Trigger warning for miscarriage.
I spent decades in abject terror of an accidental pregnancy. When my husband convinced me it was time to try for a baby, it was jarring to have my mindset spin 180 degrees and think, “Oh, shit – what if I can’t get pregnant? And then what happens if I can’t stay pregnant?”
Despite having a mom who aspired to be a fertility goddess, I knew the statistics.
One out of every three pregnancies ends in a miscarriage.
Almost every woman I know has had a miscarriage.
Some are practical and resigned, like my Judgmental Genius Doctor Sister. She told me about the fetus dying and having to remove it via a D&C. When I expressed sympathy, she said, “It’s okay. The fetus just wasn’t viable. It’s common.” Dr. Sis, though, had both medical training and a most fecund family history to help console her. She was still in her early 30s, with plenty of time for another pregnancy before age 35, when the risk of birth defects increase exponentially.
For the women who are older, or the ones with fertility issues, miscarriages are devastating. One of my relatives by marriage took years to get pregnant. When she miscarried during her first pregnancy (in her mid-thirties), she and her husband had to put on their happy faces every time they saw their pregnant couple-friends. They soldiered through months of congratulations to parents who had infants the same age their miscarried child would have been.
They were admirably tough. I suspect I would have been sick or had a surprising number of “work emergencies” that coincided with baby showers and christenings.
Most heartbreaking of all was my friend M. M married Frenchie two months after my wedding. Baby prep commenced within the year. By the time Andy and I were thinking about kids, M had miscarried five times.
Five goddamned times, each more painful than the last. Her sorrow was exacerbated by enduring loss in a nearly solitary bubble of shame.
People don’t talk about miscarriages. Maybe it has to do with our puritanical American culture, where a glimpse of a bare breast is grounds for a national hissy fit. Bodies are taboo, especially women’s bodies, with their messy monthly bleeding and breast milk.
Wanna know what’s mindfuckingly hypocritical in America? Conservatives freaking out over public breastfeeding while legislating mandatory vaginal ultrasounds before allowing abortions: “Don’t you dare show us your boobs but we’re allowed to stick this wand up your vagina.”
Maybe we don’t talk about miscarriages because of our national obsession with triumph. We celebrate every American Success story and ignore our national tragedies such as poverty, homelessness, and drug addiction. (Also lead in drinking water.)
If a woman isn’t successful at getting pregnant, she’s expected to keep her misery to herself. Which is ludicrous, considering the 33% fetal failure rate. Everyone – including men – should be as aware of the odds as Dr. Sis. Maybe then women would feel more support and less shame.
Like most women, M kept her miscarriages a secret. If she knew something was wrong, she left work quietly. Then she sat in the obstetrician’s office, crying behind her sunglasses while looking at all the happily rotund, still pregnant women.
She only talked to me and her husband about the agony.
M created a secret garden in her backyard, buying a little decorative fairy after every miscarriage. “It’s how I think of them,” she told me. “With wings. One even looks like me.” In the winter, M brought the fairies inside.
When M first told me about the fairies, I cried. So did Frenchie. He begged her to give up on a baby, saying it was too much for anyone to endure.
But M is a fighter. She didn’t give up. She found a reproductive immunologist who specialized in recurrent pregnancy loss. And she discovered that, unfortunately, her immune system was just as much of a fighter as she was. M had an above average number of “Natural Killer” cells – and those NK cells were killing the fetuses.
M also had a common gene mutation that can cause deadly clots in the placenta or umbilical cord. Physicians refer to the gene by the name of the enzyme it creates: methylenetetrahydrofolate reductase, or MTHFR.
Women affected by the gene generally – and bitterly — refer to it as “that motherfucker.” Once they know they carry the gene, however, pregnant women can be treated with blood thinners such as Lovenox.
M found that hopeful. She also learned of a recent treatment using intravenous immunoglobulin that looked like a promising method of regulating her NK cells.
After M had done this research, she attended family reunion. M’s immediate family is unusual, since her father’s second marriage — to M’s mother — occurred when he was seventy. She had septuagenarian sisters at the reunion. When M shared some of her genetic discoveries with her middle-aged niece, her niece said, “Oh, yeah, that makes sense! Your older sister had at least a dozen miscarriages before getting pregnant. And I had at least five miscarriages.”
M said, “Wait, what?! I had no idea! How come I didn’t know? That information would have been useful five pregnancies ago!”
Her niece shrugged. “You know we just don’t talk about those things.”
M went home and wept in her garden for all her “might-have-been” babies – and all the other mothers with NK cells, motherfucking genes, and silent relatives.
Since that day, M no longer hides the stories of her miscarriages. If the subject of pregnancies or fertility comes up, she tells people about her struggles.
Maybe the end of the silence will mean the end of the stigma.
Maybe it will mean more information for pregnant women.
And fewer fairies.