I Had a Miscarriage

by Jessica Zucker

  I suppose other people at the very least found my body’s return to “normal” noteworthy as well—as it happened, Sara was not the only one who commented on my size. “You don’t even look like you were pregnant,” they’d say. And what they perceived was true. I didn’t. But I still wanted to be. I assume these people thought they were saying something … nice? As if acknowledging my body had already rid itself of the physical evidence of a pregnancy that did not last would aid my mind in purging itself of its memory too. But their words hardly registered as a compliment. What people didn’t see was how this speedy size change of mine added yet another dimension to my grief. Having been pregnant for four months and so suddenly having no outward evidence of that time seemed to erase for others the excruciating pain I was in. But I wanted proof. At the very least, I needed proof.

  I wanted to look pregnant. I wanted to be pregnant.

  • • •

  Sometimes women want to maintain their newfound pregnancy shape so much so that they mourn each and every crevice as it morphs into something else. They want to be pregnant still—to hold on to the form that housed a life for however long—and maintaining the size of a pregnant body becomes part of both the longing for a pregnancy that was lost and a vital part of the grieving process too. Shape change, another complex element of the bereavement process, can be poignant.

  Keiko came to my office when she was freshly pregnant, at seven weeks along. She reported a recent rise in anxiety—steadily increasing ever since she peed on a pregnancy test and those parallel lines appeared. I asked if there was a history of mental health issues in her family, and she shared that her maternal side is dotted with depression, anxiety, and an aunt who was recently diagnosed with bipolar I. Keiko had struggled with anxiety symptoms since her twenties, manifesting in a variety of ways socially: in intimate relationships and in her career trajectory. This was also Keiko’s first pregnancy.

  Throughout her life, Keiko had been apprehensive about becoming a mother. She spoke of her fears of being “overbearing,” “underloving,” “perfectionistic,” and “hypercritical” in motherhood, and hence, wasn’t sure she wanted to enter the maternal arena at all. She didn’t expect she’d have an easy go of getting pregnant once she decided she was open to it. So when she became pregnant quickly, she found herself all the more inundated by worry about how she’d fare as a mother. During our time together, we traversed childhood issues, examined familial bonds, and unpacked relationship concerns. We explored her equivocations—their roots—and what she imagined the maternal role might entail. We were making progress.

  When Keiko went in for a routine visit at the start of her second trimester, there was no heartbeat. Her devastation was far-reaching and she soon found herself engulfed by previously unexperienced levels of anxiety. Cloaked in a cocoon of sadness, Keiko upped her sessions with me. We began meeting twice a week.

  Keiko focused on her physicality. “There’s so much confusion going on in my body,” she shared. “I mean, about my body. Well, both, I guess …”

  Understandably, Keiko found it hard to pinpoint the words to capture this particular grief. This full-body shift. This one-day-pregnant, the-next-day-not transition. This instant transition from pregnant to not pregnant without the grueling-yet-often-rewarding hours of labor, and a newborn, to show for it.

  “Yes, there is so much change going on in the body during pregnancy and when it’s lost. Tell me more about yours,” I said, hoping to encourage further exploration.

  “I see changes I don’t want to see. I feel changes I don’t want to feel. How can I miss a baby I didn’t even know and barely thought I wanted?”

  As Keiko’s size morphed from being on the precipice of robust to a postpregnancy state, she scrambled to maintain a semblance of the past. Her guilt had internalized, folding in on itself with reckless abandon, and in an effort to maintain what she thought made her a “good woman,” she yearned to appear pregnant, even though she no longer was.

  “I’m embarrassed to admit this, but I’ve been trying to keep the weight on. I’ve been eating my feelings. I’ve eaten nothing but carbs since the D&C. In search of comfort, I guess, and maybe to help pad the anxiety. I want to hold on to that puffy belly. I want to keep it close. I don’t want to see it go,” she shared.

  “You want to be pregnant still,” I said, with great understanding.

  “I really, really do! I ask my boyfriend to rub my belly every night, still. I find it soothing. It makes me feel like something is still growing in there, like he’s nurturing it.”

  In our next session, Keiko shared body-image concerns she’d navigated in her teenage years and how pregnancy—and the loss of it—stirred these visceral memories. She thought she’d “made peace with the past” but found that her miscarriage reignited ancient, loaded feelings, setting off even more anxiety.

  “I grew up being compared to my sisters,” Keiko shared. “I was usually the one who came up short. I wasn’t as pretty, or as good in school, or as comfortable in my skin. Or at least that’s what my mother always used to say. The thing is: being pregnant made me feel so beautiful and womanly, so purposeful. The change in my shape made me feel more confident. It’s weird because I didn’t even think I wanted to be pregnant, but now I realize how much I took to it. I’d look in the mirror and feel proud—things were changing, and it was all me.”

  • • •

  She’s right, of course. It was all her. The blossoming. And then the receding. It’s all us. Keiko’s point eloquently underscores why it can be so challenging to accept that we are fully at our bodies’ mercy during pregnancy and its subsequent loss.

  At twenty-seven-weeks pregnant, Hannah, an Instagram community member, messaged me after I put out a call on the @IHadaMiscarriage account saying that I’d like to talk to people about their feelings toward their bodies following pregnancy loss for an article I was writing. (I occasionally put out calls like this when I am working on a piece.) She had received news that her baby had a rare congenital condition. Her baby wouldn’t make it to full term. After seeking advice from specialist after specialist, she settled on termination.

  Her body had bloomed while pregnant—and still now, no longer pregnant, comments rushed in about its shape and size, including a coworker who carelessly asked when her baby was due. Salt in wounds. We want to still be pregnant, but we’re not. So how do we make sense of and live on in our nonpregnant bodies, bodies that may still feel or continue to look pregnant?

  Hannah reflected on her body in the wake of her termination. “Now I just feel like I look gross,” she shared, defeated. “This now-empty body—with nothing to show for it, except for these newly etched-in stretch marks, a misshapen, deflating baby bump, and dripping boobs—has got to be some sort of cruel joke. And the fact that everyone thinks I’m pregnant. And the fact that I should be. I hate my body for this. It’s all so twisted, my whole situation. All of it.”

  “It really is one of the worst feelings,” I wrote back. Because I empathized. “To be in a body that expanded with purpose, and then is no longer pregnant. It all feels so purposeless.”

  • • •

  Another patient, Grace, had a history of disordered eating that played a large part in the shame, guilt, and self-hate she felt following her first trimester miscarriage. In her teens, she developed both anorexia and bulimia. After years of keeping it a secret, she eventually confided in her mother, telling her she was forcing herself to purge what little food she would consume. But instead of comfort and support, her mother dismissed Grace’s concerns, telling her she did not have a problem.

  “She told me it was a ‘white girl’s disease,’” Grace explained. “And because we’re Black, there was simply no way I could have had any issues surrounding food, let alone issues that might have required treatment.”

  While eating disorders are often billed as a “young white woman’s problem,” like many mental health issues, Black women are actually more likely to develop e
ating disorders. But a lack of access to mental health services and the trope of the “strong Black woman” make it that much more difficult for those suffering from mental health conditions like disordered eating to seek and receive treatment.20

  From there, Grace’s disordered eating proliferated unchecked. For fifteen years, she starved herself, binged, purged, and then, she told me, she would enter into imperfect recovery for a few months, sometimes a year or two, then relapse and begin the cycle once more. After repeating this pattern a few times, she became open about her eating disorder, finding comfort in friends, coworkers, and love interests; the same comfort her mother could not give her as a young adult.

  Grace found out she was pregnant when she was five weeks along, and by week seven her nausea was so intense that her only respite came through consuming poppy-seed bagels, buttery pasta, and salty potato chips around the clock. Invariably, she began gaining weight, and the feeling of not having control over her body only deepened her longstanding inability to trust it. She wrestled with the inescapability of watching her body slowly but steadily grow, knowing she wanted the result of the pregnancy but loathing the physical and psychological process it takes to get there. As her discomfort grew, suddenly, at thirteen weeks along, she lost the pregnancy. And in the wake of her miscarriage, all her previous openness about her struggles with food came back to haunt her, as colleagues and friends voiced concerns about whether her history of low weight and disordered eating had caused her to miscarry.

  This is, of course, extremely unlikely. But that doesn’t change the fact that pregnancy can provoke myriad feelings for those with disordered eating habits, and may contribute to and expand upon complicated feelings about body size, shape, and self-worth that existed long before a pregnancy test showed a positive result. Eating disorders are often caused by a deep desire to maintain a semblance of ownership over one’s life. And what is pregnancy if not an utter lack of control? We are at the mercy of our bodies and our hormones. Weight gain, an impending life change that can feel insurmountable, and frequent comments on a pregnant person’s size all work against those who struggle with disordered eating. Grace, and others like her, find themselves ill-equipped to adequately deal with the loss of bodily autonomy that comes with pregnancy and an eating disorder’s need to maintain it.

  There were other factors working against Grace too. Her mother’s comment—that disordered eating was a white woman’s problem—continued to come up in our sessions as she waded through the guilt she felt for having miscarried. “You’re stronger than this” was the underlying message. “You don’t have the luxury of having these kinds of problems.”

  In my office, Grace was compelled to navigate the painful ramifications of the idea that her problems were miniscule at best. Her eating disorders weren’t real enough for her mother to take seriously, and she had people around her suggesting that it may have even ended her pregnancy. She spoke at length about her feelings that her miscarriage was her fault, and any grief she felt as a result was superficial and self-imposed. As she parsed these emotions, we also discussed the fact that she was at the mercy of conflicting societal expectations: maintaining a certain body shape, but being “strong” enough to rise above unhealthy beauty standards or be negatively impacted by them, and being able to relinquish a long-held way of relating to food, control, and her body in service of a pregnancy.

  Like so many of us—some far more than others—she felt as though she had been imprisoned by her body: what is expected of it, how people view it, how to maintain it, and how we are unable to completely control it.

  • • •

  And after a loss, we’re struggling with more than just what we see when we look in the mirror. Research has found that after a miscarriage, women often report feeling a sense of alienation from their bodies. Sometimes they even report feeling “defective” and like “less of a woman.”21 Add to that the possibility of not feeling at home in your skin from hormonal changes that began when pregnancy commenced, and you’re looking at one of the more challenging situations a woman can face when it comes to how she feels in her own body. For some women, this discordance is so intense that they begin feeling that their body has committed a betrayal.

  Phoebe is one of those women. She responded to me on Instagram as well. She wrote that since 2016, she has had four miscarriages, and has no children.

  “I used to think I was very attuned with my body. The first time I got pregnant, I felt very in touch with every little change, every tiny fluctuation,” she wrote. “All my losses have happened before twelve weeks, so I’ve never had the opportunity to celebrate that my body can make and sustain a pregnancy into the so-called safe zone. Honestly, I can’t think of anything to celebrate or to even like or appreciate about my body at this point. I feel so betrayed by it. It feels like it can’t possibly belong to me, or it wouldn’t have strayed so far from what I want so badly,” she explained. “It’s like I’m a stranger in my own skin. I feel physically unrecognizable. I’m infuriated and on the brink of defeat.”

  And for those who do not identify as the gender they were assigned at birth, who do not ascribe to the gender binary, or who have body dysmorphia as it relates to their identity and/or sexuality, this feeling of bodily betrayal is often compounded. From being misgendered by medical professionals to the physical signs and symptoms of pregnancy warring with their gender identity, the body becomes something of a minefield.

  I heard a lot about the feeling of being at war with one’s body from a relatively new patient, Taylor, who identifies as gender nonbinary. As a trans person, they do not identify with the gender they were assigned at birth. How their body has functioned throughout their life—be it the onset of puberty, menstruation, and the development of breasts—has felt like an affront to their true identity, a seemingly cruel reminder that who they are does not align with how they present. However, Taylor was pursuing artificial insemination because they believed experiencing pregnancy could be a chance to revel in the ways in which their body was made—capable of housing a baby—and perhaps even feel more connected to a form that, for them, oftentimes felt alien. With a history of body insecurity, self-esteem concerns, and percolating questions about what raising a child might look like, Taylor thought it wise to seek therapy before embarking on the journey to becoming a parent.

  Taylor spoke of their theoretical future pregnancy in powerful terms, imagining that carrying a child would correlate with finally feeling “ownership” over their body, often describing the very idea of pregnancy as “primal.” While Taylor told me that this attitude was often a surprise to their friends in the trans community, who sometimes find the physical act of carrying a pregnancy quite fraught with potential to fuel feelings of dysphoria, to Taylor, the thought of being pregnant offered respite from the years of body dysmorphia—obsessing over perceived “defects” or “flaws” in the body—and gender dysmorphia—the conflict between biological sex and gender identity—that had plagued Taylor since they could remember.

  Taylor had considered pregnancy to be a chance at truly appreciating the profound ways in which their body was constructed—reproductive parts and all. They speculated that pregnancy could perhaps provide a transformative opportunity to look beyond the ways in which they felt betrayed by their body and, instead, get lost in its inner workings. Relish it, even. In preparing for pregnancy, Taylor had become engrossed by the mechanics of it all. After a lifetime of being unable to accept themselves physically, Taylor was beginning to get curious about and integrate the profound ways in which their body could potentially create life. And all the ways it could go wrong too.

  Taylor lamented about pregnancy loss, before having experienced pregnancy at all. They opined that the possibility of miscarriage would no doubt transport them right back into childhood self-hate which centered around loathing their body. Quite literally hating the skin they were in.

  “It will work, right? I’ll be able to get pregnant, don’t you think?” Tay
lor asked me, tentatively hopeful. Leading up to their scheduled intrauterine insemination procedure, we spent several sessions discussing Taylor’s deep desire to experience pregnancy and the fears shrouding that aspiration. Hours before actually attempting to get pregnant, Taylor came face-to-face with debilitating panic in my office.

  “What if it doesn’t work?” they queried with desperation. “What if the science I’ve been putting so much faith in doesn’t yield what I want it to?” Taylor’s body lowered on the brown leather couch as they picked at tiny feathers poking out of the embroidered pillows.

  We remained in silence together ever so briefly.

  Witnessing their hope juxtaposed with anticipated “failure” reminded me of so many people who have sat in that exact spot—literally and figuratively—plagued by worry and sometimes optimism, imagining the worst while hoping for the best.

  “I wish I knew the answer. I sincerely wish I could tell you what will happen,” I said, as I thought to myself how game-changing it would be if I could somehow ensure a dreamed-of future for my patients. But I’m not a fortune teller. I can’t know. I don’t know. Nor am I really sure that anyone can.

  Suspended in sheer vulnerability—wanting something so badly but not having a semblance of control, nothing to ensure it will come to pass—is the place of humanity. These are the heart-opening moments we wish we could evade, but can’t.

  “Though I can’t predict the future, I hold so much hope that it’ll happen for you. I know how much you want this. I understand how meaningful this is to you. You are ready to become a parent,” I said.

  Taylor clutched the pillows on the couch once again, looking for any additional loose, pokey feathers to extract.

  I waited. And then I watched as Taylor’s body crumpled in what looked like resignation. I couldn’t help but wonder if they’d quickly ventured into a dark and muddled place—prematurely concluding that pregnancy wouldn’t be something that could come easy.