Misunderstanding Miscarriage

Nursing Clio is honored to have Lara Freidenfelds as a guest author today. Lara is the author of The Modern Period: Menstruation in Twentieth-Century America.  She blogs on the history of sex, society and women’s health in America, and publishes a monthly e-newsletter about her book-in-progress, Counting Chickens Before They Hatch?: Miscarriage in American Culture, at www.larafreidenfelds.com.

Miscarriage rarely makes the news, except in tabloids. But last year, Virginia state Senator Mark Obenshain’s ill-advised attempt to require Virginia women to report all miscarriages to the police contributed to his failure to become Virginia’s state attorney general. The bill, introduced in 2009, haunted his race for the position.

Obenshain was trying to demonstrate his moral outrage over the case of a frightened teenager who had given birth to a premature stillborn baby, and disposed of it in a dumpster. It was a tragic case, to all observers. But instead of asking how his state could better provide sex education and contraception, or provide support to teens who get pregnant, he wrote a bill aimed at surveillance and punishment. On penalty of up to a year in prison, women would be required to report all incidences of fetal demise occurring outside a physician’s supervision to the police. They were to report the pregnant woman’s name and the location of the remains, and would not be allowed to dispose of them without police supervision.

This would be an alarming proposal even if miscarriage were a rare occurrence. It smacks of Margaret Atwood’s The Handmaid’s Tale, or eighteenth century English laws, under which a woman was presumed to have committed infanticide if she had an unattended stillbirth.

But miscarriage is not rare. About 20% of confirmed pregnancies miscarry. And that is only the tip of the iceberg. Only about a third of fertilized eggs actually become babies; the rest fail to implant in the uterus, or begin to develop but are not genetically compatible with life, or stop developing for reasons still mysterious to researchers.

Obenshain’s bill was promptly ridiculed. Obenshain was forced to reach out to Planned Parenthood to try to fix his gaffe, and was rebuffed; in the end, he himself withdrew the bill.

What remains interesting to me, as the episode resurfaced in the news, is how exactly Obenshain was taken to task. I see two major threads. One, in a subtle way, reinforces Obenshain’s perspective. The other is perhaps more counter-cultural.

Some of Obenshain’s critics emphasized the emotional burden the reporting requirement would place on women who are presumed to already be mourning a grave loss. It is true that today in the United States, many women experience miscarriages, even very early ones, as akin to losing a child. Even Obenshain’s supporters surely were aghast at the idea of emotionally torturing women who were devastated to lose their pregnancies.

The more counter-cultural perspective was that, as obstetrician Carrie Terrell has explained, miscarriage is “a completely normal and natural event. It would be sort of like having to report every time you had intercourse or your period. It’s a normal part of a woman’s reproductive life.” If we wanted to be sure to report every single miscarriage, we’d need to report every single menstrual period as a possible miscarriage. Many of those early losses look exactly like regular periods. None of us who have been heterosexually active, fertile women in fact know how many early pregnancy losses we have had.

I would like to see both of these perspectives taken into account, not only in preventing ridiculous laws like that proposed by Obenshain, but in understanding miscarriage more generally. Many women today need emotional support and understanding when they lose pregnancies, and they deserve that support. At the same time, it could help us a great deal to learn to regard miscarriage as common, natural, and normal. Miscarriages are a regular part of a healthy women’s reproductive life, just like intercourse, menstruation, and pregnancies that go to term.

Featured image caption: Fall Leaves. (Wikimedia)

Lara Freidenfelds

Lara Freidenfelds is a historian of health, reproduction, and parenting in America. She is the author of The Myth of the Perfect Pregnancy: a History of Miscarriage in America and The Modern Period: Menstruation in Twentieth-Century America. Sign up for her newsletter and find links to her op-eds and blog essays at www.larafreidenfelds.com.

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