The first time I remember wanting to be a mom was when my little sister was born, 12 days before my sixth birthday. The first time we took her out I carried her around proudly and called her “my baby.” Not “my sister” or “my baby sister,” “my baby.”

Since then, I’ve known, without a single doubt, that I wanted to be a mother. I’ve loved the children I’ve cared for as a childcare provider, but I’ve known that the love I had for each of them would pale in comparison to the love I would have for my own child. I’ve loved many people, but I know none of them have been my one true love; my one true love will be my child.

On May 25, I took two pregnancy tests, and they both turned positive. Those two tests sat on my bathroom counter, and every time I saw them, they confirmed that my one true love was alive inside me. But just days after finding out I was pregnant, my OB told me she was concerned about an ectopic pregnancy because I’d had surgery on my reproductive organs to treat endometriosis only two months earlier. She ordered some tests and while waiting for the results, I decided to take another pregnancy test, just to be sure. But that test only showed one line: not pregnant.

Heartbreak isn’t a strong enough word to describe the agony I felt sitting on the bathroom floor staring at that negative pregnancy test. I cried the way that mothers do in movies when they lose their children—a kind of crying that I always thought was exaggerated for dramatic effect. For five weeks my baby was alive inside of me. Part of me. When my baby died I felt the absence inside of me, like a piece of of me was suddenly gone.

On The Fear Of Pregnancy Loss In The First Trimester
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I want to be clear that this is my individual experience of pregnancy and pregnancy loss. We all have different opinions about when a pregnancy constitutes a life, and all those opinions are valid. The moment I knew I was pregnant, I became immediately attached to that life. This does not happen for all women and that is completely fine. Each experience is different. This one is mine.

In my grief-addled brain, I desperately tried to make sense of what had happened, and only two explanations seemed to fit: either this was all part of some universal plan that I didn’t understand, or my body, which had failed me so many times already, had failed again.

A lot of what people said in their attempts to comfort me was along the lines of the “universal plan” explanation. Most people don’t know what to say when confronted with the enormity of someone else’s grief, so they resort to cliches like “everything happens for a reason” and “nothing happens in God’s world by mistake” and “on the other side of every struggle is a lesson.”

Either this was all part of some universal plan that I didn’t understand, or my body, which had failed me so many times already, had failed again.
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When I was struggling in the past, I found cliches like this comforting. But when faced with the loss of a child, they sounded hollow and cruel. How could there be some kind of lesson in this loss? What purpose could a higher power have for taking a baby from me? How could there be beauty on the other side of this?

I was forced to reexamine my beliefs on a higher power and the universe, and I came to the conclusion that I don’t believe in a higher power or a universe that would take my baby as part of some greater plan or to teach me a lesson about resilience or least of all to punish me for my past sins. And without an external force to blame for doing this to me, all that I was left with was the conclusion that my body had done this to me. My body had rejected a baby that it somehow couldn’t support.

My body was an easy target for my anger and hatred and pain because I was so accustomed to hating my body. I can’t really remember a time when I was comfortable in my body. What I do remember is the constant battle I waged against my body and the battle I felt my body had waged against me.

The Criminalization of Miscarriage Makes Me Fear My Eating Disorder
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When I got my period, my body and I very quickly became enemies. The flood of hormones brought crippling depression. I started to gain weight, which is completely normal during puberty, but I compounded this weight gain by overeating to cope with the depression that had turned my world monochromatic. Within a few years of getting my period I was “the fat kid” and got bullied relentlessly.

A couple of years after my period began, I started showing symptoms of what would be diagnosed, 12 years later, as endometriosis. Every month my cramps were so painful that I could barely move, sometimes so painful that I would vomit. I would bleed so heavily that I had to change my tampon between every class. The weeks surrounding my period would bring awful GI problems that left me running to the bathroom as often as I could.

By the time I was in high school, it was clear to me that this fat, malfunctioning body which tortured me all the time was my enemy. So, I started on my quest to tame the wild body that made me feel so out of control, to make it more acceptable. What started as a “diet and exercise plan” quickly morphed into an eating disorder that would rule my life for the next 12 years. It was easy to punish a body that made me feel so awful, physically and emotionally. I believed it was what my body deserved.

My body was an easy target for my anger and hatred and pain because I was so accustomed to hating my body.
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When I finally got into treatment for my eating disorder, I was ready to make peace with my body, but I wasn’t prepared for what that would entail. When I stopped using eating disorder behaviors I gained a lot of weight. Suddenly, I was the fat kid again, and I hated my body more than I ever had, even before the eating disorder ever started.

I was confronted with the fact that my body, when it is healthy, is an overweight body. I can force my body to be thin by depriving it and pushing it beyond its limits and punishing it constantly, but when I am kind to my body and feed it when it needs to be fed and move it only as much as it wants to move, my body wants to be fat. And that’s when I decided that, if I was ever going to be happy again, I had to accept my fat body exactly as it was. Which was exactly as hard as it sounded.

I found a really good therapist who helped me see the connection between my core beliefs that I was broken and not good enough and not worthy of love and the way that I treated my myself. And how my belief that I deserved bad things and that they were my fault meant I’d never be free from them.

Over the course of several months, I used eating disorder behaviors less, and finally, I stopped. I started hiking and doing yoga—activities that allowed me to be present in my body and see what my body was capable of doing. Slowly, I began to view my body as a vessel for my experiences in the world rather than a symbol of my value to the world.

Eventually, I didn’t really think about my body that much at all. I could walk by a mirror and look or not look, and if I did look it wouldn’t ruin my day. That was my version of accepting my body.

Acceptance was as far as I’d gotten before I got pregnant. Being pregnant was the first time I’d ever really felt at home in my body, completely okay with my body. I’d wanted to be pregnant my whole life, and when I finally was, everything felt right. This body I had hated for years was no longer my enemy.

But just as quickly as the peace was made, it was shattered. When I miscarried I felt betrayed by my body. Betrayed by a body whose reproductive system had never worked quite right. A body that was my prison while it suffered through a chronic illness. A body that had just gone through surgery to remove endometriosis so I could get pregnant. A body that I had never really liked in the first place, no matter how thin I got. A body which I had beaten and starved and mistreated for years. A body that had given me a baby and then taken it away.

I wondered how could I continue to live in my body, a body that apparently hated me as much as I hated it. Why else would it give me the one thing I wanted more than anything and then take it away?

In the aftermath of my miscarriage, I wanted to hurt my body as much as it had hurt me. But to my surprise, I found that I couldn’t. There were days where the grief was so overwhelming that I forgot to eat, but when I purposely tried to restrict or force myself to exercise when I didn’t want to, it didn’t provide the sense of relief or control that it used to. There have been times when intrusive thoughts about self harm have taken over my brain, but I couldn’t bring myself to actually act on them.

In the aftermath of my miscarriage, I wanted to hurt my body as much as it had hurt me. But to my surprise, I found that I couldn’t.
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No matter how angry I am at this body that has betrayed me, no matter how much I hate it for taking my baby from me, I can’t hurt it anymore. I’ve learned to value my body and myself too much to cause myself harm.

I’m beginning to understand that the anger and hatred I’ve been directing at my body is misplaced. When grief is too excruciating, it’s much easier to turn to more accessible emotions and direct them at something more concrete than the abstract experience of loss. It’s much easier to assign blame to my faulty body than it is to accept that my miscarriage just happened—that there isn’t any reason or explanation. But doing what’s easy and rationalizing away grief doesn’t allow healing.

I’m starting to engage in the much more difficult process of accepting and forgiving rather than blaming and harming. I know it’s going to be a long process, but by now, my body can handle it.

“Your baby has no heartbeat.”

I stared at the doctor in shock, my eyes instantly stinging with tears as his words sunk in.

I looked back and forth from the devastated look on my husband’s face to the sonogram screen, silently pleading for that tiny little black and white flicker to suddenly appear, unable to believe this was really happening.

How could the baby, who was developing so well for the last nine weeks, just be gone?

Within moments of hearing those devastating words, I was told I would have to have a D&C, that this was my only treatment option.

Ten to twenty-five percent of all pregnancies end in miscarriage. In some cases a woman may wait and see if the body naturally expels the tissue, but this is not a viable or recommended option for many people. This is when a dilation and curettage (D&C) may be needed. A D&C is a surgical procedure, typically done in the first trimester, to remove tissue from inside your uterus after a miscarriage. The patient is placed under general anesthesia — or, in very rare cases, under heavy sedation — while the procedure is done. (There is also a D&E procedure that removes tissue and also requires anesthesia, but this is typically used after the first trimester.)

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Historically, the D&C has been the dominant treatment method for people after a miscarriage, and it has generally been considered safe — and for some, it may be necessary. But there is an increased risk of complications whenever anesthesia is used, due to potential reactions to the medication and resulting breathing problems. And for those who already have a history of reacting unfavorably to anesthesia, this can add additional complications.

Recent studies have also found that there may be more risks to a D&C than previously thought. Researchers from the European Society of Human Reproduction and Embryology analyzed 21 different studies on D&Cs and discovered that the procedure is connected with a 29% greater chance of preterm birth (defined as birth occurring before 37 weeks) and a 69% greater chance of very preterm birth (less than 32 weeks) in a future pregnancy. This study of almost 2 million women also found the risk of prematurity was even higher in women with several previous D&Cs.

This is not intended to cause alarm in women who have already had a D&C, or to endorse one procedure over another — but patients should always be advised of every option available to them, not just the standard D&C.

Manual vacuum aspiration (MVA), for instance, is a safe treatment option in an early miscarriage. In this procedure the cervix is numbed and tissue is removed with a hand-held device (MVA) or a small electric device (referred to as an EVA). The procedure lasts, at most, 10 minutes. The patient remains completely awake and alert the whole time, and it is now the recommended method of treatment for early miscarriages by the World Health Organization. The Journal of American Science also reports that the MVA is effective, less time consuming, and less costly, and since it doesn’t require general anesthesia, the risk of complications is less than a D&C.

Patients should always be advised of every option available to them, not just the standard D&C.
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Another study published in The International Journal of Obstetric and Gynecology reports that the MVA is “an alternative to the standard surgical curettage, performed under local anesthetic. It is a safe, and possibly cost-effective procedure, with advantages for both the patient and the health-care system.”

There is also a medication option where a patient is given misoprostol, a drug that causes the tissue to pass. Patients take the pills at home and often have to follow up with their doctor afterwards to ensure the procedure was effective.

I was not informed of these other options after my own miscarriage by any provider, including my doctor, a highly-regarded physician in New York City, and the staff at the surgical center. As a clinician that has worked in a medical setting, and with patients who have miscarried, I was already aware that other options to the D&C existed, but none of my providers discussed these with me. At one point I was even told by staff at the center that “if you have a miscarriage then you have to get a D&C.”

When I met with the “counselor,” employed by the surgical center to speak with patients before they see the doctor to inform them of treatment options and review consent forms, they only brought the information and consent forms for the D&C and said nothing about the MVA or the option to take misoprostol at home.

I continued to refuse the D&C. Having had difficulty with anesthesia in the past, I saw no need to have this if it wasn’t absolutely necessary, and finally, after going through multiple staff members and supervisors, I was given the proper consent forms for an MVA and was taken to one of the on-duty doctors who confirmed that an MVA is an applicable treatment option in an early miscarriage.

In speaking with many other women who have also been in this situation, they too shared stories of not being informed that there were other options, and many told me they had never been told that the MVA procedure even existed.

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There are compelling reasons why patients might not be getting a full picture of their options after a miscarriage, the location of where the procedure is performed being one. Many D&Cs continue to be performed in hospital operating rooms, despite the advances in miscarriage management, and even though, with the exception of certain complicated cases, there is no longer a medical need that necessitates a patient going to the hospital after a miscarriage for a D&C.

This is often due to physician preference rather than what the patient wants. Studies have shown that medical providers’ attitudes toward newer treatment have remained stagnant, that many physicians still utilize the older D&C method and still prefer to treat pregnancy loss in the hospital operating room, according to research published by the Guttmacher Institute and the National Institutes of Health.

Even if a D&C is the right treatment option for a woman, it isn’t medically necessary for this to be done in the hospital and it can be performed in other medical settings, such as a surgical center or a private doctors office. Requiring people to go to the hospital OR (operating room) often adds significant stress, time, and cost to an already painful situation.

New York City-based physicians, Drs. Priypa Praditpa and Anne R. Davis, concluded in at 2015 study, “Manual vacuum aspiration: A safe and effective treatment for early miscarriage,” that the MVA is not only a safe procedure, but that “for too long, patients have blamed themselves for a miscarriage and physicians have relied on the D&C in the OR. Changes in the culture surrounding miscarriage are long overdue.”

At one point I was even told by staff at the center that ‘if you have a miscarriage then you have to get a D&C.’
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The financial aspect to the D&C likely plays a role and provides an incentive to which procedure doctors perform and where they perform it. Providers can bill insurance companies at a higher rate once anesthesia is administered and even more so if it is done in a hospital. Anesthesiologists typically bill at a base rate and then at each 15-minute interval while the patient is under their care.

Both the MVA and the medication option are considerably less expensive than a D&C, with the average cost of an MVA being less than half the cost of a D&C in the OR — $968 for the MVA, compared to $1,965 for the D&C, according to Praditpa and Davis’s research. The Healthcare Bluebook also lists the “fair” billable price for a provider to charge for a D&C as $2,728, though that can go all the way up to $6,820.

For uninsured women, the cost of a D&C can be staggering; though prices vary depending on provider and location, they often range from $4,000 to $9,000. Insured women have also reported exorbitant out-of-pocket expenses after a D&C, ranging from several hundred dollars to well over a thousand depending on their individual insurance plans. This further skews the incentive for medical providers to offer more economical treatment options.

But it’s not just about money or location. A miscarriage is already an emotional and painful time and it is every woman’s right to know all of their treatment options so they, not the medical staff or office billing manager, can make the best decision for their body — a decision based not on increasing profit or perpetuating unnecessary medical procedures, but on their individual needs.

My fantasy of sharing the news of my planned pregnancy was vivid, more lucid than a dream, and extraordinarily straightforward. I’d take a pregnancy test and learn I was pregnant. I’d immediately tell people. They’d be happy and we’d celebrate!

But I only made it through step one.

After “YES” appeared on a stick wet with pee, I went online and through a series of rabbit holes, descended to a devastating truth: 15–25% of recognized pregnancies will end in a miscarriage, and 80% of these miscarriages occur in the first trimester.

Roughly speaking, this averages to a 20% risk. As in, line me up in a room with just nine other people, and two of us will leave without a baby.

I’d have to wait to tell people, and I’d have to wait to feel anything approaching excitement. Because how can one be happy, when perched on the edge of a staggering precipice?

I don’t wait completely. I can’t.

Twenty minutes after learning the stat about first trimester miscarriage, I call my mom.

“I just took a pregnancy test,” I say, slowly, measured.

“And…?”

“It said yes…”

“Oh my…”

“BUT! It’s really early. And it’s totally possible that something could happen. I don’t want to get too excited.”

“Oh.”

Three days later, I break, comically easy, when two of my best friends inquire about my efforts to conceive.

“Well,” I say. “Actually. I am pregnant.”

Their eyes widen and they start to exclaim…

“BUT! I’m really not supposed to tell people. It’s super early and something could happen,” I quickly interject.

They stop, and nod solemnly instead.

This is not how I planned it.

Sure, I knew people don’t tend to announce their pregnancy right away, but not for three months? Because there’s a 20% chance of losing the baby? This was never covered in the cultural literature we call the Wonders of Childbirth.

Consider: In one recent study, more than half of respondents said they thought miscarriage was extremely rare, occurring in fewer than 6% of pregnancies, with men twice as likely as women to mistakenly believe this.

To report on the actual facts surrounding miscarriage would, perhaps, be unseemly; it’s far more quintessentially American for bright and blissful mommy blogs to revel in the sanctimonious miracle of birth. And it’s far easier to sell your pro-life (anti-choice) case that the life of a fetus must be cherished and protected at all costs if that fetus is presented as a guaranteed baby.

Maybe, too, we don’t hear much about miscarriage because the women who’ve lost babies are made to feel deeply embarrassed. That study about miscarriage misconceptions? It also found that 41% of women felt they had done something to cause their miscarriage, 41% felt alone, and 28% were ashamed.

These staggering stats are rooted in a host of fraught myths about pregnancy/miscarriage. A whopping 76% of people believe stress leads to miscarriage (not true), 64% think lifting heavy objects can cause pregnancy loss (nope), and 20% claim getting into an argument is enough to ensure a fetus’ death (absolutely not).

Whatever the reason, here we are, information-less and left to our own devices, fending for scraps at the bottom of internet rabbit holes.

Perhaps now is the right time to share some other facts society never tells you:

Even after an ultrasound confirms the pregnancy, there’s a >15% chance of pregnancy loss for a woman my age (33).

Most miscarriages are caused by fatal genetic problems in the baby.

1 in 4 women experience a miscarriage in their lifetimes.

More than anything, no one ever tells you: It is not the woman’s fault.

For two weeks, I don’t tell anyone else. Why are you not drinking? I’m trying to be good! Are you pregnant? Not yet…but we’re trying hard! (wink wink) You look tired. God, yes, it’s been a long week!

In the absence of telling, of excitement, I worry instead. The baby is almost invisible, the size of a lentil according to my newly downloaded pregnancy app, and already I’m certain I’m ruining its life.

I wasn’t supposed to drink while we were trying, just in case, but a week before I took the pregnancy test, I indulged in a glass of wine at girls’ night. Could that do it?

What about yoga? Sushi? Sleeping funny? Sex?

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My husband is anxious too, already sharing his concerns about dropping the baby on its head, or fucking it up forever thanks to unintentionally bad parenting skills. But my anxiety is deeper, more visceral — because I know if something happens before the baby is born, any suspicion will be directed toward me.

It can’t possibly be his fault. I’m the bearer. I’m the vessel. It has to be mine.

We live in a world, after all, with headlines crowing “One in four miscarriages could be prevented with changes to a woman’s lifestyle”; a world in which women must resort to posting about their partners blaming them for pregnancy loss on anonymous message boards.

“After a pregnancy loss, many women feel a sense of responsibility or guilt for what has happened with their child. These feelings of responsibility can lead to a host of unpleasant emotions that bereaved mothers and their partners carry around for years,” one representative study states.

One day, I eat salmon in a sushi burrito; halfway through eating it, I remember reading something about raw fish being unsafe during pregnancy, and panic. That night, I dream that I inhale a cocktail in a comically large glass with a colorful straw. I awake in a sweat before the dream can end as what’s become my greatest nightmare.

If I lose the baby…Will I blame me?
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If I lose the baby, will my husband blame me, divorce me, hate me? Will I blame me? Will I look in the mirror and see a woman whose selfishness has destroyed all that’s good, like Eve turning paradise into ashes?

(To be clear, I would only feel this way because we’ve chosen this pregnancy; if I had not made the choice, if the circumstances were different, I would’ve readily received an abortion. That choice is moral and right and every person’s to make.)

Yes yes, I know I said it’s not the woman’s fault. But I also know that won’t stop anyone from acting like it is.

It’s week 7, and we’re about to have our first ultrasound, an 8:45 am appointment. I oversleep, and spend the morning snapping at everything and nothing in particular. The dog, for barking. My husband, for taking too long to brush his teeth. The silverware, for not being where it should be. I’m operating at a frequency that signals impending explosion, so my husband leaves the house to walk the dog and escape the likely debris.

This appointment has me in a state.

When we finally arrive at the check-in desk, exactly five minutes late (it feels more like five years) I’m immediately sent to a room to pee in a tube. I panic — what if I can’t pee?! — but make it through, and then away we go, to a clinical little room where I’ll be meeting my child for the first time, if indeed the child still exists.

My doctor shoves a tube of some sort into my vagina, and there it is: a tiny flicker on a sonogram screen. My baby. Alive.

We listen to the heart beat, and it’s so fast. Too fast?! But my doctor doesn’t seem worried.

And then, just like that, we’re done. For today, at least, my baby is still here.

I go home, and do more research. At week 7, the chance of miscarriage for someone my age is 11%. Line me up now with nine other women in a room, and only one of us will leave without a baby. This is better!

I recognize this probably sounds overdramatic. But there really is a certain cruelty to this process; to telling us Here is this baby you wanted! But wait! It might not be for long.

Then again, I wonder if maybe this is the ultimate first test.

In the first trimester, in the second, in the third, in labor, in infancy, in grade school, in high school, in college, in beyond — something unexpectedly bad could happen. Stillbirth, dropped on the head, car accident, disease, murder, suicide, falling out of a window, slipping on ice, eating a poisonous mushroom, choking on a sandwich, nuclear explosion.

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Any one of these things could happen. Most of these and other things happen all the time.

And so I have a choice — and the first decision of this early motherhood comes sharply into focus. I can be anxious unceasingly, spending my days online, consulting alarming statistics, telling myself I’m just trying to stay prepared. Or I can embrace in this moment that there is a chance, a better chance than not with each passing day, that I will have this baby.

I’m choosing the latter, and to carry this truth throughout motherhood. In a world that scrutinizes, dissects, and penalizes women at every turn from pregnancy to motherhood, I will be shouting my pregnancy news loudly, knowing that whatever happens, I will not be to blame.

And if I have this baby, and especially if it’s a girl? I’ll be ready with my message: Be fearless. Be strong. And my darling, it’s not your fault.

In Naturalis Historia, the Roman naturalist Pliny the Elder wrote that period blood has the power to stop whirlwinds, kill bees, and drive dogs mad…

If you feel compelled to chuckle, keep in mind that nearly 2,000 years later, menstruation is still shrouded in myth, taboo, and beliefs that are nearly as bizarre as what ‘ol Pliny was peddling.

In fact, the actual science of why people have periods is almost stranger than the myths. And while periods are part of the everyday lives of over half the population, the answer to the simple question “why do they exist?” is far from being common knowledge.

Humans — along with old world primates and certain types of bats — are one of the few species on Earth that menstruate. In these species, a drop in the levels of the hormone progesterone triggers the breakdown of the inner lining of the uterus. What follows is an extraordinary process of scar-free wound healing. The uterus can break down and regenerate every month, hundreds of times in a lifetime — all without ever leaving a scar.

This incredible process is practically unheard of in adult tissues, but, as many of us know, periods can also be debilitating. So biologists have been puzzled as to why this phenomenon should have evolved. And, more specifically, why did it only evolve in humans, old world primates, and certain bats?

Recent research suggests that the answer lies in an ancient conflict. It’s in the best interests of the father (or parent providing the sperm) for the mother (or parent providing the egg) to pour as much energy and resources into pregnancy as possible. But it’s in the best interests of the mother to balance the needs of pregnancy with maintaining their own health. In humans, this conflict has left its mark on our very DNA.

We each have two complete copies of the human genome: one paternal and one maternal. Usually, the two copies are equally active. But sometimes, the father or mother modifies their copy so that certain genes are “off” — most of the genes that are modified in this way are involved in fetal growth.

Herein lies the rub.

If both copies of those parental genes were active, the fetus would grow abnormally large. So, in the copy of the genome she provides, the mother’s body gets the hell in there and shuts those genes off.

Likewise, there are certain genes that repress growth, and if both copies of those genes were on, the fetus would be abnormally small. The father goes in and shuts those genes off. The size to which the fetus will grow is ultimately determined by this genetic tug-of-war.

This conflict has also driven the evolution of a particularly gruesome kind of placenta: the hemochorial placenta.

Some types of placentas don’t invade maternal tissues at all. But the hemochorial placenta — which all menstruating species have — burrows through the walls of the uterus and hooks into the mother’s bloodstream. Once the invasion is complete, the placenta can control the mother’s entire body by releasing hormones into her blood. So it was necessary for people with wombs to develop a defense system to mediate placental invasion.

This was particularly crucial because of another strange quirk of human biology: Human embryos are 10 times more likely than other mammals to carry an abnormal number of chromosomes. Some variation in chromosome number can be tolerated: For instance, three copies of chromosome 21 in Down Syndrome or only one copy of the X chromosome in Turner Syndrome. But in general, embryos with large parts of their genomes missing or duplicated will not be able to develop.

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Because so many human embryos are actually inviable, our species has an incredibly high rate of miscarriage. Fifteen percent of clinically recognized pregnancies end in miscarriage, but counting pregnancies that aren’t clinically recognized, that number is actually closer to 50%. Unfortunately, society tends to tell pregnant people that something is wrong with them if they experience miscarriage, when really, a high chance of miscarriage is just part of being human.

Periods result from an adaptation to those two things: the invasive, hemochorial placenta and the prevalence of chromosomal abnormalities. One thing that humans, old world primates, and menstruating bats all have in common is a phenomenon called “spontaneous decidualization.”

Decidualization is the remodeling of the uterine lining that occurs in preparation for pregnancy. In other animals, decidualization is triggered by the presence of an embryo, but menstruating species have taken control of that process. In these species, decidualization occurs cyclically, whether there is an embryo or not.

A high chance of miscarriage is just part of being human.
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So why is this a good thing? Here’s why. Many people believe that the uterine lining thickens and changes in order to provide a hospitable environment for an embryo, but that’s not the whole story. Once the cells of the uterine lining turn into decidual cells, they gain the ability to sense whether or not an embryo is developing normally, even before it implants. If it is, the cells permit the invasion of the placenta. But if it’s not, the cells quickly self-destruct. By making the transformation into decidual cells occur cyclically, our species has made sure it’s prepared to defend against potentially harmful pregnancies before the embryo implants.

Some biologists argue that periods are just the coincidental result of combining spontaneous decidualization with cycling hormone levels. Once cells are decidualized, a drop in progesterone will trigger them to self-destruct. And, so long as pregnancy doesn’t occur, progesterone levels rise and fall each month.

It makes sense that periods might not have intrinsic benefit, because in the natural state, periods are pretty rare. Our ancestors, who were more frequently pregnant, only had about 40 periods in a lifetime. But some biologists think that menstruation does have intrinsic benefit. Because the uterus is able to repeatedly break down and rebuild itself, it may be able to learn from previous reproductive events and adapt. If this is true, it might explain why most pregnant people who experience miscarriage eventually go on to successfully conceive.

Menstruation is, in many ways, a potent symbol of the socio-cultural stronghold the patriarchy still wields. In a society that has become increasingly inured to the ubiquity of sex and violence, periods remain largely unmentionable, further complicating our long history with the uterine lining. But I tend to believe that — although he may have been oh-so-wrong in the specifics — Pliny the Elder was damn right when he wrote “over and above all this there is no limit to woman’s power.”

Frida Kahlo’s “Henry Ford Hospital” (Credit: flickr/libby rosof)

By Miriam Jameson

Almost two years ago, I was at my doctor’s office, receiving some of the worst news of my life. I don’t remember what the room looked like, what the doctor was wearing, or where I was seated.

I remember that I wanted to scream after the doctor told me: “This happens to 1 in 4 pregnancies — it is very common — and I am so sorry.”

I remember how this made me feel — like a statistic.

I remember feeling like I didn’t have the right to cry.

It was a moment I’ll never forget.

***

In May of this year, I sat at the piano, unsure of what was about to happen. As a songwriter, I don’t plan ahead, or indeed “compose” in the conventional way; instead, I prefer to create improvisational music as I’m moved to do so. This is not how most create, but it’s the only way I know how — to take the authenticity of a moment and hit record.

That day, confused as to why I was feeling so heavy with emotion, I had a vision. In my mind, I was rocking the baby we’d lost, filled with the entirety of a mother’s love. It was from this emotion, this image, that I began to record “Baby J.”

Art has long been used as a tool to process grief, and through that, to create something beautiful; it’s an extraordinary transformation, and a deeply powerful one. As The New York Times put it in a story on artistic creation post-9/11, “Artists have always combated grave tragedy with grave beauty.”

Miscarriage grief can be particularly profound; our national discourse on the topic is so limited that many who have experienced it feel they must bear the burden alone, in silence, which makes the act of artistic expression all the more impactful.

Frida Kahlo began painting in large part as a response to her own miscarriage; in paintings, the surreal aspect of losing a child manifested itself in her signature style — as in the painting “Henry Ford Hospital,” containing a red baby floating above her hospital bed and naked body, connected by rope. Countless other paintings, murals, and photo collections, as well as films, have been created in response to pregnancy loss.

And of course, music has long been a medium that those grieving have turned to — from Lily Allen in “Something’s Not Right” (“We had forever/We never got it together/I waited for you/For you I made it better”) to Hillary Scott in “The Will” (“I may never understand/That a broken heart is a part of your plan”).

Beyonce has spoken candidly about how pregnancy loss inspired her song “Heartbeat,” in which she sings, unaccompanied, “You took the life right out of me/I’m longing for your heartbeat.”

My own song has no lyrics, instead expressing the pain of miscarriage through a short, simple melody alone. But in all these acts of creation, there is a connecting motivation: using art to express something that often feels like it can’t possibly be expressed.

The most beautiful thing about sharing “Baby J” is that it’s not about me. It may be my feelings in the recording, but I am the “every woman.” Because whether you have five children, no children, don’t want children, or have left it for the future to decide — you may have experienced loss. And that loss cuts to the center of who we are as women.

I invite you to listen. And if you’re so inclined, I encourage you, in moments of grief, to create.

***

Just three months after writing my song, I learned about something I had been oblivious to my entire life: October is National Infant & Pregnancy Loss Awareness Month. Upon learning this, I sent out a flurry of emails — to bloggers, to organizations — in the hopes of collaborating to assist in their efforts, engender a more open conversation, and encourage creative works as a way to inspire healing.

As timing would have it, I connected with the executive director at First Candle, a nonprofit devoted to providing support and free grief counseling to those who have lost a child. For the month of October and in honor of National Infant & Pregnancy Loss Awareness Month, 50% of proceeds from “Baby J” on iTunes will go directly to First Candle.

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Lead image: flickr/Martin Howard