I Navigated the Grief of My Second Trimester Miscarriage by Widely Sharing My Story

An excerpt from Normalize It: Upending the Silence, Stigma, and Shame That Shape Women's Lives

Psychologist Jessica Zucker explores the impact of talking openly about her miscarriage in her new book NORMALIZE IT.

Sixteen weeks into my second pregnancy, I had a miscarriage, alone at home on an otherwise unremarkable autumn afternoon. I had officially entered the supposed “safe zone” of the second trimester, the point in pregnancy where risks of fetal complications and loss drop dramatically. By the time I saw bright red blood, I was certain I was “out of the woods.” I had finally begun to wrap my mind around the idea of having another child. My husband and I were excited to introduce a newborn into the confident rhythm we had established with our three-and-a-half-year-old son. It was the beginning of one of the most devastating and profound experiences of my life.

As a clinical psychologist who specializes in reproductive and maternal mental health, I was well aware that up to 1 in 4 pregnancies end in miscarriage. I knew the heart-wrenching reality of that experience as well as I could without having yet lived through it myself. Throughout my own pregnancy, I’d listened to heartbreaking stories of pregnancy loss, including chemical pregnancies, ectopic pregnancies, twin loss, infant loss, stillbirths, and terminations for medical reasons. I’d sat with countless women as they processed their grief, how their histories and experiences compounded those feelings, and how the unfortunate silence, stigma, and shame that so often follow pregnancy and infant loss heightened their pain. Now, however, my theoretical knowledge of the experience became corporeal.

Despite the fact that up to 25 percent of known pregnancies end in miscarriage (the actual number being likely much higher due to chemical pregnancies and underreporting), research shows that a majority of women feel a sense of shame, self-blame, and guilt in the aftermath of pregnancy loss. Cultural ideas about women’s bodies and patriarchal messages have wormed their way into women’s own perceptions of themselves, firmly planting the idea that if we haven’t “successfully” carried a healthy baby to term, our bodies must be somehow defective or inadequate, or we must have done something “wrong” to cause the loss. However, most miscarriages are the result of fetal chromosomal abnormalities, not the result of anything a woman did or didn’t do. Despite this, a national survey found that people believed miscarriage could be caused by going through a stressful event (76 percent of responders), lifting a heavy object (64 percent), previously having an intrauterine device (IUD) (28 percent), or taking birth control pills (22 percent). The misconceptions surrounding miscarriage get even wilder: The survey found 21 percent of people believed it could be caused by getting into an argument, 7 percent thought it could be caused by moderate exercise, and 4 percent thought it could be caused by having sex.

In my practice, I’ve found that the impulse to blame ourselves is often about perceptions of control. If I did something wrong and this is my fault, that means maybe I can do things differently the next time around and therefore change the outcome. There is shame in those thoughts, but perversely, there is also a sense of agency. That grasp for control is closely related to the cultural stigma attached to pregnancy loss that prevents women from talking about it openly and breeds isolation and misinformation. But when women know the facts about miscarriage and why it happens, they are less likely to blame themselves.

We live in a culture that tells women that so many of the challenges they face are somehow our fault and that whatever we’re feeling about those challenges should be kept quiet. That cultural message often keeps us from talking about the most important and real experiences in our lives, overwhelmed by the fear that if we do speak our truths, we will be met with stunned stares or awkward lapses in conversations. But in the absence of real, nuanced, and sometimes messy conversations about the truth of our experiences, we feel ashamed and often end up turning our pain inward, convinced we should be able to swallow it and push through.

Even as someone who fully believes in the importance of talking about stigmatized issues like pregnancy loss, sexual trauma, anxiety and depression, and aging, I know from experience that doing so is hard. There’s no single source of the pressure to stay silent about these taboo subjects; it’s in the water, so to speak. Women go through so many potentially momentous transitions over the course of their lives, inhabiting many roles and navigating continually changing bodies while fielding messages from a culture hellbent on telling them how to look, how to feel, how to act, how to be at every available opportunity. In so many moments in a woman’s life, there’s an insidious whisper: This is too messy. Don’t talk about it.

It is no surprise that shame is often woven throughout the details of my patients’ stories, adding an additional layer of pain to their experience. Time and time again, I’ve seen women open up about insecurities, anger, loneliness, trauma, and other complex feelings they haven’t shared widely before, for fear of how their emotions would be received. In my work, I am privileged to have the opportunity to help women sensitively untangle their stories from the shame that so often surrounds them. I am privileged to see—and even more so to feel—the revolutionary power of what happens when they break through the pressure to stay quiet and instead normalize talking about their experiences.

I experienced this firsthand after my miscarriage. Throughout the ordeal, my innate impulse was not to stay silent, but to connect. As the miscarriage was happening and in its immediate aftermath, I texted my family and closest friends: I had a miscarriage. I was open about the emotional and physiological pain of navigating what turned out to be full-blown labor alone at home, having to cut the umbilical cord myself, hemorrhaging, and undergoing an unmedicated dilation and curettage (D&C). I was candid about my milk coming in, looking pregnant for days following my loss, the bone-chilling all-day anxiety. I didn’t keep it in; I let it out.

In the years since my loss, I’ve spent a lot of time reflecting on why I didn’t feel the searing sense of shame and the impulse to self- blame that so many women do in this dark and disorienting period. Part of it, I’m sure, was that I knew I had sturdy support around me: my husband, family, friends, colleagues, a therapist. My training as a psychologist may also have helped bolster my natural rejection of the shame that so often surrounds pregnancy loss, not to mention the years I had spent talking about this very shame with patients in my practice. I had learned from the hours upon hours of hearing women’s stories and helping them process their feelings about the full spectrum of emotions surrounding loss: anguish, anger, fear, dread, hopelessness. Through working with these women, I saw firsthand that we bring our own personal histories to our grief—in other words, it’s learned. The fact that I didn’t reflexively feel the impulse to blame myself for the miscarriage underscored that this shame is not necessarily innate.

But while I knew my miscarriage was not a failing of my body, that I hadn’t done anything to deserve or bring about this outcome, this knowledge could not protect me from the societal stigma. My need to connect over it was instinctual, but reactions from other people made me second-guess myself. Should I not have shared? Were the details of my loss too much? Should I be over this by now? In the weeks after my loss, a friend inquired about how I was doing, and I asked if she wanted to see photos of the daughter I’d just recently lost—another friend, a midwife, had met me at my doctor’s office amid this torturous event and had the foresight to take photos following the D&C procedure, knowing I might one day cherish the images as a testament to my child’s brief existence. She was here. She was mine. My friend said she did want to see the photos, but upon seeing them, she recoiled, a look of horror and fear on her face.

I was blindsided by her reaction. At the same time, I found strange comfort in knowing that I was not alone in experiencing that prickly sense of alienation. I knew that millions of women worldwide were familiar with that deep ache.

Fortunately, I had a dedicated place in my life to talk about both my experience and the societal stigma around it. One of the first phone calls I made the day after my miscarriage was to my therapist, Valerie. Therapy offers a space to fully unpack feelings, understand the roots of those feelings, and feel seen and understood. It can also be one of the most powerful spaces from which to begin normalizing these stigmatized issues, and not only because therapy is a safe place to talk about them. By harnessing the power of neuroplasticity—the process by which experiences and feelings influence the actual structure and functional ability of the brain—talking with a trained professional can literally change our brain chemistry, allowing us to better handle fear and difficult emotions and gain confidence.

Exploring my multilayered grief with my therapist on a weekly basis was nothing short of sacred. She bore witness to the ebb and flow of the ever-so-sharp feelings that poked and prodded my days in the aftermath of my loss. I was technically postpartum but my arms were empty, and I was hit hard by my body’s hormonal changes. Valerie was with me every step of the way, validating the spectrum of feelings I experienced, empathizing with the intense pain that washed over me, listening to my outrage as people spewed ill-fitting platitudes. This ritual of 50-minute sessions strung together over weeks and months was vital to my healing and emboldened me to honor my loss by talking about it.

The antidote to the shame and stigma that shapes women’s lives is to replace silence with telling our stories. Intimate conversations like the ones that take place with a trained mental health professional are among the most essential ways we can address stigma and shame in our own lives, whether we go into the session with that objective or not. But what if we could create safe spaces to talk outside the walls of a clinician’s office?

Talking about our experiences and addressing the complex feelings that surround them doesn’t necessarily have to be shouted from the rooftops. You don’t have to blast it out on social media or write about it in a book with the hope of shifting the cultural landscape. I’m simply advocating for us, as women, to begin talking about the things that we don’t talk enough about, to normalize conversations about the things that make us feel alone. Mustering the courage to crack open the door to the unpolished truth of our lived experiences has the potential to be both personally and culturally transformative.

When I got on the phone with Valerie the first time after my miscarriage, I felt numb. But as I recited the heinous details of the experience, my initial numbness morphed into something else entirely: relief. I articulated my chaotic feelings and discussed how best to care for myself emotionally, and for me, talking felt like a lifeline, an essential way to process the trauma I’d been through. Although I’d never know the baby I was no longer carrying, I wanted to acknowledge her brief existence, the moments when I’d held her in my window-clad, blue-tiled bathroom after my doctor instructed me over the phone how to cut the umbilical cord. This meant something to me. How could it not?

What I didn’t expect, however, was how much talking about this experience in therapy would help normalize these conversations with other people in my life, including conversations with people about the unintentionally hurtful comments that came my way in the wake of my loss. There was one friend in particular who’d gone down the “at least” rabbit hole with me mere hours after my baby fell from my body—At least you have a healthy child, at least you know you can get pregnant, at least you’ve got a thriving career. I knew she’d been well-intentioned, but I didn’t want her lack of knowledge about what I was feeling to create additional hurt for me. When I spoke to Valerie about this interaction, I was allowed the space to really think through how I felt, what I wanted to convey to my friend (and others like her) and why.

This preparation gave me new insight into the roadblocks to vulnerability that stop women from sharing their stories. I could articulate how the “at least” cycle of thinking undermines the legitimacy of a traumatic experience and shuts the other person down, even when that was not the intention. I could express what would be more supportive: being present, checking in to ask how I was doing, not trying to make me feel better or hurry my process along but just being with me in the whiplash of it all, side by side, relating over the hard stuff.

My friend got it and appreciated the feedback. She thought focusing on the “good” things happening in my life would help balance out the excruciating anguish of the loss. I explained that I was still very aware of the wonderful things I had in my life and that this loss didn’t erase that beauty, but I had to sink into the pain because the pain was searing. She understood that. Following our conversation, she showed up in such sensitive and loving ways.

I knew talking about my miscarriage was a necessity for my personal healing, but talking about it also changed the course of my professional life. The trauma was seared into my psyche in the same ways that so many other women’s experiences shaped them. I wanted to somehow make a dent in the societal silence, to investigate why women were prone to blaming themselves and thinking their bodies had somehow failed. I wanted to reach women who wouldn’t necessarily sit in my office. I wanted a zeitgeist shift.

I know from my own experience and that of my patients, as well as a well-established body of research, that when we don’t allow ourselves to feel whatever it is we are truly feeling, we suffer more. Moreover, I’ve learned—through reading piles of books, sitting in seminars en route to completing my doctoral degree in clinical psychology, and through day-to-day life—that feeling our feelings in their entirety and speaking those feelings out loud makes space for essential insights, new pockets of peace, and, ultimately, the eradication of silence, stigma, and shame. The more we speak up about our hardships, our struggles, and our pain, the sooner we usher in the change we need . . . and deserve.

Adapted with permission from Normalize It: Upending the Silence, Stigma, and Shame That Shape Women's Lives by Jessica Zucker, PhD (PESI Publishing, Inc.).

Jessica Zucker is a Los Angeles-based psychologist specializing in reproductive health and the author of the award-winning book I HAD A MISCARRIAGE: A Memoir, a Movement. Jessica is the creator of the viral #IHadaMiscarriage campaign. Her writing has appeared in The New York Times, The Washington Post, New York Magazine, Vogue, and Harvard Business Review, among others. She’s been featured on NPR, CNN, The Today Show, and Good Morning America and earned advanced degrees from New York University and Harvard University. Her second book, NORMALIZE IT: Upending the Silence, Stigma, and Shame That Shape Women’s Lives, is out now and available everywhere books are sold.