Thursday 29 January 2015

Jessica: I had a miscarriage. Talk to me

Jessica Zucker is a clinical psychologist in Los Angeles who specializes in women’s reproductive and maternal mental health. Find her online www.drjessicazucker.com and on Twitter @DrZucker. This article is republished with kind permission from Jessica and was originally published in the Washington Post.

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Trauma stains the heart like pomegranate juice on a white linen couch, erupting perspectives and shifting ideas of order. No matter what you attempt to do, it’s there.

I can feel in my body every detail from that day two years ago despite the passage of time. And now, as my 13-month-old daughter comes barreling toward my breasts for comfort and nourishment, I occasionally feel an emotional tug somewhere deep inside. I’ve come to identity this feeling as a pinch of my soul’s memory, of the girl that wasn’t and the beauty of pain in the mash up of life. Trauma left me living on the outskirts for a while. But as my girl playfully cuddles into my body, I feel a sense of return.

At 16 weeks pregnant I had a life-threatening miscarriage, what I now think of as an unassisted homebirth to a daughter I will never know. As if it wasn’t hard enough to lose this pregnancy, I was dumbfounded by the reactions of those around me, or more accurately, the inactions.

A handful of people who comforted the bruised places in my heart and bore the pain alongside me helped restore me. But, for the most part, people seemed to vanish. Where did they go? I wondered to myself in the immediate aftermath of this mind-bending loss. With few exceptions, it seemed that people around me—old friends and new friends alike—feared contamination. I couldn’t figure out if my impressions were based in part on my postpartum haywire hormones heightening my sensitivity, or if my friends were in fact reaching out to me less than usual. Relationships mutated, as if time might diminish my miscarriage germs and things would magically return to normal.

My hunch was validated when a dear friend shared what another friend of ours told her following my miscarriage. She explained that it stimulated too many fears in her. She wasn’t sure what to say or how to act, so she said nothing. When I could muster comic relief, I would joke that it seemed like people thought if I sneezed on them or even simply spoke to them, they too might have a second trimester miscarriage. I felt like the circumstances of my life were seen as a toxic threat. I was temporarily quarantined.

After I contracted malaria in Nigeria over a decade ago, my infectious disease, which rendered me frayed and emaciated, seemed to be a conversation piece rather than a reason to pull back. Maybe people viewed my survival as an interesting war story because it didn’t include death.

As a society we struggle, or worse, we fail, when it comes to rituals that honor mourning out-of-order losses.

Sentiments of potential contagion were illuminated further by a patient of mine who humbly wondered, “Did this happen to you because this happened to me?” I heard my patient asking if her openness about her very humanity (namely her pregnancy losses) somehow spurred this in me, implying that we can lodge trauma into someone by merely talking. Tucked further into the nexus of her query is a kernel of shame. Perhaps she felt her hardships and the sharing of her intimate stories infected me, implanting a vector that directly manifested my loss. I was bowled over. This inquiry induced a loss for words. We held eye contact as I ambled around in my mind for the potential roots of her question—where this stemmed from in accordance with her childhood history, the possible cultural influences, as well as what it might represent about our nascent therapeutic relationship. As humans, our ever-present vulnerability is made less potent if we imagine we had a hand in the creation of negative outcomes.

If only we had this much control.

Sometimes we view loss as a competition, as if one kind of grief is more worthy of our tears. But suffering is suffering. When we recognize this, competition becomes superfluous.

There are no inoculations that guard against miscarriage if we engage in the messiness of creating life. We don’t infect each other by speaking our truths or sifting through our grief out loud. Communing clearly is not the problem. Out-of-order loss is. Vaccines don’t exist for such things, nor can they.

But we pretend our silence will vaccinate us and we use that belief to justify our reluctance to extend compassion.

“People just don’t know what to say!”

I implore us to talk about the very things that make us uncomfortable—to examine our fears, superstitions, and our premonitions—if only as an exercise in understanding what it feels like to engage rather than clam up when faced with out-of-order death.

Perhaps the very antidote to drowning in the heartbreak of reproductive trauma is talking about it candidly and exorcising shame. Maybe if we move closer to discussions of grief, we can actually alter this stale cultural ethos, so that the ache of loss might ease through the compassion emanating from community. Maybe a societal shift such as this will in fact catch on and infiltrate like an emotional revolution, infecting us with benevolence.

If conversation about the vicissitudes of miscarriage became contagious, then the shame and isolation that often accompany this type of loss could perhaps be contained.

There are countless viruses we can contract over the course of our lives. To be sure, miscarriage isn’t one of them.

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