I Had a Miscarriage

by Jessica Zucker

  • • •

  Upon my return to work after my maternity leave with Liev, interactions with patients who’d mentioned struggling with my baby bump seemed to resume quite effortlessly, now that the visible reminder of my pregnancy had dissipated. We revisited their expressed feelings and made sure to sensitively acknowledge the transition that occurred in my personal life, which invariably affected my work life. But the newly established rhythm of working three full days and spending the others with my son felt mostly effortless.

  So there was no reason for me to think my ability to merge my personal and professional life would in any way be altered by another pregnancy. I figured, I’ve done this once before, surely I can do this again. In fact, the ease of my pregnancy with Liev and my ability to navigate the subsequent “work-life balance” factored heavily in my decision to have another child. I could do this. Of course, there was no way for me to know that I would only be pregnant for four short, albeit physically uncomfortable, months. I had no idea that at the very moment when it would become physically obvious to my patients that I was pregnant, that pregnancy would cease to exist.

  I emailed my patients to inform them that I’d lost the pregnancy and rescheduled their sessions. In writing, I assured them I was okay and that I looked forward to seeing them the following week. But when I returned, I was inundated by questions. I answered almost always in concise yet honest detail. I didn’t want to incite fright; I also didn’t want to be dishonest. “So you mean you went to your regular checkup at sixteen weeks and there was no heartbeat?” I felt compelled to reply candidly, “No, that’s not how it happened. The baby actually fell out while I was at home. The day before, the heartbeat was there and everything looked fine.”

  I wondered how the change in my physical and mental presence would be experienced by my patients. Penelope, for one, chose not to return to therapy for a while. She said that my second-trimester miscarriage was a real-life manifestation of her “biggest nightmare.” “If a later pregnancy loss happened to you,” she explained, “it means it could happen to me.”

  Processing this particular type of trauma was not something I had learned about en route to completing my doctorate. Even the textbooks that I’d read about pregnancy complications—the medical ones, the psychological ones—never mentioned the therapist—her pregnancy—or how to address within the therapeutic dyad her obvious loss of a pregnancy. I would have to learn this as I went along.

  I speculated that my miscarriage might potentially strengthen some of my patient interactions, because I now understood their grief from a corporeal, and not simply a theoretical, perspective. But I also recognized that my miscarriage might accentuate my vulnerability in ways that could hinder the therapeutic process. Would my patients be inhibited from freely discussing what might now, in the face of my fresh pain, seem like mundane details of their daily lives? I feared that they might want to protect me, comfort me, run from me, or shield themselves from my anguish, if only to fortify themselves against their own.

  And they did. I felt uncomfortably center stage. Though I continued on in my empathy, I was invariably bogged down by my life, my loss, my all-too-pervasive grief. Some of my patients were forthcoming about the fears my loss provoked: “I had never really considered you as someone that bad things could happen to.” “What if you had died? Then what of me?” Another common refrain: “If you’re grieving, how will there be space for my grief here too? How can you support me if you are presumably in need of support yourself?” I needed time and space to deliberate each question, valid in its own way. We addressed their concerns each time they arose. Like grief, their newfound articulated fears of my humanness—their therapist’s vulnerability—deserved keen attention and the inevitable softening of time.

  In juxtaposition, other patients picked up where they left off in their previous sessions, resuming reflection on their own lives, seemingly unscathed by my sudden absence from the office and lack of a bulging belly. The truth is, though, I will never really know if they (consciously or even unconsciously) inhibited themselves for my sake. Personally, I felt zero judgment as they shared their struggles, of course, and was relieved to focus on someone other than myself as my body and mind reconfigured without a baby. But it was impossible for me not to contemplate the very real possibility that they were caught up in worrying about me, and perhaps to the detriment of their own therapeutic process. I invited them to share anything on their minds, most especially questions or concerns about my abrupt and recent change in pregnancy status, and in the end I have to trust my patients in the same way they trust me—I must err on the side of credence. I will likely never know what went on (if anything) in the context of their minds when I returned less poised, less like myself, less pregnant. I might never know if they even noticed.

  Penelope eventually returned to my office, newly pregnant. In one session near the end of her first trimester, she paused in silent reverie—and then whispered, “I’m worried that what happened to you will happen to me.”

  I reassured Penelope that fear was inevitable, especially when it is tethered to a previous loss—grief knows no timeline, and one pregnancy does not erase the loss of another. With glassy eyes and a deep sigh, she said that hearing me talk about my residual worries eased the sense of isolation that surrounded her miscarriages, allowing her to feel less alone. She was growing less afraid of losing again.

  • • •

  Several months later, I got pregnant again, for a third time. The beginning of this pregnancy coincided with Penelope’s last trimester. I, like Penelope, was now angst-ridden and plagued with uncertainty, despite evidence that the baby was healthy. This time around, Penelope seemed particularly attuned to my eyes. “You look worried,” she’d say tenderly, her concern for me seemingly eclipsing even her own worries about giving birth. She was perceptive. My worry was indeed ever present. Each trip to the bathroom between patients included checking for blood: evidence of potential demise. Each morning, I reflexively went through a checklist of pregnancy symptoms, scanning my body to be sure that this pregnancy was holding fast. And I practically held my breath as I lay on the exam table awaiting each and every ultrasound, expecting the worst.

  “I am worried,” I would tell Penelope, honoring the trust we had long established within the confines of those four walls. “Pregnancy after pregnancy loss can be exhausting on so many levels. Loss has a way of stealing surrender.” My therapeutic instincts had changed—mostly in the months following my miscarriage and through my subsequent pregnancy—and I wasn’t necessarily confident for the better. But this was where I was. Speaking a bit more openly felt inevitable and somewhat refreshing, and according to my gut, was the best way to assist Penelope in her continued journey. This was uncharted territory, to be sure, but it felt foreordained. This was where I was supposed to be. This was what I was supposed to share. While Penelope’s fears eased, I continued, very pregnant, to hear agonizing stories detailing a slew of pregnancy complications from other patients—complications I was all too aware could befall me. My patients and I had now strayed far from a pristine therapeutic dyad. We haphazardly made our way through a maze of human emotions. In sessions, I found myself reflexively saying “I understand how that feels” without considering how revealing these moments of solidarity truly were. I silently underlined comments I heard, shocked at how similar they were to thoughts that had entered my own mind.

  Being pregnant—twice, in short succession—took its mental and physical toll. When I gave birth to my healthy daughter Noa Raye the following December, I took a much-needed maternity leave. I wept when I returned to my office, not because I struggled with the necessity of returning to work sans child, but because, following so many anxiety-laden months, my body still needed another release. It had safely brought my daughter into the world, but the overwhelm that grew inside me and along with her had remained. Going back to work, in a way, was another birth. Another transformation. Another beginning. No longer preoccu
pied with a pregnancy I felt could go wrong at any moment, I felt a sense of renewal and a sturdiness that I hadn’t substantially embodied in over a year. I was more fully there, deeply present. I had missed this. I had missed me.

  When I was back at work, a new patient, Maya, came to see me. She was ten weeks pregnant. Fifteen minutes into her first session, while describing sleepless nights filled with fear about becoming a parent, she paused, glanced at my bookcase, and then looked back at me: “Can I ask: Are you a mother?”

  There was a time when I would have reflexively asked Maya what my maternity might mean to her. But instead, I considered revealing a small but profound piece of my life. I had changed. The “before” and “after” marked by my loss did not sequester itself to my personal life; it had altered my identity as a mental health provider too. And that transition—that subtle but marked shift in how I viewed therapy within the confines of my own trauma, and the newly discovered ability for that trauma to be discussed in a way that validated my patients’ fears without overshadowing them—landed me somewhere between being a blank slate and the focal point of any therapeutic relationship. I had discovered a much more ideal middle ground.

  “Yes,” I told Maya. “I have two children.”

  5

  “If only it could have continued on this way.”

  Talking to my patients about my miscarriage got easier. I was practiced, and could easily guide conversations away from myself, forever focused on the primary reasons for these visits and my role as facilitator, not the focal point. Talking to people in my personal life, however, seemed to grow more muddled at every turn.

  In those initial hours following my loss, I was barely able to cobble together a coherent sentence, and couldn’t imagine mustering the emotional energy it would’ve required to reach out to everyone individually, those closest to me that I had not been able to include in my frantic text. Still, I knew I had to tell people. So I settled on a group email. I figured it was best to share the news while it remained fresh, so people wouldn’t inadvertently trigger me by asking how pregnancy was going, how I was feeling, how far along I was, whether I had a name picked out. Those common inquiries can be emotional landmines for anyone who has experienced a loss, and I set out to avoid the impending minefield entirely.

  Chronicling the details of that day, abbreviated though they were, ended up being surprisingly cathartic. There was a peace that accompanied being able to reach out to those around me who needed to know what had transpired in a way that was contained. I also found relief in the ability to protect myself from the possibility that I would have to share my story before I was ready; that a well-meaning friend or family member, innocently asking about my pregnancy or how I was feeling, would blindside me. In dispersing the details of my miscarriage in a way that best suited me, I was discovering new parts of myself in real time as I made my way through this written reflection on my brief pregnancy.

  Midway through the second paragraph of my email-turned-novella, I wrote:

  I know this may sound unexpected—weird, even—but somehow I have this deep-seated feeling that I trust my body now more than ever before. How can this even be? Surviving the birth process at home alone brought out this uncanny, almost animalistic ferocity in me, both psychologically and physically. It’s what was required. What this inexplicable experience has driven home is that this now bleeding, empty body of mine—a body pregnant only hours ago—works. I inherently believe this. I’m not sure if this feeling will morph or be maintained, but right now I feel a sense of categorial trust. My body did not fail; it did its job, as painful as this dissolution may be.

  Looking back, I think my writerly inclination that evening was powered purely by adrenaline. Once I got started, it was hard to stop. Writing has that way about it for me. In an attempt at fending off dreaded questions by preemptively addressing the intricate details, I was not only acknowledging and attempting to assuage people’s fears—I was acknowledging and fortifying myself from my own. But borne out of necessity was a reprieve I didn’t realize I needed until it overcame me. This email, in essence, acted as a temporary lifeline as I sifted through the horror of my pregnancy gone wrong; getting it all out on paper and intimately evaluating the range of emotion flooding my weary body rang powerful.

  This email also served as a kind of invitation for my loved ones—an invitation into this enervated chapter of my life. A chapter on death, and life after.

  And so, the writing continued. I just couldn’t seem to steal myself from the page once I got going.

  There are these wild, fleeting moments when my heart seems to literally expand—perhaps a dogged appreciation for my own survival and for the shape of my life; backed up against moments of irreparable shatter, my own heart still technically beating whilst feeling anything but viable, convinced emotional resuscitation will never be. Trauma seems to provoke this dichotomy, this corporeal confusion, as it were. It’s both: gratitude for what is and utter despair for what isn’t (and what could have been).

  I clicked Send.

  With the tap of a key, off went my accidental sermon—about life, death, the liminal spaces in between—to those who didn’t yet know. Straightaway, the love rushed in. Expressions of shock and compassion in equal measure. I was awed by the benevolent responses to this requiem on the loss of my pregnancy as I lay there bleeding, reading their words as my phone lit up with each reply, thanking my lucky stars for the privilege of having such a tender cadre of loved ones who would see me through what would no doubt be a dark, if not the darkest, period of my life.

  • • •

  One of the early responses that made my heart swell was from my wise-beyond-his-years younger brother, writing from Tel Aviv, where he was barreling through medical school:

  Dear Jess,

  Let me start by saying that I have so much love and admiration for you. I hope you remember through the most trying times that you have so many people that love you and care for you.

  I can’t imagine what you have gone through these past many hours and what you continue to experience now. I am so sorry that you had to go through such trauma. I don’t know how anyone could stay calm through such an ordeal.

  Since there is no advice or consolation I can give that will make things better, I’ll just tell you that I’m glad you are okay. I hope you are recovering physically and that you are comfortable now.

  Please know that I am here for you. Such a silly, trite expression, but I really am. You can call me any time, and I mean that. If you even slightly want to talk, don’t be shy. I’ll be a willing ear. And don’t feel pressured to talk to me, either. When you feel ready.

  I wish more than anything that I could just give you a big, long hug. You and Jason. Please share this with him, if you like. My words apply to both of you. I love you both.

  Always look forward to the future. It’s going to be great.

  Tons of love,

  David

  If only these initial life preservers of support were enough to buoy me through the future waves of grief and mourning. If only the timeline of grief adhered to society’s limited understanding of it, lasting a short period then vanishing under a sea of lovingly premade meals and kind sympathy cards and a few whispered tales of solidarity. If only my brother’s words were enough. If only it could have continued on this way.

  • • •

  Within a matter of days, it was time to leave the house; to drop off Liev at school, take him to swim class, go on play-dates. What choice did I have? My head was topsy-turvy and I felt anything but poised for these meetups, but I wanted to keep Liev’s life running as usual, so I showered, dressed, threw on lipstick, even, and headed out into the world.

  I braved it. A world that had spinned madly on as I endured the worst trauma of my life. A world that had simply maneuvered around me that fateful day on the sidewalk, when I clutched the plastic bag holding the remains of my daughter and squeezed the blood-soaked towels between my thighs. A world that do
esn’t much like talking about miscarriage, let alone a baby dying and falling out of your body in your home. I didn’t feel like I belonged to this world. I didn’t believe this world wanted to belong to me.

  My forlorn body—on display as I ventured into requisite pleasantries at preschool pickup—slumped as I said my hellos. Still bleeding and required to wear a clunky pad, I felt like a teenager again—a gawky stranger in my own skin, confused by a body I didn’t fully understand. Excruciating reminders of what was and then what wasn’t, and also, what definitely shouldn’t be: belly hollowing, hormones blazing, blood continuing. Smiling fellow-mom acquaintances uttered niceties—the usual hellos and how are yous—as, unbeknown to them, the aftereffects of my loss ravaged my should-be pregnant body.

  In more ways than one, I was still stuck on that sidewalk, shouting the details of my loss to my sister over the phone as people simply carried on around me. This time, it was my body shouting. In pain. In anguish. In anger. Soon, my voice would follow.

  • • •

  As I not-so-gingerly shared my story with other friends, family, and random people who remembered I was pregnant, I increasingly became more stunned by the reactions—the actions and inactions of people around me. All I yearned for were authentic yet simple pleasantries. Even just a plain “How are you feeling?” would suffice. Four words. Nothing more. Instead, I heard variations on “You’re so strong, you’ll be fine. You’ll get through this.”

  I didn’t want pity or saccharine sympathy, of course. And I certainly didn’t want to enter into a trauma-off, which so often seemed to be the outcome—women comparing their loss stories to mine. Examples abound, but there’s one in particular that sticks out: A woman I didn’t know messaged me on Instagram following her scheduled D&C to extract a pregnancy she lost at eight weeks. She said something to the effect of, “My D&C went smoothly. It was not as big of a deal as I thought it would be at all. I went to sleep; didn’t feel a thing. Woke up and it was done. Just like yours but two months earlier.” I was taken aback and naturally thought that she must’ve messaged the wrong person. But she didn’t. She meant to reach out to me.