When You Lose a Pregnancy at Home
The cultural norms around miscarriage are not serving any of us well
Not so long ago, talking about pregnancy was considered indelicate. Acknowledging a woman was pregnant meant acknowledging women have sex and, well… heaven forbid. We talk a little more openly about sex and pregnancy now, but we still rarely talk about something that can often happen next—pregnancy loss. We’ve never been comfortable with women and death, women and blood, women and something outside of living childbirth.
I think the thing that surprised me the most about my own miscarriage is perhaps the thing that should have been the most obvious about it. It was a work of loneliness. I didn’t get pregnant alone, but I miscarried alone. Even with a supportive partner, even with emotional support, miscarriage—like birth—is a physically solitary labor.
It’s a solitary labor accomplished by so many of us. A miscarriage seeps into the car while a woman is picking up her other children from school. It drips into the first half of an important meeting. It blooms in the middle of the night.
Sometimes a miscarriage starts during a long shift at a restaurant. An expectant mother carries plates of eggs and bacon to table three. She’s had to retie her apron; it’s feeling tight for the first time as her stomach expands. When she sets the plates down, she feels a wetness between her legs that should not be there. Sure I’ll bring over more coffee—just one minute. Our girl will have to wait for her break to see what’s wrong. She may have to finish her shift before going to the doctor. She may not go to the doctor at all. She’ll go home to bleed, and when the bleeding is over, she’ll go back to work to serve. Or she’ll bleed while she works. It will be a week or two or three before her apron doesn’t feel tight anymore.
Few people ask any of these women if they’re okay during or after their miscarriage because often they haven’t told anyone they were pregnant. One didn’t want her children to get excited too soon, the other didn’t want to miss out on the next promotion, and our waitress couldn’t afford to be given fewer shifts.
My third pregnancy, the one I miscarried, I told people I was pregnant as soon as I knew. Most of them expressed shock. Was I sure I wanted to be telling people already? What if it didn’t “work out”? I didn’t really understand what they meant. Surely even if the pregnancy ended, that didn’t mean it didn’t “work out.” It just meant it worked out differently than I’d hoped.
Since most miscarriages happens sometime between conception and the 12th week of pregnancy, most women miscarry at home. It’s not a process that generally needs medical intervention. When it does, usually medication can help. Women pick up the pills at the pharmacy and swallow them at home. I didn’t need pills. Just an appointment to verify I was miscarrying. The blood pooled beneath me as I got the ultrasound. There was no heartbeat. I was sent home to let the miscarriage finish itself.
I didn’t get pregnant alone, but I miscarried alone.
I’d started my miscarriage in bed. I woke up to it and the sound of my children’s voices. I carried it with me for days, bleeding in cars and on couches and while I made the kids lunch. I finished my miscarriage on the toilet. Is this one of the reasons we don’t talk about miscarriages? Because so many of them happen in the bathroom? The only thing we’re willing to talk about women doing in the bathroom is their hair and makeup. But other things happen there too, including the loss of pregnancies they’ve hoped for, feared, or felt ambivalence toward. Even unwanted pregnancies extract a toll as they are expelled from our bodies. It’s odd to stand in front of a bathroom mirror to apply lipstick a few days after it’s been the only witness to your loss.
I wanted someone trained in pregnancy loss care to come and brush the hair from my eyes as I miscarried in my home. In my country, insurance will rarely pay for a midwife for at-home birth. Of course, we’ve not figured out a co-pay for a pregnancy loss doula for death.
Miscarriage was frightening. There was so much blood it felt like more than my uterus was being emptied. Sometimes a clot fell out of me that was so big, so solid, it seemed it must have been made up of some of the tissue of my heart, my lungs, my stomach. My miscarriage hurt. The pain felt like a stage of labor. It felt this way because that’s what it was. In the United States, the labor that produces living children is exploited for profit while the labor that expels dead embryos is expected to remain quiet. I didn’t moan while I gave birth to my three living daughters, but I moaned while I miscarried.
When I had my first child, there was so much blood a nurse had to get on her hands and knees to clean up the floor around the hospital bed while I labored. When I lost my pregnancy at home, I got down on my hands and knees to clean up the blood on the tile around the toilet while I labored. I was crying, and when I wiped my face, red smeared across my cheek. I washed my hands and face and sat down on the toilet again. As I contracted I wondered, Why do we call this a miscarriage?
A miscarriage of justice is a failure of the justice system to do what it is supposed to do. A miscarriage occurs when a set of predetermined rules has not been followed. As unwanted as this miscarriage was, I could feel my body doing what it was supposed to do when confronted with an impossibility. I wasn’t miscarrying—I was functioning.
At the time, I lived in the Bay Area and was surrounded by people in tech marveling over their self-built algorithms with their input and output variables. What about my body could sense something in the code of my self-built embryo wasn’t quite right and in response knew what sequence to follow? When would we openly marvel over the human body and what it can do? Openly weep over it, too? I thanked my form even as I felt cursed by it. A final, tearing contraction pushed tissue, blood, water, and an embryo with a still heart out of me. I cleaned myself up, looked into the toilet, and flushed.
Miscarriage is messy and productive, like many of the things that happen in the home. And like so many of the things that happen in the home, it’s isolated there and not allowed to bleed into the rest of our lives. There is no support for the miscarrying woman in our legal codes or our cultural customs. We’ve gotten a bit more comfortable with women having sex and a little more comfortable with them being pregnant. But we still cannot bear to witness them when their bodies have worked and in that working flushed out death.