Health

Are we over-sharing lost pregnancies?

Devastated by perinatal deaths, parents reach out in sometimes disturbingly public ways

The mourning after

Jacopo Raule/Getty Images

Last month, Jay-Z released Glory, a song dedicated to his newborn daughter that triggered a gossip maelstrom. In it, the privacy-obsessed rapper revealed intimate details of a previous pregnancy with his wife, Beyoncé Knowles: “Last time the miscarriage was so tragic / We was afraid you’d disappear / But nah baby you magic.” Lyrical merit aside, the verse signals a watershed as the first rap song to lament a miscarriage—and yet another marker of the evolving openness, even militancy, surrounding perinatal loss.

Miscarriages (legally defined as the death of a fetus of less than 20 weeks) or stillbirths (the death of fetuses over 20 weeks) are a sad reality in at least 20 per cent of pregnancies. In 2002, singer Tori Amos discussed the “emptiness” she felt after her multiple miscarriages, on the U.K.’s Channel 4: “There’s no coffin, there’s no outward symbology, there’s no ritual. There’s just you and your partner. It’s not a reality for anyone else.” A decade later, that landscape has shifted radically. Miscarriage news is splashed in tabloids, as on last month’s OK! cover: “Leah’s heartbreak: she suffers a miscarriage,” about Teen Mom 2 star Leah Messer. Parents express their grief via T-shirts that read, “An angel watches over me.” The Internet hosts myriad “miscarriage” blogs and “stillbirth” tribute pages. One woman in the U.K. even used a photograph of her stillborn child as her Facebook avatar.

Such images are increasingly common. Since 2005, the Colorado-based charity Now I Lay Me Down to Sleep has provided volunteer photographers around the world who record gentle images of stillborn children for parents. Hospitals also provide “memory boxes” with footprints and handprints, and remembrance cards. “Mementoes help parents grieve openly,” says Glenn Breen, an ecumenical chaplain at Halifax’s IWK Health Centre: “For them to go home without any way of honouring the lost child isn’t emotionally healthy.” Naming ceremonies also offer solace, Breen says: “Parents haven’t had the chance to parent that child. So the ability to spiritually parent by naming is important.” When the fetus’s sex is indeterminate, a gender-neutral name like Taylor is chosen, he explains. The annual Walk to Remember across North America recognizes perinatal deaths, as do yearly memorials like one held at Toronto’s Mount Sinai, says Rebecca Purdie, a social worker in the hospital: “Ritual legitimizes the magnitude of the loss; it gives families permission to start grieving.” Tangible touchstones help parents cope with the abstract nature of the loss, she says: “It’s not just grieving a baby but a lifetime—who that child would have been.”

The U.S. religious right led the way in public displays of embryonic death, an activity critics call “fetus fetishization.” Recently, Republican presidential candidate Rick Santorum retold his story about taking the body of his 20-week-old son, delivered in 1996 and named Gabriel, home from the hospital so his young children could hold it and say goodbye. Last December, devout Christians Jim Bob and Michelle Duggar, the stars of 19 Kids and Counting, stoked furor by posting photos of their 20th child, Jubilee Shalom, who died at 25 weeks, on their blog. Gauzy black and white images of the fetus—a tiny hand holding Michelle’s finger, a little foot—were handed out at the memorial before hitting TMZ.com.

Given the obsession with female fecundity—tabloid scrutiny of “baby bumps,” gushing media coverage over the birth of celebrity babies like Beyoncé’s—it’s hardly surprising perinatal death has migrated into the mainstream. Last year, TV reporter Lisa Ling appeared on The View to discuss her miscarriage—and her new website, Secret Society of Women, which has a forum on the topic. The cultural acceptance that grief trumps others’ discomfort has paved the way as well. Couples were once expected to “deal with it” and “move on.” The newer message is that the loss will never disappear but will shift with time. Writing letters to children who died before birth or sharing their image is healing, not morbid or unseemly, according to some grief counsellors, even if the wider public hasn’t reached such acceptance. When TMZ.com reposted images of the Duggars’ child, commenters voiced disgust: “This is wrong. SO wrong,” one wrote.

We’re watching perinatal death following the trajectory of divorce before it—from stigma and silence to over-sharing as boundaries are tested and even blurred. The week the song Glory dropped, Slate’s “Dear Prudence” columnist Emily Yoffe fielded a question from a woman whose sister delivered a full-term stillborn child and wanted to send out a “birth” announcement with a photo of her and her husband holding their dead child. Yoffe advised against it: though the couple had “suffered a crushing loss,” she wrote, it would be wiser to circulate the image among intimates only; a “birth” notice would be “confusing and disturbing” since an actual birth hadn’t occurred.

The public focus on pregnancy, now routinely announced before the high-risk first trimester via Facebook’s new “Expected: Child” option, can heighten the sense of loss and stoke anger among women whose pregnancies end suddenly, says Purdie. The Web’s virtual nature is a haven for celebrating unborn children, some of whom even have their own Facebook pages. “There’s pregnant people and babies everywhere,” one woman grieving an early-term miscarriage vented on Ling’s website. Purdie notes that returning to work or social circles where women have children or are pregnant can be alienating for those who’ve lost their baby: “Women feel it’s a club they don’t belong to.”

But, as blogs attest, mobilizing around loss can amplify it, and extend the mourning process. “Mother of an Angel,” a regular poster on Ling’s website, reports she’s so mired in grief three years after losing her child she’s neglecting her other children. David Morrison, president of the Strathmor Group, a health consultancy in Charlottetown specializing in grief and palliative-care counselling, has seen the focus on perinatal death stall the healthy grieving process. Putting a lifelike photograph of a stillborn child in an office, for instance, could create awkwardness with co-workers, he says: “Such a public parade of grief risks alienating people who could provided important support.”

Grief counsellors observe that honouring and ritualizing fetal death can also blur legal distinctions of what constitutes life, a topic under debate in the U.S. election and potentially in Canada, as Conservative MP Stephen Woodworth tries to reopen the abortion debate with his proposal that Parliament study whether the definition of “human being” is contemporaneous with medical imaging. As Breen puts it: “You can talk about the legal aspects of how people define life, but in a health centre people don’t say, ‘The fetus died at 16 weeks.’ That’s clinical language. They say, ‘Our baby has died,’ and that goes with a host of grief and life adjustments.” Which means that the evolving focus on perinatal death potentially affects far more than bereaved families.

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