Doctors can help end the stigma around miscarriage
Miscarriage is very common – one in four pregnancies end in miscarriage – but most people suffer in silence, without their family and friends knowing about it. Most miscarriages happen in the first trimester, before women are ‘showing’ and before most people have announced the pregnancy. Once it’s happened, it can be too painful for people to share their stories, especially with people who didn’t know about the pregnancy in the first place. Yet this is the time they need support the most.
Unfortunately, doctors unwillingly and unknowingly contribute to the isolation and silent suffering around miscarriage because most tell their patients not to share the pregnancy news until after the first trimester. As a miscarriage and fertility specialist, this is how I was trained to counsel patients, and I’ve said it for years. When patients are thrilled with a reassuring first trimester ultrasound (that shows an appropriate size of pregnancy and a fetal heartbeat), we’re taught to share in the joy but ensure ‘cautious optimism’ and warn patients that miscarriage can still happen. When patients ask, “When can I announce the pregnancy?” we usually say, “Wait until after 12 weeks, just in case.”
Just in case of what? Just in case the pregnancy stops developing and you have to go back and tell all of those people you joyfully announced your news to that actually, you had a miscarriage. The doctor’s advice to wait to announce a pregnancy is given with good intentions and supposedly with the patient’s best interest in mind. However, after years of caring for women with recurrent miscarriage, I think that as doctors, we’re making things worse. When patients need support the most, they are suffering alone. This pattern contributes to the stigma around miscarriage, and we can change that.
Now when patients ask, “When can I announce the pregnancy?” I say, “When you’re ready” and “Consider sharing it with close friends and family first.” I care for many patients with recurrent miscarriages, and everyone is different. A new pregnancy for couples with recurrent pregnancy loss is a new opportunity to suffer – the joy of a positive pregnancy test is numbed by their past pain. I recommend seeking support and focusing on self-care during the process. Many are hesitant to share their miscarriages with family and friends because they aren’t sure what people will say. And people can (unwillingly and unknowingly) say unhelpful things like ‘It’s meant to be,’ ‘It’s God’s plan,’ ‘Be patient,’ ‘Just relax.’ However, my patients who do share will often find comfort in the outpouring of support and willingness of others to share their own experiences. Many patients discover that their own mothers, sisters, friends, and colleagues had miscarriages and had never shared because it just never came up or they didn’t know what to say.
Sharing allows for couples to feel less isolated, less ashamed about miscarriage. Sharing is not for everyone, but it can be a positive step towards decreasing the stigma and increasing awareness for how common miscarriage can be. People are starting to be more open about miscarriage, and we’ve watched several celebrities talk openly about their miscarriages: Beyoncé, Nancy Kerrigan, Gwyneth Paltrow, Courteney Cox, Celine Dion, and more.
A new Instagram account is all about sharing the experience of miscarriage: #IHadaMiscarriage. Dr. Jessica Zucker, a Los Angeles-based psychologist who had her own second trimester miscarriage, started the account and has had an overwhelmingly positive response from women around the world who are comforted by her message. To People, Dr. Zucker emphasizes “the more people share their stories, the more we continue to dispel the stigma and shame and feelings of guilt or even self-blame that can arise.”
Miscarriage is common, and it’s emotionally painful. Let’s stop hiding from it. The more we can share and support each other the fewer people will suffer in silence and the stigma around miscarriage can end.
Dr. Lora Shahine is the Director for the Center for Recurrent Pregnancy Loss at Pacific NW Fertility in Seattle and author of Not Broken: An Approachable Guide to Miscarriage and Recurrent Pregnancy Loss. Learn more and connect with Dr. Shahine at lorashahine.com, Twitter, Instagram, and Facebook @drlorashahine