An article published earlier this year in Obstetrics and Gynecology exposed Americans’ misunderstandings about miscarriage. A team of researchers asked over 1,000 adults about their knowledge of miscarriage, including how common it is and why it occurs. Among the more common misperceptions: 55% of respondents reported that miscarriage was uncommon (occurring in 5% or less of all pregnancies), 76% agreed that stressful events could cause miscarriage, while another 64% blamed lifting heavy objects. Other commonly believed causes included history of STD, past use of IUD or oral contraception, and getting into an argument. Furthermore, 47% of those who had experienced miscarriage felt guilty, 41% reported they had done something wrong, 41% felt alone, 38% thought they could have prevented it, and 28% felt ashamed.1
Recent studies instead put miscarriage prevalence at 15-20%, and scientists agree that the most common cause of miscarriage is aneuploidy, the presence of an abnormal number of chromosomes. The research team behind the Obstetrics and Gynecology article speculates that the high numbers who felt guilty and ashamed perhaps stem from the culture of silence surrounding miscarriage. After all, if you believe miscarriage to be rare, and have never heard anyone else admit to the experience, it might be easier to believe it is your fault when you have one.
This latest study serves as a good source that captures an alarming ignorance. And while the article has generated some discussion and has been rightly lauded for opening up a dialogue on miscarriage, the research leaves important questions unresolved: why do these misconceptions persist? Why does it make more sense to women and couples experiencing miscarriage to blame a heated argument as the cause, rather than the random commingling of chromosomes taking place at fertilization? Why do women and their partners continue to keep quiet about miscarriage, perpetuating the cycle of silence?
When I first began researching the history of miscarriage, I supposed that this silence and guilt was an old habit, a cultural convention passed down through generations, perhaps carried over from an older era when women’s roles centered on their ability to conceive and carry a child. On my first archival trip, I discovered how wrong that supposition was. I was shocked by the number of women who openly expressed happiness in the event of a miscarriage. In the intervening years, I have continued to find more examples of women in the past speaking out, speaking frankly, and speaking frequently about their miscarriage experiences.
“I am happy again.” These were the words Annie Van Ness recorded in her journal in 1875 when she miscarried her first pregnancy. Married just over a year, and counting her pennies since her husband lost almost all of his money in “the Wall St smash up” of 1873, Annie Van Ness was “cross and irritable” when she found herself pregnant. But after two months of feeling “ill humored,” Van Ness took up her pen to write: “Quite a change has come over the spirit of my dream since I last wrote, and I am happy again, a week ago last night I was taken sick at the supper table, I went to my room and retired early, to make a long story short I will say, that the next day Ma told me she had seen her first grand child, (if it wasn’t any larger than a jointed doll,) I just happened to think that any body might imagine from reading this that I had a baby, but I haven’t! it was only what they call a miss–.”2
Annie Van Ness expressed no guilt, shame, or loneliness in the wake of her miscarriage. Instead she felt happy, she shared it with her mother, and reported the news cheerfully in her journal. If Van Ness could talk so openly and happily about her miscarriage in an era we consider restrictive, oppressive, and narrow in terms of women’s reproductive control, why can’t we do so now?
Mary Bushnell and Frank Cheney married in November of 1863, and immediately began to populate their house with children. By the end of 1878, the Cheneys had 9 children, and Frank was busy traveling for the family silk manufacturing business. Mary Cheney wrote her husband frequently, updating him on the family news, as well as on her own health. In June of 1879, she had another pregnancy to report, and described it with a resigned air: “I was not mistaken about myself when you went away. But it is all right, I am feeling perfectly well, and everyone says I look so… I really believe this is getting to be my normal condition.” After 16 years of almost constant pregnancy, childbearing, and nursing (the longest stretch between pregnancies was three years, but most lasted only a year), Cheney was certainly accustomed to being pregnant.3
We cannot know if the Cheneys ever discussed preventing pregnancy, but we must consider their large family in its historical context. By 1879, abortion was outlawed in the Cheney’s home state of Connecticut. Just that year, the state would also sign into law an anti-contraceptive amendment to the already existing anti-obscenity statutes. The new amendment not only outlawed the manufacture, sale, and advertising of contraception, but also stipulated that anyone who used “any drug, medicine, article, or instrument whatever, for the purpose of preventing conception,” would be subject to penalty.4 In what would turn out to be the most stringent of all the anti-contraception laws passed in the U.S. in the late nineteenth century, Connecticut criminalized the use of contraception by couples like Mary and Frank Cheney (and perhaps the most publically overturned of such laws, in the Supreme Court decision Griswald v Connecticut in 1965).
When Mary Cheney became pregnant in the summer of 1879, she may have agreed with Connecticut lawmakers in thinking that the prevention of conception should be a crime, or she may have felt disappointed in not being able to put a stop to the unceasing stream of pregnancies — she does not say either way in her letters. However, three weeks later, when she lost the pregnancy in miscarriage, her letter to Frank was full of relief: “O Bliss, O Rapture unforeseen! The imaginary Number 10, whom I had already begun to love, is not a real entity as yet, and I hope will not be for a long time to come.”5 Cheney was visibly happy about her miscarriage, but her writings present us with another question for our current situation — can one be happy about losing a wanted pregnancy?
To fully understand how we got to where we are today — the shame, the loneliness, the silence — we need to consider the reproductive freedoms gained over the course of the last hundred years; gains historians usually only write about in terms of triumph and progress. Annie Van Ness and her compatriots did not have access to effective birth control, could not easily or legally obtain an abortion, and were often misadvised about when their “safe” days for sex were. I, on the other hand, have been able to acquire and afford contraception since my late teens. If needed I can obtain a legal abortion (at least right now in my state), and I have a pretty good idea of what time of the month I should not have sex if I want to avoid pregnancy. And yet all of these wonderful control mechanisms I have at my disposal are at least partially to blame for why I might feel guilty about a miscarriage.
As contraception and abortion became legal, safe, effective, and affordable for more American women in the latter half of the twentieth century, and scientists untangled the physiology of pregnancy to better understand how it happens and how to avoid it, many women came to feel that they had absolute control over when they got pregnant. That sense of control only increased with advances in artificial insemination, leading many Americans to believe that modern medicine can fix any reproductive problem. But with great control always comes great responsibility. Because they do have such unprecedented control over their fertility, how many women now feel that, when something goes wrong, it must be their fault?
Along with the perceived control, we have also formed two dichotomous, and quite rigid categories to describe pregnancy: unwanted and wanted. The common narrative tells us that, if not carried to term, “unwanted” pregnancies end in abortion, whereas “wanted” pregnancies end in miscarriage. But what about all the women that fall somewhere between or outside of these simplistic categories? Mary Cheney, in her writings, shows every sign of wanting her ninth pregnancy, and even refers to it as a “sweet trial,” and something she had already begun to love. But at the same time she was overjoyed that she had miscarried.
Mary Cheney serves not only as an example of the difficulties in controlling the size of one’s family in the late nineteenth century, but also as an example of the emotions that surely many women face today. We cannot exclude the countless women who may “want” a pregnancy and yet feel some positive emotions in the wake of a miscarriage. While undoubtedly many of the 750,000–1,000,000 women per year who experience miscarriage are devastated by the experience and see nothing to be happy about, we cannot believe that that is the only possible response to the event. We have created a narrative about pregnancy that completely excludes positive miscarriage responses, or even ambivalent ones. Can’t a woman and her partner feel both saddened and relieved when she miscarries?
Lara Freidenfelds recently implored us all to post news about our miscarriages on Facebook (like Mark Zuckerberg did), and I certainly agree that this would help break the cycle of silence and perhaps bring more comfort to women experiencing miscarriage, whether it be their first or fifth. If we actively seek out first-person accounts of miscarriage, maybe we can reduce the number of women and their partners who feel guilty, ashamed, and alone in the wake of a miscarriage. But I also think we need to consider the few publicized pregnancy narratives and how they might give strength to those feelings. What about women who delighted in their pregnancies and would have loved another child, but who found some relief in miscarrying a pregnancy? What about those who were unsure of how to feel about an unintended pregnancy and found joy in a miscarriage? I bet their Facebook posts would not be met with the outpourings of support garnered by Zuckerberg’s moving story.
We need to not only increase the public discussion of miscarriage in modern America, but also to admit that, in the words of Penelope Trunk (a woman who was attacked via social media and scolded in the press for publicizing her relief in miscarrying), there should not be “a ‘correct’ emotion for miscarriage.” Women lose pregnancies in a variety of ways, with or without medical aid, for any number of reasons, so doesn’t it make sense that women would also have a range of responses and emotions about the event? While for some it may be entirely appropriate to describe the experience as a tragedy or to talk about “suffering” a miscarriage, these descriptors do not fit everyone. When I miscarried a wanted pregnancy three years ago, I was sad, but to this day do not describe it as a tragedy, something I suffered, or a happy event. Surely there’s a place for all of us in a public dialogue about miscarriage?
- Johan Bardos, Daniel Hercz, Jenna Friedenthal, Stacey Missmer, and Zev Williams, “A National Survey on Public Perceptions of Miscarriage,” Obstetrics and Gynecology 125, no. 6 (June 2015): 1313-1320. Return to text.
- Annie Youmans Van Ness, Diary of Annie L. Van Ness, 1864-1881 (Alexandria, VA: Alexander Street Press, 2004), 685. Return to text.
- Mary Bushnell Cheney to Frank Cheney, June 24, 1879, Box 1, folder 1, Cheney Family Papers, Sophia Smith Collection, Smith College, Northampton, MA. Return to text.
- Carol Flora Brooks, “The Early History of the Anti-Contraceptive Laws in Massachusetts and Connecticut,” American Quarterly 18, no. 1 (Spring, 1966): 3-23. Return to text.
- Mary Bushnell Cheney to Frank Cheney, July 9, 1879, Box 1, folder 1, Cheney Family Papers, Sophia Smith Collection. Return to text.
Thank you for sharing this important post Dr. W! For those of us who have suffered from miscarriage, your post helps us know that we are not alone in our feelings. I was married when I suffered a miscarriage and while I was sad at the time, I also felt relief because my marriage was a shambles and near its end. For both myself and my former spouse this was the best thing that could have happened because it enabled us to cut ties totally and ensure that we did not have a child that would be shuttled between parents and raised in a chaotic environment due to divorce. To many this would seem a selfish position, however like some of the 19th century women profiled in your blog I knew this was the best thing for everyone.
Thanks for sharing Michelle! Your story adds another layer to complexity of miscarriage responses. The more we have these candid conversations about the range of emotions following a miscarriage, the fewer women get left out of the narrative.