Nursing Clio

Nursing Clio is honored to have Carrie Pitzulo as our guest author today. Carrie is an Assistant Professor of History at University of West Georgia, where she teaches courses in the history of American women, gender and sexuality. Carrie received her Ph.D. from the City University of New York Graduate Center in 2008. Her first book, Bachelors and Bunnies: The Sexual Politics of Playboy, was published by the University of Chicago Press in 2011. Carrie’s current project explores the role of women and gender in the nation’s last public hanging.

Recently, Marjorie Ingall, writing for the Tablet, discusses the complicated – but sometimes very simple – feelings women have about their abortions or miscarriages. In “My Abortion, My Miscarriage, and My Right To Have My Own Feelings,” Ingall presents a sensitive, levelheaded rendering of her own spectrum of reproductive experiences. She describes the relief she felt at terminating a pregnancy in her youth, and the overwhelming sadness she felt at a later miscarriage, before having two healthy children. Ingall points out the lack of cultural acceptance of women’s wide variety of feelings about their own lives: “No matter what we feel—sadness at a miscarriage, relief at an abortion—women are told their feelings aren’t legitimate. Someone—a politician, a friend, a member of the clergy—invariably tells us to buck up if we’re devastated by the loss of a wanted pregnancy, and/or to hate ourselves if we’re not devastated to end an unwanted one.”

Likewise, at Slate, Jessica Grose rightly points out that public confessions of termination too often focus on the extremes of abortion, to the detriment of the pro-choice perspective:“We trot out the saddest stories: a woman who really wanted a baby but terminated because the baby was not going to be able to live outside the womb or a woman who can’t afford another child without tumbling into poverty. But a lot of women have abortions and don’t look back. A lot of women don’t want a baby, and they don’t care whether the fetus is viable or how much money is in their bank account. Where are their essays?” Both Ingall and Grose are spot-on. I’ve had two miscarriages and can attest to the lack of agency accorded to women in feeling and interpreting their own lives. I came away from my miscarriages feeling ashamed and guilty for not expressing the feelings other people, including strangers, projected onto me. Scholar Leslie J. Reagan provides historical context:

A woman’s response to miscarriage is neither purely personal nor universal. Rather, the meaning of miscarriage is historically and culturally constructed….The normative representation of miscarriage has dramatically changed during the twentieth century from hazard to blessing to tragedy….Today, when the emotional distress following a miscarriage is highlighted, the physical stress of the event tends to be obscured…[1]

My second pregnancy was very brief and I knew immediately that it wasn’t working. So I was relieved when it went away gently and dramatically differently than the first, which ended with a life-threatening hemorrhage. A week prior to that initial (first trimester) miscarriage, my husband and I found out the pregnancy would not continue, when an ultrasound revealed a blighted ovum. We both felt a lot of sadness, but after a few days, I had mostly processed the new reality and tried to prepare for the physical event that I knew was imminent. That was impossible, however, as the unexpected complications made it the worst, and most dangerous, physical event of my life.

The miscarriage began naturally, but soon the bleeding became overwhelming. I repeatedly asked the emergency room doctor if I was going to die. She told me that I would not, but if I had lived in another time or place, my “story would have ended very differently.” Ultimately, I lost thirty percent of my blood, and required four transfusions. When it was all over, after my blood was replaced and I had an emergency D & C, I felt…fabulous. Physically, the improvement was instantaneous (although also brief, since soon the trauma to my body set in, and I could hardly get out of bed or walk for days). Right after I woke from surgery, I felt elated. The contrast with how I felt only a few hours earlier was marked. My primary emotion was joy and relief to be alive.

But I quickly got the message that my feelings were not acceptable. The next morning, a nurse came to my room and asked how I felt. I exclaimed, “Great!” I was still high on the full complement of blood running through my veins, and was so grateful to no longer be collapsing, passing out, vomiting all over myself, and generally feeling the worst sickness I had ever experienced. The nurse literally stopped in her tracks and looked at me like I was crazy. She recovered after a few seconds, completely ignored what I said, and then offered her condolences. For a moment I was confused; why was she so solemn? For me, the pregnancy ended the previous week, when I learned of the blighted ovum. The more recent physical ordeal seemed a separate, horrible event. I realized the nurse was only thinking of the loss of my pregnancy. She went on to inform me of her own miscarriage, and assured me that I would cry every time I saw a child on the street and would grieve all over again every year on my dead baby’s missed birthday. I was flabbergasted, but immediately lowered my voice to take on the demeanor of a grieving mother. Later, the same nurse prepped my husband for his inevitable onslaught of grief. There was no space for his gratitude at having dodged young widowhood. Leslie Reagan points out that this is a common experience: “[H]ospitals continue to be insensitive to some women and participate in establishing norms for female behavior and feeling. Those norms are rooted in a conservative gender ideology that treats motherhood as woman’s greatest achievement and its denial as woman’s greatest suffering….Hospital materials and staff tell the woman how she will feel instead of listening to her description of how she understands her miscarriage.”[2]

From that day in the hospital, it was all the same. Unlike Ingall’s experience, however, I did not feel that I wasn’t allowed to be devastated after the failed pregnancy, but rather that I wasn’t devastated enough.  Many well-meaning women said some version of, “You have experienced a real loss, don’t let anyone minimize what you’ve been through.” They were talking only about the lost baby, not the traumatic physical event. Ironically, this was always said while also informing me that I had a right to my own feelings about the experience, and that I shouldn’t let others project their feelings onto me.

Personally, I did not feel that I had experienced a “real” loss. I know women whose children have died. This was absolutely not that. I have children in my life who are my light, and if the unfathomable happened to any of them, that would be a “real” loss. What I felt about the failed pregnancies was profound disappointment at the loss of potential and whatever fantasies I had about the future, but I accepted and understood them. I was okay with it. Maybe it’s the wisdom of my “advanced maternal age.” I’d seen so many women go through the same thing, I knew that miscarriage is a very common, normal reproductive experience. And on a spiritual level, I did not believe that anyone died. For me, it was a matter of bad timing, not death. The lingering trauma primarily concerned the physical event, even though I did feel sadness at the time of my first due date, and experienced – and continue to experience – a variety of feelings about what happened to me. Other women have very different interpretations of their miscarriages, and I respect those differences. These events are too personal to put one label on all of them.

As Ingall and Grose point out, women’s experiences of their lives, especially their reproductive lives, should not be forced into a rigid box of cultural expectation. Unfortunately, it’s that very box that determines how American culture and policy treat women, their health, and their bodies. Anti-abortion mania, judgment of women who choose to not procreate, judgment of women who do procreate and breastfeed, or don’t breastfeed, or work, or don’t work… As a culture, we insist on fetishizing motherhood, and only want to imagine glowing pregnancies and bouncing babies. But the spectrum of women’s reproductive lives encompasses so much more than that. Women have myriad experiences and feelings, but we are taught to deny the unpleasant, to hide what doesn’t conform to unfair, unrealistic, simplistic expectations.

While I understand how profoundly personal these life experiences are, and thus many women feel hesitant or unwilling to discuss them openly, I wish that more women would talk honestly about their reproductive lives. If these subjects were less taboo – I had many women merely whisper their miscarriage stories to me when they found out I had been through it, like a shared dirty secret – it would be difficult to isolate and demonize women for the fact of their womanhood, wherever they fall on the reproductive spectrum. Significantly, if we acknowledged women as complex and diverse, it would also be much harder to pass legislation that discounts women’s health, agency, and very lives. We need to stop assuming that women can ever conform to a one-size-fits all label, because our experiences are historically, culturally, and personally contingent. Women need the flexibility, compassion, and space to create lives of their own meaning. Without that, we deny women’s full humanity.