How We Can Help Eliminate The Silence And Shame Surrounding Miscarriage

Psychologist Dr. Jessica Zucker is on a mission to break the silence surrounding miscarriage—and to help parents grieve their losses

Dr. Jessica Zucker, Ph.D., specialized in reproductive and maternal mental health—but didn’t truly understand the impact of miscarriage until she lost her second baby at 16 weeks while at home alone. Her personal experience paired with her professional background make her uniquely able to navigate life after pregnancy loss, and it’s her mission to hold and guide others who are struggling and help them process and grieve.

Zucker, the author of I Had a Miscarriage: A Memoir, a Movement and the creator of the #IHadaMiscarriage campaign, is focused on two questions that seem simple at first, one for those who have had miscarriages and one for those who have not: How can I process the grief of my miscarriage? and How can I support someone I love who had a miscarriage?

Scary Mommy sat down with Dr. Zucker to explore these two questions, which necessitates exploring some even bigger questions, like: Why is miscarriage so stigmatized? Why do people who suffer them feel shame? And why is most everyone simply silent on the issue, whether they’ve experienced one or whether they find out a loved one has lost a pregnancy?

Scary Mommy: What is your best advice for how to be helpful to a friend after they’ve experienced a pregnancy loss?

Dr. Jessica Zucker:

People typically don’t know what to say or what to do based primarily on the fact that, as a culture, we fail to adequately talk about grief. We barely acknowledge it. Especially this particular type of loss, what I commonly refer to as an out-of-order loss. Loss of someone or something others couldn’t see, touch, know. This kind of loss spurs grief many simply don’t know how to approach — the loss of an imagined family member.

In the absence of knowing what to say or what not to say, people frequently rely on well-meaning, albeit unhelpful platitudes. Platitudes are likely to land with a dull thud, potentially stunning the griever into silence. Phrases such as: “At least you know you can get pregnant,” “It wasn’t meant to be,” “God has a plan,” and “Everything happens for a reason” do not help. These words do not relay support. Instead, they shove grief into the outskirts while not so subtly reiterating the looming cultural trifecta of silence, stigma, and shame.

The most profound thing we can do for our loved ones in their time of pain is to meet them where they are — resisting temptations to “fix,” predict the future, or make unsolicited suggestions.

Do say: “How are you?”

Don’t say: “It’ll be different next time.”

Do say: “If and/or when you’d like to talk about your experience, I’m here.”

Don’t say: “Stay positive.”

Do say: “I’m here to support you through whatever it is you are feeling.”

Don’t say: “Maybe you should do IVF next time or adopt…”

It’s simple: say what you imagine you might want to hear if you were in her shoes. Do what you imagine you might find loving if you had just unexpectedly lost a pregnancy. And if it’s tough to figure out what you think you might want to hear in the aftermath of a loss, stick with consistency, compassion, and love.

What do you wish more people understood about what it’s like to grieve a miscarriage?

That grief is a human right.

That grief is anything but linear.

And that grief is not something to push through, but instead to settle into, explore, and get comfortable with, as it were.

I suggest allowing yourself to feel whatever it is you are feeling, because no feeling lasts forever. If/when you flirt with thoughts like: I am the only one, attempt to remember that there are millions among us who understand this ache too well.

Grief is circuitous. There is no discrete timeline. It’s messy. And there are certainly no guidelines or roadmaps for navigating the grief that can accompany pregnancy and infant loss. So please, do your best to be gentle with yourself in its wake. Resist urges to sidestep grief, to swallow it, to put yourself in situations where you can’t be fully acknowledged for what you’ve just undergone.

In my book, I reflect on how trauma and grief suspended me in mid-air — making it difficult for me to be fully present in my life but also making it difficult to allow myself to fully fall apart, too. There’s no such thing as powering through grief or perfecting it, either. We put one foot in front of the other. Somedays, that’s the best we can do. Other days, we have the energy for more.

If you get the sense that professional help might be necessary, get it.

If you want to share your story, do it.

If you find solace in theology, go to it.

If you prefer privacy, respect that.

If you yearn for connection, locate a support group or places online carved out for communing around these particular types of losses.

Lean on friends.

Through it all, attempt to keep in mind that you did nothing to deserve this. Nothing. Your story matters.

If you could go back and talk to yourself in the days after your loss, what kind of advice would you give?

I wish I knew that pregnancy loss has the potential to rattle you to the core.

I wish I knew that grief comes in waves, is unpredictable, has no definitive beginning, middle or end.

I wish I knew that the wild ride of post-traumatic stress deserves and requires pointed attention.

I wish I knew that navigating postpartum hormones with empty arms might catapult me into another galaxy.

I wish I knew that pregnancy after pregnancy loss would be fraught from start to finish.

I came to learn that heartache and hope intermingle.

I came to learn that leaning into grief might just be the very antidote to drowning in it.

I came to learn that no amount of steal the flagrant anxiety or begets a different outcome.

In facing vulnerability straight on, I was met with a deepened relationship with myself and even a bit more surrender. I came to find connection and community in unlikely places — like corners of the internet and on social media. I found out firsthand that speaking our truths can be a potent salve.

But here’s the thing: it’s not like I was altogether unfamiliar with these notions from a theoretical perspective. Yet, after I was lambasted by the spectrum of emotions that can follow pregnancy loss, I learned in real time that no amount of knowledge or book reading can emotionally prepare you for lived experiences. I learned that grief is natural, it is normal, a birthright. I learned that no one is immune.

Why do you think women feel shame around miscarriage?

There is a strident trifecta swirling around the topic of miscarriage — made up of silence, stigma, and shame. https://www.amazon.com/I-Had-Miscarriage-Memoir-Movement/dp/1558612882 As I discuss in-depth in my book, each aspect of this trifecta stokes the next. The cultural silence provokes the blanketed stigma. The stigma ignites the insidious and all too pervasive shame.

It’s a troubling cycle we find ourselves in as we navigate life after loss, as we are slapped by a society that shuts down when it comes to conversations around out-of-order loss. In turn, grievers are often met with stilted, awkward platitudes, whispered saccharine-coated sentiments, or worse, complete silence.

As the silence permeates, the griever might begin to question themselves and the very thing that just left them shattered. Was this my fault?Am I not supposed to talk about this? Maybe I should be over it by now.Alienated and thrust to the outskirts of communities, grievers begin to embody and potentially even embrace the stigma. And this lays the groundwork for shame to fester.

The simplest way to achieve an antidote to this unhelpful cycle is to speak our truths. To persist in telling our stories. To gently and unequivocally resist self-blame — looking to the science and research about the actual reasons miscarriage occur, rather than creating elaborate stories in our minds that all too often center on somehow having had the control to bring about a different reproductive outcome. To remember that we are, in fact, not alone.

Approximately 1 in 4 pregnancies result in miscarriage, yet somehow we don’t seem to know of anyone who has been through it until we speak about our own. In no longer being hush hush about these profound experiences, we can change the cultural tide. We can live in a world that acknowledges miscarriage and the resulting emotions. We can cultivate a society that honors grief and hard conversations. We must work to do this for ourselves and for future generations, particularly because miscarriage is not going anywhere.

My sense is that people blame themselves because, with the lack of a cultural framework for speaking openly about and addressing pregnancy loss, they turn inward. They turn in on themselves. I think we can agree that women are groomed to blame themselves for too many things from the get go, and miscarriage is a ripe opportunity to hurl harsh statements at oneself or to believe that somehow you could’ve done something differently that would have brought about a different result.

We struggle with miscarriage in part because all too often we are surrounded by images of glowing baby bumps that we imagine got there easily. We live in a society that relies on happy endings in order to get through. We were raised in a world that commends achievement, accolades, and positivity. We were taught that if we try hard enough to achieve something, we can and we will. Pregnancy, and all that can happen within it, falls outside of this ubiquitous trope. We cannot control chromosomes, genetics, or things unbeknownst to us that may be happening in our bodies that can take a pregnancy of course. We don’t have all the control. But we turn to questions like: What if I exercised too much? Was it that sip of wine? Did this happen to me because I was ambivalent about becoming a mother? Or, alternatively, did this happen because I wanted it too much?

The research informs us that these things did not provoke the miscarriage. But, the mind fiddles. The mind yearns for understanding, meaning, and closure. The mind wants to believe: Now that I know what I did to create this loss, next time I will do something differently. It’s magical thinking. It makes sense that we grasp onto this way of thinking amid grief, even if it is faulty and ultimately unproductive. My hope is that if the cultural conversation surrounding miscarriage became a mainstay—and it was integrated into society—the knee-jerk reaction to place blame on oneself might dissipate.

What to do if you have “bump envy”?

Acknowledge it, share with someone who “gets” it, and feel whatever it is you are feeling.

Own it.

It can sincerely suck to see a glowing baby bump bouncing down the street when you’ve just lost yours (or the hope of it). Then, recall the statistics. Approximately 1 in 4 pregnancies result in miscarriage, about 1 in 160 in stillbirth, 1 in 7 struggle with fertility issues, and those who terminate for medical reasons, lose a twin, an infants to SIDS, turn to surrogacy, go on to get pregnant after a pregnancy loss, etc. And hopefully, in remembering these statistics, your envy eases up a bit and you realize that it is quite likely that the beautiful belly you were so envious of may not necessarily have gotten there unscathed.

We assume it was all unicorns and rainbows when we are despairing. We look in on other people’s lives and think things are perfect, or at the very least, not tainted by the type of grief we are drowning in. But, the truth is, she too may have struggled to get where she is now. She too might have a story to tell.

As you point out in your book, not all miscarriages are met with sorrow—some are a relief, and this can be for any number of reasons. Why is this response to a miscarriage especially taboo to talk about?

In my clinical practice and in my online community, I have heard women reflect on being relieved in the aftermath of miscarriage. Relief seems to follow from a hunch or intuition that something wasn’t going right in the pregnancy, ambivalence about having a child, a desire not to become a mother at all (or not to expand the family further), and/or rooted in a belief that miscarriage is, in a sense, nature taking its course. Not everyone gets attached to a pregnancy from the get go; and not everyone begins to envision a baby upon seeing the two pink lines appear in the positive pregnancy test window.

Given the fact that women are traditionally expected to become mothers — or at the very least expected to want to be– those who feel a sense of relief after loss might tiptoe on eggshells as they try to share their candid feelings. “I’m okay, really. I’m not sad” might be met with quizzical expressions or haphazard attempts at reassuring the person that “time will help” or that “feeling the pain is normal,” encouraging them not to stave it off, but instead requesting they be honest about their heartache. But, for some, pregnancy loss is not mired in myriad emotions. For some, heartbreak is not the experience. Their loved ones might be surprised by this response. What’s more is that the pregnancy loss community itself might not feel like a natural home for them either, as they don’t hear their experiences echoed in the same way we hear about feelings like disappointment, sadness, or devastation. As such, feelings of relief or ambivalence oftentimes go underground, rendering the discussion around them especially taboo.

This interview has been edited for clarity and length.