Last week, Mark Zuckerberg joyfully announced on Facebook that he and his wife, Priscilla Chan, are expecting a daughter. More solemnly, he added that Chan had experienced three miscarriages before this pregnancy. He shared this personal story as a gesture of support and solidarity with other couples facing similar difficulties. It had meant a lot to him when his friends who had struggled to have children shared their experiences, and now it was his turn.
Zuckerberg’s Facebook post sparked an outpouring of tens of thousands of congratulatory messages, including a remarkable number of miscarriage stories. There is a real hunger for this kind of sharing.
Why are we eager for new ways to commiserate over our experiences of early pregnancy loss? Is this an expression of a long-suppressed need? Or has something about the experience of pregnancy changed?
As a historian, I see many ways in which dramatic, mostly-positive social changes of the past two centuries have had unintended consequences when it comes to early pregnancy loss. In colonial America, life was uncertain, the faithful were expected to trust God and submit to Fate, and women were celebrated and respected for the bounty of their wombs. Women had large families, and almost invariably lost some infants to epidemic disease. Early pregnancy losses hardly registered.
Over the nineteenth and twentieth centuries, the drastic reduction in infant mortality and the development of effective birth control allowed us to plan our families and our lives. It has also imbued us with an expectation of control that is sadly thwarted by frequent early miscarriage. The nineteenth and twentieth-century development of increasingly intensive, emotionally-involved parenting has been rewarding for parents and children. It can also lead to heartbreak when parental bonding begins very early in still-tentative pregnancies.
The explosion of affordable consumer goods beginning in the twentieth century has made our lives more comfortable. Consumer culture has also brought us aggressive marketing practices aimed at selling baby products to those who do not know yet whether they have viable pregnancies. The legalization of abortion in 1973 has engendered debates in which all parties tend to assume, incorrectly, that pregnancies that are not aborted will inevitably go to term.
Technological developments, and the rituals we have built around new technologies, are a key part of the story in the last several decades. Medical and scientific innovations have brought us the health benefits of early prenatal care, ultrasound, home pregnancy testing, and in vitro fertilization. They have also misleadingly led us to expect that, if we take care of our pregnancies by accessing high-quality medical care, all will be well. Ultrasound has afforded unprecedented opportunities for early bonding, but has heightened our experiences of loss. Home pregnancy tests offer exciting news and prompt healthy behaviors, but they also reveal many miscarriages that would otherwise have been indistinguishable from menstrual periods. Much good has come of the modern innovations of the past 200 years, but also much heartbreak.
History has led us to a particular experience of early pregnancy loss, one which is no less real for being the product of historical influences. So what can we do now?
First, we can follow Zuckerberg and Chan’s example. We can share our miscarriage stories, so that we know we are not alone. In these days of ultra-sensitive home pregnancy tests, 20% of recognized pregnancies miscarry, mostly in the first couple months of gestation. A third of women who have had two children will also have had a miscarriage. We all know couples who have experienced miscarriage. It would help tremendously if we could talk about it.
We can also take Zuckerberg and Chan’s example a step further. Women who want to share news of their positive home pregnancy tests should feel encouraged to do so. Their friends and families can offer them good wishes for their still-tentative pregnancies. If a pregnancy does not come to fruition, they will have family and friends to comfort and support them.
In addition, as more people share their experiences openly, younger friends and family members will intuitively have a more realistic understanding of how pregnancy works when they are ready to “try.” They may choose to approach pregnancy with a more cautious optimism. They will know from firsthand stories that early pregnancies are fragile, but also that most miscarriages happen to healthy women who will go on to have healthy children. The more we share our experiences, the more young couples will be able to embark on childbearing with an informed blend of realism and hope.
The way we talk about our childbearing experiences shapes those experiences for future generations. Sharing stories, as Zuckerberg and Chan did, can help us envision how we might take the edge off the pains and enhance the wonders of that experience.