Wall art depicting a woman and a fetus in a womb

How Did We Get Here? An Interview with Lara Freidenfelds

Lara Freidenfelds’s new book, The Myth of the Perfect Pregnancy: A History of Miscarriage in America, explores the history of pregnancy and miscarriage in the U.S., unveiling a rich story of consumerism, medical advances, mothering advice, scientific technologies, and changing ideals of parenthood, gender, and family. Using the lens of miscarriage, Freidenfelds examines how we got to our current social construct of pregnancy, as one that can be definitively determined in the early weeks of gestation, medically-managed to success in all cases, and celebrated with numerous consumer-driven rituals. Freidenfelds illustrates how pervasive the myth of the perfect pregnancy is, how many social and cultural forces present this narrative to prospective parents, and how dangerous this myth can be to so many couples in the face of miscarriage rates that are still as high as 30%. With a fascinating combination of archival research and ethnographic research on maternity websites and apps, Freidenfelds has produced a highly-readable book that should be your New Year’s gift to everyone you know.

Recently, I sat down with Freidenfelds to discuss this riveting book.

Shannon: Let’s start at the beginning: can you tell me about the genesis of this project?

Cover art, The Myth of the Perfect Pregnancy. (©Oxford University Press)

Lara: I was finishing up my dissertation on what would become my book, The Modern Period: Menstruation in Twentieth-Century America. I had almost finished my Ph.D. in the history of science, focused on the history of women’s health, so I thought I knew a lot. And then I miscarried my first pregnancy at what I believed was about eleven weeks. I started having a little bleeding and my doctor tried to find a heartbeat and couldn’t find one. It turned out I had a blighted ovum [an empty sac with no embryo]. The embryo had stopped growing at about six weeks and my body had absorbed it, so all that showed up on the ultrasound was an empty gestational sac. I was shocked. And then I started looking at the statistics of miscarriage rates and I felt not just shocked but betrayed. I felt like, why didn’t anyone explain it to me?

This happened right before I was supposed to fly to Boston to meet with my committee to finalize the dissertation. I got advice from one health care practitioner, which was: “Cancel the trip; you can’t handle this now.” But I said “I think I need to decide for myself.” I really didn’t want to have no baby and no Ph.D. Those were the two big things that were supposed to happen in my life that year, and this was taking all of it away. So I went on the trip, and while there, I sat down with Katy Park [historian of medieval and early modern medicine and gender] and said “People keep saying ‘stop trying to analyze this, Lara, you just have to have your feelings.” And I said, “I like to analyze things, that’s what helps me feel better!” And Katy said: “Absolutely! That’s what women’s studies is for.” And that is where the book started. My inclination to analyze what had happened to me, to understand it, not just how I felt at the moment, but why I felt that way, where that came from, why I was shocked by something that turns out to be statistically pretty normal.

Shannon: What surprised you the most when you were doing the research for this?

Lara: Initially, I was surprised by how hard it was to find someone with the perspective that I seemed to have or with the coping style I seemed to have, which was to say: “Wait a minute, maybe I don’t have to mourn this pregnancy, maybe I shouldn’t have been encouraged to get so attached to it in the first place.” Having that perspective, at least at the time I started this research, seemed taboo. And then when I had my postdoctoral fellowship in 2006, I was surprised that even thoughtful academics, when I said: “We don’t necessarily have to mourn miscarriages,” they finished my sentence by saying “Yeah, a lot of people have unwanted pregnancies and then they’re happy when they miscarry.” And I thought, “Yes, but that’s not the end of my sentence.” It was surprising how hard it was to suggest something where you can have a wanted pregnancy and yet accept its end. And I had to say: “No, no, no. I’m talking about when you did mean to get pregnant and you really want to have this baby, but you understand it might not work out, do you have to mourn the loss of a baby? Can you have a different reaction? Is there something else?” It was interesting that it took me asserting that that’s what my project was to make people understand.

Pregnancy test. (Wikimedia Commons)

Shannon: Another pervasive attitude that you do a really good job of historicizing is the dichotomy between wanted and unwanted pregnancies, how recent that binary is. And you are asking, “Why does it have to be one or the other? Why can’t there be a middle ground, or grey area, or messiness?”

Lara: But also what counts as unplanned has changed. “Unplanned” initially meant that you wanted to have children someday, not when you were 17. And more recently, people started saying: “It was unplanned because we were going to wait another year.” Just think about that difference! Initially “planned” was a very broad time period, more defined by having a partner, or being done with high school or college. Today it’s a very narrow definition of intended. We’re getting so precise with it. People say “Oh yeah, I know women who got really upset when they didn’t get pregnant the first month they were trying.” That’s beyond the limits of biology; we can’t do that!

Shannon: What role do you see feminism playing in the myth of the perfect pregnancy?

Lara: What’s interesting to me about this is how much conservatives and liberals seem to have the same perspective on miscarriage. That there’s this agreed narrative. The narrative I’ve seen from feminism is you need to respect women’s difficulties and pain. And that’s really important. My perspective is very much a feminist perspective, but it’s quite different. Partly because I’m a historian, I say: if the experiences were different before, we should ask how does social context shape our experience? And should we, as feminists, adjust our social context if we don’t like what it’s doing to our experiences? Mostly the feminist reaction has been we need to understand women’s experiences and where they’re coming from. And that has tended to align with, interestingly, a very pro-life narrative about miscarriage. When women lose babies, we can’t go dismissing their feelings; we have to honor them. And that to me is part of the reason this is so interesting, so important to investigate. Why do we have this agreement?

And that’s also why I want to be sensitive in how I present this. Because the shared experience is real. As much as it is an experience based on our current social constructs and therefore maybe amenable to shifting it to another direction that would be more comfortable and happier, that doesn’t mean it’s not real right now.

Shannon: I’ve seen that too, that the modern feminist reaction has been, “Let’s acknowledge women’s feelings,” but the dominant narrative has continued to be about the grief and loss of miscarriage. And it makes me wonder, what is the danger in saying: “I’m sad but I’m not going to mourn the loss of a child”? Or why is proposing a pregnancy that is not dependent upon the rituals of the home pregnancy test on Instagram, or an ultrasound image on Facebook, threatening?

Lara: I’m sympathetic to people who would react negatively to: “what you’re feeling is embedded in a social construct and maybe that will change.” It seems like it invalidates your feelings. And it’s important for us, as historians or social scientists, to realize that when we propose that perspective, it’s threatening, because it can sound like “you don’t really feel that way,” or “you don’t need to feel that way.”

Also, I’m telling people not to engage with a giant industry promoting happiness. People don’t want to hear that. Other people have written about how social media prompts people to memorialize many events that they would not have otherwise thought of as worthy of memorializing. And even worse, it prompts people to set up their life to have events to photograph. There is nothing like a toddler hugging a giant pumpkin. And I did that! And I do have some of those photos that I love. I don’t want to deny how nice the ritual can be, and the shared ideas of how to memorialize positive aspects of our lives. But they have propagated like crazy. When they happen throughout pregnancy, the timing is not great. We’re doing that to our pregnancies when maybe a different approach would be better. We need positive ways of doing it that would still support the biological realities of pregnancies’ uncertainties.

Most of what we’re talking about has been what upper-middle-class women do, but it’s not just upper-middle-class women. This reaches beyond people who have some ability to plan pregnancy. Buying onesies and putting pictures of them on Instagram is something accessible to a much wider range of Americans than being able to plan your perfect pregnancy, after your perfect wedding, after your perfect establishment of two professional jobs. There’s a lot more people participating in at least portions of this culture than I think academics realize.

Shannon: Even if there are segments of the population who can’t access this narrative or these products, one of the things your book shows is that because of how pervasive the narrative is, we forget that this is a class-based system. So for women who don’t have economic access to these rituals, we expect that they do, and it ends up disadvantaging women who can’t access it.

Lara: Absolutely, there is judgment that falls on women who don’t do it, can’t do what is now a tremendous range of things, a huge load of work that you’re supposed to do during pregnancy, a lot of which is irrelevant to the health of the pregnancy. The expectations, and the judgment about less-privileged women’s pregnancies matters tremendously. If middle-class women are supposed to do ten more things during their pregnancy, then that’s ten more things that poor women are doing wrong. And that’s a huge problem.

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