I'm Sorry for My Loss

1. Language Shapes the Experience of Pregnancy Loss

In a culture where we have “no common agreement about the nature of life in the womb and no word for beings who are lost in pregnancy through miscarriage, stillbirth or abortion,” the ones we choose—and those that get ascribed to our situation whether or not we’re on board—affect how the loss is perceived.

Words matter. The language used to describe pregnancy and pregnancy loss is often inadequate, either too clinical or too politically charged. Terms like "fetus" and "products of conception" can feel invalidating, while "baby" carries emotional weight that may not align with everyone's experience. This lack of a shared vocabulary contributes to the difficulty in discussing and processing these losses.

• Medical jargon vs. emotional language
• Political baggage of terms like "abortion"
• Lack of a neutral term for a pre-baby entity

Personal language is key. Individuals use a variety of terms to describe their pregnancies and losses, and it's crucial to respect and reflect their choices. Medical professionals and support systems should use reflective language, taking cues from the patient rather than imposing their own terminology. This approach validates the individual's experience and fosters a sense of understanding.

• Reflective language from providers
• Respecting individual preferences
• Avoiding assumptions about feelings

The power of naming. The absence of a common language for pregnancy loss creates a lexical gap, leaving many feeling unheard and unseen. This lack of vocabulary contributes to the stigma and shame surrounding these experiences. The words we use, or don't use, shape how we perceive and process loss, highlighting the need for more inclusive and compassionate language.

• Lexical gaps in English
• Impact of chosen words on perception
• Need for new language and frameworks

2. Reproduction in America: A History of Control and Inequity

For most of history, childbirth was the same old story: women were frequently pregnant but often trying not to be, birth could be very dangerous, and abortion was attempted and achieved through various rudimentary methods.

Colonial era realities. In colonial America, women were expected to be constantly pregnant, with childbirth being a communal and exclusively female experience. High rates of miscarriage, stillbirth, and infant death were common, and women often tried to avoid pregnancy through various methods, including herbal remedies.

• Frequent pregnancies and high mortality
• Communal and female-centric childbirth
• Rudimentary methods of contraception and abortion

Slavery and reproductive control. Enslaved Black women faced extreme coercion and interference in their reproduction, with slaveholders profiting from their children. They experienced dangerous pregnancies, high rates of miscarriage and stillbirth, and were often separated from their children. They also used herbal remedies to try to control their fertility.

• Enslaved women as property
• Coercion and interference in reproduction
• Use of herbal abortifacients

Victorian era and the rise of gynecology. The Victorian era saw a shift towards smaller, more emotionally intense families, with pregnancy becoming a private matter. This period also marked the rise of male doctors in the field of gynecology, often at the expense of female midwives. The medicalization of childbirth led to dangerous experimentation on enslaved women and poor immigrants, highlighting the intersection of racism, sexism, and medical practice.

• Separate spheres and the privacy of pregnancy
• Rise of male doctors and the medicalization of birth
• Dangerous experimentation on marginalized women

3. Medical Advances and the Shifting Landscape of Pregnancy

By the early twentieth century, Americans on the whole were healthier and living longer, but newborn and maternal mortality rates remained high.

Early 20th-century reforms. The early 20th century saw the rise of prenatal care and the establishment of the Children's Bureau, which aimed to educate mothers and improve infant and maternal health. However, these reforms also led to the delegitimization of midwifery, particularly for Black and immigrant women.

• Rise of prenatal care and public health initiatives
• The Sheppard-Towner Act and its impact
• The delegitimization of midwifery

Birth control and eugenics. Margaret Sanger's birth control movement intersected with the eugenics movement, which sought to control reproduction based on racist and classist ideas. This led to forced sterilizations and other discriminatory practices, highlighting the complex and often problematic history of reproductive rights in America.

• Margaret Sanger and the birth control movement
• The rise of eugenics and its racist implications
• The Comstock Act and its impact on contraception

Post-WWII changes. After World War II, maternal mortality rates dropped dramatically due to antibiotics and blood transfusions. However, childbirth became increasingly medicalized, with women often separated from their babies and subjected to interventions like episiotomies and twilight sleep.

• Dramatic drop in maternal mortality
• Medicalization of childbirth and hospital births
• The rise of the "perfect" mother

4. The Rise of "Choice" and the Modern Miscarriage

The pill put control into a woman’s own hands.

The pill and the women's movement. The introduction of the birth control pill in 1960 and the legalization of abortion through Roe v. Wade in 1973 gave women unprecedented control over their reproductive lives. This led to a shift in how women saw themselves, as mothers by choice rather than fate.

• The birth control pill and its impact
• The women's health movement and Our Bodies, Ourselves
• The legalization of abortion through Roe v. Wade

The rise of "choice" and its consequences. The ability to choose pregnancy led to the idea that all pregnancies should be successful, contributing to a sense of failure and shame when loss occurred. This also led to a culture of silence around miscarriage, making it an invisible and often isolating experience.

• The idea of "wanted" pregnancies
• The rise of guilt, shame, and blame
• The invisibility of pregnancy loss

The two-tiered system of abortion. The Hyde Amendment, passed in 1976, restricted federal funding for abortion, creating a two-tiered system where low-income women had limited access to care. This further complicated the landscape of reproductive rights and highlighted the intersection of class, race, and access to healthcare.

• The Hyde Amendment and its impact
• The return of a two-tiered system
• The disproportionate impact on marginalized communities

5. The Fetus as a Cultural Icon: Visualizing the Unborn

The fetus was now a stand-alone fella.

Early fetal displays. The fetus first appeared as a scientific specimen in the mid-1800s, with doctors using fetal tissue to establish their expertise. This led to public displays of embryos and fetuses at world's fairs, often presented as scientific curiosities.

• Fetuses as scientific specimens
• Public displays at world's fairs
• The beginning of the "medicalized" fetus

The rise of fetal imagery. The 1960s saw the rise of fetal imagery in popular culture, with Lennart Nilsson's photos in Life magazine depicting the fetus as a separate, autonomous being. This imagery, often idealized and devoid of context, contributed to the idea that the fetus was a person with rights separate from the pregnant person.

• Lennart Nilsson's photos in Life magazine
• The fetus as a stand-alone entity
• The erasure of the pregnant person

Ultrasounds and the modern fetus. The widespread use of ultrasounds in the 1980s further solidified the fetus as a cultural icon, allowing parents to see their developing baby on screen. This, combined with antiabortion messaging, led to the increasing notion that a fetus is a person with the same rights as the mother.

• The rise of sonograms and their impact
• The fetus as a symbol in antiabortion messaging
• The increasing primacy of the fetus over the pregnant person

6. The Legal Morass: Navigating Abortion and Miscarriage Laws

The language and the laws have led to confusion in states with abortion restrictions, which for the most part consider the act an abortion only if the woman or her doctor ends the pregnancy and offer exceptions for “dire medical situations.”

The post-Roe landscape. The overturning of Roe v. Wade in 2022 has created a chaotic legal landscape, with states enacting a patchwork of laws that restrict or ban abortion. These laws often fail to distinguish between abortion and miscarriage, leading to confusion and denial of care for those experiencing pregnancy loss.

• The overturning of Roe v. Wade
• The patchwork of state laws
• The confusion between abortion and miscarriage

The criminalization of pregnancy loss. In some states, women who miscarry or seek abortions are increasingly being criminalized, with some facing investigations and prosecutions. This has led to a climate of fear and uncertainty, particularly for women of color and low-income individuals.

• Increased criminalization of pregnancy loss
• The targeting of marginalized communities
• The chilling effect on healthcare providers

The lack of clarity and consistency. The laws surrounding abortion and miscarriage are often vague and inconsistent, leaving doctors unsure of how to proceed in complex medical situations. This has led to delayed care, denial of treatment, and a growing sense of fear and distrust in the medical system.

• Vague and inconsistent laws
• The fear of legal repercussions
• The lack of medical clarity

7. Grief, Ritual, and the Search for Meaning After Loss

The helplessness and loneliness so many of us feel after pregnancy loss are not a coincidence.

The silencing of grief. American culture is deeply uncomfortable with grief, particularly female grief. This discomfort, combined with the political and social complexities surrounding pregnancy loss, has led to a culture of silence and isolation for those who experience it.

• The discomfort with grief in American culture
• The silencing of female grief
• The isolation of pregnancy loss

The need for ritual and recognition. In the absence of societal rituals, many people create their own ways to commemorate their losses, including making or buying talismans, jewelry, and other keepsakes. These objects provide a tangible connection to the lost pregnancy and help to validate the grief.

• The lack of societal rituals for pregnancy loss
• The creation of personal rituals and talismans
• The need for tangible connections

The importance of community and support. The isolation of pregnancy loss can be deeply damaging, and many find solace in connecting with others who have shared similar experiences. Support groups, online communities, and advocacy organizations provide a space for people to share their stories, find validation, and work towards change.

• The importance of community and support
• The power of sharing stories
• The need for advocacy and change

Last updated: February 3, 2025