two centuries. Much of the change was positive. Striving for control over conception has led to modern birth control and women’s right to make decisions about their bodies. Emphasizing loving attachment between parents and children has resulted in more fulfilling parenting. Modern prenatal care has meant healthier mothers and babies. Consumer culture has brought some nifty baby gear.
But I could see that each of these cultural trends, when pushed beyond what science, medicine, and human bodies could guarantee, has led to unrealistic expectations of perfection, and inevitable experiences of disappointment and failure. Grief over early pregnancy losses is the epitome of this distress.
At the time I miscarried, in 2003, American childbearing culture already seemed overwrought to me. Websites were beginning to send out e-newsletters, pushing women to learn about embryonic development on a weekly basis, timed to their personal due date. It seemed ridiculously fine-grained, even obsessive, compared with the monthly sketches in my paper pregnancy manual. In Berkeley, where I lived at the time, the trend was for women to preserve their pregnancy memories in the form of a decorated plaster cast of their pregnant bellies. In comparison, I only had a few photos of my mother pregnant, and only incidentally, in family photos with older children. I knew a few women who had received ultrasound scans at 8 weeks, much earlier than the usual 18 weeks, even though they had not had any complications, just because they had fancy obstetricians who served wealthy communities. “How much more extreme could it get?” I thought. Boy, was I naïve.