Let's Talk About Miscarriage
Miscarriage is isolating and traumatic. We speak with someone who has had two: my wife.
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TRIGGER WARNING: This post includes discussion of miscarriage, abortion, and me being a lousy spouse.
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If you’ve experienced a miscarriage and would like to share your story, email me at jaredpaventi@gmail.com. All responses will be shared anonymously.
In 2015, my wife had two miscarriages.
We didn’t have them. She did. She lived it on her own.
Because, you see, I wasn’t wholly there for her.
Because I wasn’t sure I wanted another child.
(Your honor, the defense stipulates that he was a sonofabitch, and that due to space, you should read every paragraph after this point as if it began with the phrase “Feel free to hate me but...”)
I can’t speak for other fathers of children who were miscarried1 but I was disconnected on a couple of levels.
First, I wasn’t the one physically with child. It only sounds like a cop out, but it wasn’t in me or dependent on me for life. I felt this way a little bit with our first. I wasn’t pregnant so it was just some ethereal thing that would eventually happen. “It’s not real until it’s real” was my funny ha-ha phrase at the time, but I didn’t know what to expect. I had never been a parent before so it wasn’t until I was handed the baby that it became real.
And, yeah, I wasn’t interested in a second kid. This was a point of division for my wife and I for a couple of years. I was trying to present what I believed were logical, rational arguments — money, space in our home, genetic inheritances2, bringing a child into the chaos of this world, etc. — and she was sure that we were incomplete without a second child3. It was injurious to us both and didn’t make being married easy. There was a point where she told me that she felt our marriage was incomplete, that there was a child-sized hole that needed to be filled. It hit hard, though I’m not sure it hit as hard as my inaction, indifference, or other in- words as related to the miscarriages.
I remember the first rather clearly. It was a summer evening and we had just come back from our annual vacation with college friends. One of them had just recently texted that they noticed she didn’t consume a drop of alcohol on the trip and asked if it was possible that she was pregnant. I ignored the email, still angry about the fact that she was.
My wife approached me one evening and said that she was in a great deal of abdominal pain and bleeding from a place you should be bleeding when you’re pregnant. So, we hopped in the car and went to the ER, where we sat for hours. One of the Spiderman movies was on TNT4, blaring towards our little lounge booth of a couch. Shortly after 11 p.m., they put us in a room, the doctor examined her, and confirmed that she was in the middle of a miscarriage but there wasn’t much to do other than let it run its course. We were sent home with instructions to call the doctors the next day.
About a week later, I drove her to the in-and-out surgical center for a D&C5.
That fall/winter, she was pregnant again. It was during one of her appointments where it was discovered that the fetus wasn’t the right size based on the math. For the uninitiated, there is the back envelope math of the last menstrual period, when you tested positive and when you think you think conception may have occurred. And then there is the ultrasound tech, with her wand and belly goo6, who takes an image and measures it for a best guess at the age. These numbers were far apart. The fetus had stopped growing; I’m not sure it was even far enough along to have a heartbeat yet, but that was that.
(Your honor, may I please speak. Thank you. As previously stipulated, I wasn’t much of a husband during this time period and I have rightfully earned the scorn of those who have read up until this point. Eventually, I realized that I was in the wrong. I finally accepted that my wife’s want of another child would always be stronger than my want of anything else, tangible or otherwise. So, we came to an agreement. I would take my head out of my ass and get in the game, but we would pause the trying for a few months because she needed to give her brain and body a much-needed break. At this point, I would ask the court to resume reading this entry without any stipulations about me being a sonofabitch.
Our second child was born in June 2017, completely healthy. She turned seven in June and treats life as a bull in a china shop, as she should. And I was wrong about all of it. Loud wrong. Wrong wrong really wrong. Thank you.)
After miscarriage people often assume that the woman’s loss is greater than the man’s because of her physical connection to the baby. This may be true for you. You may feel disappointed rather than distressed.
— The U.K.’s Miscarriage Association
So, my own hesitation aside, I think it is validating to know that it’s not an isolated feeling for a partner or spouse to feel the loss similarly.
But, on the flip side, there is something to be said for hearing the heartbeat or seeing movement (either from a kick or on the ultrasound) and the emotions that follow the sudden absence of that.
We have friends who experienced something similar after more than a year of fertility treatments. The doctors had counseled them to be conservative in sharing their good news, as the pregnancy was considered high-risk. They were on the precipice of an announcement when the miscarriage occurred. For some reason that was never really clear to me, a surgical removal of the fetus was not possible, so they induced her to deliver.
(Abortion rant in 3...2…1... The religious anti-abortion position is fraught with cherry-picked talking points, as are most religion-based positions because The Bible is rife with continuity and interpretation issues. Go read Exodus 21. In addition to allowing the sale of your daughters, it has some clear language about the pregnant woman’s health superseding the baby’s. Abortion was widely practiced in ancient times. This isn’t biblical belief as much as an assault on the rights of women. But what the fuck do I know? Maybe we should suspend all of our laws and go back to 19th century era statutes, you know, back when everything was hunky-dory in America. Support your local Planned Parenthood and make a plan to vote.
Also, if you’re like me and enjoy getting yourself worked up and enraged over a topic, go ahead and listen/read this report from NPR.)
Fertility procedures are not cheap and health insurance coverage of these things are spotty and terrible. I imagine my friends and others in this space felt both personal loss as well as financial anxiety from the strain on their resources.
Miscarriage is a different kind of loss. It’s not like grieving for someone you knew. Instead you might mourn the loss of your baby’s future and your own future as that baby’s parent. This can be hard for others to understand and relate to.
— The U.K.’s Miscarriage Association
It’s not unheard of to grieve someone you haven’t met, but you’re not grieving someone unfamiliar to you. To the mother, it’s part of them and there may be extraordinary guilt felt by her as a result. Mothers are supposed to protect their young and do everything they can to ensure a healthy baby, yet an unviable pregnancy often has little to do with the mother’s choices.
There is another layer to this. Losing the baby inside of you, followed by the potential of the invasive procedure to remove the tissue, is a traumatic experience. I wasn’t at all of the meetings with her OB/GYN, but I don’t remember ever hearing anyone counsel my wife to speak with a mental health practitioner. This seems like a no-brainer. Sitting before you is a woman going through all of the emotional trauma of losing a child, compounded by the fact that the child was inside their body and they couldn’t protect it. The “What if…” thinking that fuels anxiety is running on all cylinders.
What if I could have done something different?
What if I went to a different doctor?
What if this keeps happening?
What if I can’t get pregnant?
And who is to tell where grief starts and ends? Is there depression hiding in our midst? Anxiety and panic? How much of what is happening is hormonal as the body begins readjusting to a non-pregnant state and is that keeping people from seeking therapy?
It’s a lonely place to be and the Miscarriage Association says that women often withdraw, even from their partner, because they feel as if no one else has gone through this type of pain7 or they won’t leave their home because they can’t bear the thought of seeing happy families with children.
For all of those reasons — and other symptoms like reliving the miscarriage repeatedly, nightmares about the miscarriage, and intrusive and uncontrollable thoughts — the organization recommends speaking with a professional.
But, maybe we should speak to someone who lived through this.
Maybe, we should speak to my wife.
Dirt Nap Q&A: Missy Paventi
Missy Paventi and I got married on July 13, 2002. We met as undergrads at St. Bonaventure University and decided to move back home after school, as I had a two-year appointment in Syracuse University’s athletic department. By the end of my run, I decided that I didn’t want to work in college sports anymore and she was on her way to getting tenure as a high school history teacher. So, we stayed. We got engaged in December 2000, married 18 months later, and now have two kids.
Dirt Nap has been a ride for her, as I rarely tell her what I’m writing about; truly, I didn’t even tell her that I was starting this enterprise. Anyhow, I asked her months ago if she would be interested in talking about it and gave her the questions a few weeks back. I wanted her to take her time and think things through, but I also knew that she was going to need time to sit with the questions before answering.
I can count on two hands the number of people in our lives that know anything about what you’ve read so far. What follows is known by even fewer.
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I want to get something out of the way first. We’ve talked about this but haven’t talked about this. I was a dick and I misread the situation. I left you alone at a time when — in hindsight — you needed me. It wasn’t consciously done to punish or make you feel that way, but I don’t think intent mattered at the time. I should have been more. More present. More supportive. Just more.
I think that there is something that is linked to these miscarriages that cannot be separated or ignored as I address the grief surrounding those two losses: You and I were not in a good place in our marriage when these events occurred in 2015. In fact, I’m confident in saying it was the most distant and furthest from being “happily in love” that we have ever been.
You had very strong feelings (against) having another child. We disagreed and argued about this and we didn’t come to a resolution before I got pregnant. When I got pregnant, your response was not happiness and there was a level of disinterest on your part about this pregnancy that started immediately. I felt alone long before I lost each of the babies. So, when I miscarried in the summer and again just before Thanksgiving I felt like your response and lack of support was tied up in where we were as a married couple.
Obviously my feelings were deeply tied up in the dilemma about having more children, my husband hating me (I really thought that you were deeply angry with me for pushing to do something you were against), and absolute sadness I experienced each time.
The best thing I did was go to therapy for myself and the second best thing I did was make you come for several sessions. Those sessions where you were present and we were forced to face our issues head on did more for us as a couple than a year worth of “conversations.” I think it kept us together. I mean that.
Without pressing you to live through each instance, what are your clearest memories from each miscarriage?
The first miscarriage came in the summer of 2015 and happened “naturally” for lack of a better word. I remember we were out at a restaurant and I went to the bathroom with our oldest only to discover that I was bleeding heavily. We ended up in the emergency room later that night because the blood loss was freaking me out. I remember the nurses and doctor in the ER being kind, but matter of fact, about what was happening. An ER doctor told me I should wait six months to try again.
The second miscarriage felt much more traumatic. I was pregnant but the hormone levels were not rising correctly. My OB had me coming back nearly every day for blood draws and exams as we inched from four to six weeks. As we got closer to the seven- to eight-week mark, the exam showed no heartbeat and little fetal development. My options were to wait and allow the miscarriage to happen or to have a dilation and curettage. I opted for the second choice as waiting seemed awful.
I will never forget that the day of the procedure when I went to the surgery center the paperwork I signed at the front desk said “abortion.” That hit hard. I had always (wrongly) assumed abortions were for unwanted pregnancies. I wanted this child so badly, but what was happening biologically made this necessary. There was no child. There was no heartbeat. I had always been pro-choice but I realized now that women were making decisions that were medical; decisions about pregnancies they hoped for and wanted. Decisions that are private and painful.
When you are in the middle of grief, you don’t always have words to explain the feelings and the recognition came later during therapy and in the aftermath of the crisis.
At any point along the way did your doctor recommend speaking to a therapist?
I have thought about this and I honestly don’t remember. Our conversations were around the medical part. Could I get pregnant again? What did this mean for my chances? What role had my age played in both of these miscarriages? All the tests from the D&C showed that there was nothing odd or unusual that would indicate a long-term problem connected to my body.
I remember the doctors I saw being kind and compassionate and they never rushed me out or told me it would be “fine.” I don’t know if they told me to seek therapy. I don’t think they did in a direct way. The person who did recommend therapy was my sister-in-law. She was incredibly kind and patient with me as I tried to understand what I was feeling. I’m grateful that she pressed me to find someone to talk to. A close friend was kind enough to give me a couple of names of therapists who could help.
I know you experienced grief, but did you recognize the trauma of the miscarriage? Did you have an appreciation the underlying trauma — and its side effects — for the fact not only was there a death but that it happened in your body?
Trauma is the word I wish someone had used in 2015. It was traumatic, physically and emotionally. I remember wanting to sleep. I wanted to close my eyes and be in darkness. I didn’t want to feel anything. I wanted to disassociate from everything that was joyful. I wanted the dark.
The problem was I felt everything. I felt the physical pain of what my body was doing and I felt every emotion. Anger, sadness, resentment; I was like an exposed nerve. When you are in the middle of grief, you don’t always have words to explain the feelings and the recognition came later during therapy and in the aftermath of the crisis.
It didn’t help that while I was going through it, it was a secret. I guess that was my choice, but who wants to talk about this? I went to work and pretended everything was fine. I missed a day or two, but soldiered on. I quietly fell apart every night in the dark.
I told a few close friends and family. Thank God I shared it with some people because those women got me through some really dark times. Those women showed me empathy and listened to me weep and rage.
No one let’s people into the dark corners of their brain where they beat themselves up. For as in the open as I have been with you over the years and publicly with Dirt Nap, I keep those little spaces to myself and try not to visit there often. In those dark spaces in your brain, did you turn on yourself to lay blame? That you didn’t take the right vitamins or were damaged or too old8?
The dark spaces in my brain told me two stories:
First, was the shame and guilt that you can’t successfully carry a baby. Women are conditioned to believe that they can conceive, carry, deliver, feed and raise a child. It is supposed to be our superpower. It should be like breathing; something your body just does without thought. What was wrong with me? Why could other people do this and not me? I had carried a baby to term, but now I was over 35 and that is a thing when it comes to having babies. Was I too old? I wondered if all the stress or some random thing I did caused this to happen. I blamed myself for all of it.
Second, the dark part of my brain told me my trauma did not measure up to real death. I should be thankful that I could get pregnant. I should be thankful for the healthy child I already had. I should be thankful that this happened so early and not when I was further along or during labor. My feelings were NOT valid according to the voices in my brain. I should suck it up and just stop feeling bad. Clearly, that is not a healthy way to manage loss.
Our second kid turned seven years old this month. I have no regrets and I know you don’t either. But, did you ever find yourself looking back and wondering how one of the miscarried babies would be similar or different than the one we have?
I did think about those babies. The holidays and those anticipated due dates were especially tough. I wondered about their gender, hair color and demeanor.
Each loss of those early pregnancies haunted me when we got pregnant again in fall 2016. I was so carefree and joyful about being pregnant with our oldest and that is not how I felt during those nine months with our second child. I was afraid for 24 weeks. I was anxious about how often I felt the baby move. I knew this was our last chance.
When you give birth at 40 years old it feels like a victory. It was like I beat science or the odds. Not everyone gets a happy ending to their grief story and I’m incredibly grateful for our rainbow baby.
If you’ve experienced a miscarriage and would like to share your story, email me at jaredpaventi@gmail.com. All responses will be shared anonymously.
Final thoughts on finality…
It’s magical thinking to imagine ourselves able to prevent our own miscarriages, and we need help not to blame ourselves for losing what we wanted most, a child. The new legal trend to police and persecute women who miscarry is as barbaric as it is ignorant of the most basic knowledge of how pregnancy works. The idea that women can be held criminally responsible for miscarriage is a misogynist fantasy, divorced from the reality of miscarriage.
— We Suffer in Silence, The Guardian
Dirt Nap is the Substack newsletter about death, grief and dying that is written and edited by Jared Paventi. It’s published every Friday morning. Dirt Nap is free and we simply ask that you subscribe and/or share with others.
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And what a shitty term that is. Miscarried. Like the mother dropped the fetus or fumbled it after being tackled.
Mental health, Celiac disease, and obesity among so many other things.
I’m oversimplifying this argument in the interest of space.
Don’t ask me how I remember these things.
Dilation and curettage. An abortion. Because the fetus died. You see abortion is health care, not just an inconvenient method of birth control. Support your local Planned Parenthood and vote.
Technical term
This is pretty common in disease-related areas. When I worked around Alzheimer’s disease, I often heard that no one else understood what the caregiver was going through.
We were in our late 30s when this all went down.
I can relate to this so well having gone through it and thank you both for the thoughtfulness and vulnerability in this post. What struck me at my core is at no point did our fertility specialist suggest therapy would be beneficial. Eventually we did get the support we needed. Today we are proud parents of our adopted daughter and today the house is very empty now that she is on her next adventure in college.
Hi Jared. Man, this is gritty, honest and important. Thanks to you and Missy. Your questions, and her responses blended in a way that lit this piece up. Clearly you both picked strong, self-aware, big-hearted partners. Missy's insights are like gold mined from a very painful river.
I love the way you both draw attention to the potential, often overlooked, connection between grief and trauma. Maybe a topic for another day?
I hope it’s okay for me to offer an extended comment. I know you are not speaking for men as a group, Jared, and are speaking on a very personal level, but your experience is powerful, and your ability to communicate is so skillful, I wonder if some readers may be tempted to overgeneralize your experiences to men as a whole.
I have to admit, I cringed just a bit when I read this quote from the U.K Miscarriage Association:
"After miscarriage people often assume that the woman’s loss is greater than the man’s because of her physical connection to the baby. This may be true for you. You may feel disappointed rather than distressed."
Yes, this is true for some men, but for many others grief after pregnancy loss is intense and complex. Men sometimes fall into the trap of believing their grief is less important than a female partner’s or that they have no right to grieve, that they should “suck it up” and “be strong” for a partner. Or that they are “weak” if they grieve.
Some men (and, as Missy notes, women) rationalize their grief away by telling themselves things like “It’s not a real loss.” Or, as the quote above makes clear, by assuming “It was my partner who felt the heartbeat inside her body, not mine. She’s the one who experienced the loss, I’m just a bystander.” Men may also receive subtle or overt messages, and/or social pressure, to be stoical, and to “get on with things.”
As you point out, mental health support is often inadequate or lacking, and parents are often left to take the initiative to find therapists and/or support groups and resources on their own. Unfortunately, men are often less apt to take the initiative, and when such help is offered may be less receptive to accepting it.
Coincidentally, I wrote an article about men and grief after miscarriage which is scheduled for publication later this year in Social Work Today. I cannot share a link since it’s still on the editorial drawing board, but here are a few snippets I dug out from the draft (citations deleted) in case it's of any interest:
"According to Britta White, MSW, LCSW, a psychotherapist specializing in pregnancy loss, “Men may feel pressure to minimize or suppress their grief in order to ‘hold it together’. They may be less likely to verbalize feelings, and more likely to try to avoid grief or trauma by throwing themselves into tasks, work, or supporting a grieving partner. Some may use alcohol or substances in attempts to numb underlying emotional pain.”
A study analyzing existing research on the impact of pregnancy loss on men found that they tend to report less intense and less enduring levels of psychological distress than women but are more likely to engage in negative “compensatory” behaviors such as increased alcohol consumption.
The analysis also found that “men often feel that their role is primarily as a ‘supporter’ to their female partner, and that this precludes recognition of their own loss. These studies also reported that men may feel overlooked and marginalized in comparison to their female partners, whose pain is typically more visible...”
"…This masking and/or displacement of emotions, as well as the fact that men don’t share the same kind of physical connection with an expected infant, has caused some healthcare and mental health professionals, as well as normative cultural beliefs, to assume men do not significantly bond with an unborn child and do not grieve the loss, or that their grief is less intense.
Recent research, however, has found such bonding can be significant and often begins early in a pregnancy. “It’s a misconception,” says White, “that a father does not have a strong bond with the unborn child. The early stages of pregnancy can foster a powerful emotional connection within men as they envision their future as father. The shattering of these dreams, even at an early stage, can be devastating.”
I'm sorry for being so longwinded. I hope it's okay to engage in this way. Thanks to you both for tackling this topic with such courage and honesty. My comments are in no way intended as a critique on your journey, Jared, which is so damn painful. You and Missy nailed how hard this stuff is and how hard it can be on relationships. I just did not want people to read this DN and walk away thinking “Oh, I guess it’s only women who grieve.” Conversely, I’m also not implying that there is anything wrong with men who don’t feel grief. It’s so dang complex. Thanks again for shining a light on this topic!