About 10 to 20 percent of known pregnancies end in miscarriage. Miscarriage is defined as the spontaneous loss of a pregnancy before the 20th week. As a South Asian woman born and raised in the United States, I had wondered how many of these miscarriages occurred to people who look like me. I was aware research studies often underrepresent South Asians but the desire to feel included and acknowledged was heightened after I experienced three miscarriages of my own.
Until these experiences, I held an intellectual understanding of loss and grief as a Licensed Clinical Psychologist with a background in Women’s Studies. I knew it wasn’t a woman’s fault when a miscarriage occurred, for example, and knew how to walk a patient through the painful stages of grief. I knew, too, that it could feel devastating for life to take a nasty turn. What I didn’t know until I experienced loss, however, was how each miscarriage could carry with it such different meaning and weight—both on the psyche and the body.
My first miscarriage occurred when I was 31. I thought I was nine weeks pregnant when I had my first ultrasound and didn’t know what to expect. I followed what the nurse told me to do, held my husband’s hand and waited to see a little image on the ultrasound screen. That’s what happens in the movies, right? I didn’t expect there to be silence and a vacant gestational sac staring back at me. We soon learned that this was characteristic of having a blighted ovum, which occurs when a fertilized egg attaches itself to the uterine wall but the embryo does not develop. I took an oral medication that allowed my body to labor the remains of that pregnancy in my master bedroom. I grieved but learned that there can be room for hope again.
My second pregnancy occurred about a year later and we were fortunate to have everything go as planned. I was nervous for the first half of that pregnancy each time we entered the ultrasound room but over time, my nerves eased and I started to experience joy each time I heard our daughter’s quick heartbeat. She was lovely and we felt so blessed. Given what happened before, I felt grateful that the experience was behind us. I felt fortunate that our marriage had withstood the pangs of grief that come with any loss and could now experience the ups and downs of parenting for the first time.
My second and third miscarriages both occurred about three years later. 2018 certainly took us by surprise. I rationally knew that miscarriages were always a possibility but I hadn’t expected two pregnancies to fail within months of each other. The hardest part was seeing and hearing a heartbeat for one of them. It got stronger and stronger at each ultrasound and having a second child had started to become a reality in my mind.
This time it wasn’t a blighted ovum but the presence of an additional set of chromosomes that led to a loss. Triploidy is a rare chromosomal abnormality that could lead to an infant’s death within the first days of life. On one hand, it could be seen as a blessing that this baby did not survive. On the other hand, the image of that fetus in my bathroom is something that is etched into my memory forever. I had told this child just the night before that if my bleeding was related to her being in some sort of pain, she needed to do what was best. I asked her not to stay in my body to provide me with some sort of temporary comfort if it meant more pain for her.
I felt attached to her in a way I have not been connected to another being before. It is still hard to distinguish if this was love, intuition or self-preservation. I hadn’t met her but our bodies were connected for a few weeks and I wanted her soul to find freedom if it was in discomfort. I felt grateful that my body had been a vehicle for whoever she was for that short time. It was sad and so painful saying goodbye, yet I know that somewhere and somehow we would always be connected.
It took me a few months to gather strength to try yet again for a second child. I was surprised I was even considering it but the doctors found no compelling reason for the losses so far and indicated there was a good chance that all would be well. I felt guilty for even wanting to try again. I had a healthy toddler, I already had two miscarriages in my history and maybe I needed to find gratitude in the life we had as a trio. We had always wanted a blended family and had even started the adoption process to bring home a little girl from India too, fully aware that the process may take three years or more. But would I regret not trying at all for another pregnancy one day? Would I look back and wonder what could’ve been? So we tried again to learn a new term yet again: Missed Abortion.
This is when the embryo has died but there is no expulsion from the body. It is also referred to as a delayed miscarriage, silent miscarriage or spontaneous abortion. The challenge here was experiencing morning sickness and watching my body change in response to the pregnancy hormone swirling about in my body. I had believed this to be a hopeful sign, especially when my friends and family encouraged me to consider my anxiety as a consequence of my history and not because something unfortunate was yet to happen.
While these experiences happen to women of all ethnic and cultural backgrounds, being South Asian American added a layer to this process of pregnancy, loss, grief and coping. It came with the best of intentions but I would too often hear that I “just need to be positive” before, during and after my losses. Or that if I prayed harder it would all feel better or be okay. I had a family member react with such surprise that I had stopped praying or performing any religious rituals, making me shameful for my anger and grief.
Someone else urged me to consider whether I had done anything to create these outcomes like take a flight too early in the pregnancy or exercise too vigorously. Simultaneously, many older members in the community asked when I was giving my daughter another sibling without considering the possibility that I had been trying harder than they knew to meet their hopes for my family. I knew their intentions were good and their context different from mine, rarely labeling negative affective states or discussing topics like grief.
Depending on the circumstances of the day, my responses to the above comments were often not as grounded as I would’ve liked. I would ask, “what does positivity have to do with an extra chromosome?” and “who exactly am I praying to and what am I praying for?” I didn’t want to pray for pregnancy if it meant more pain for our baby and family. I didn’t want to pray for pregnancy if it was a selfish endeavor to consider given all that we had already lost and all that we were lucky to have.
Throughout our grieving process, I was struck by the silence regarding miscarriages already experienced by people in my community. It was only after my husband and I committed to being open about our experiences did we hear about others experiencing something similar. Why the silence, I wondered, when it came to something about a woman’s body? What made it so taboo if it was, indeed, something that happened so often? And where were the pujas and prayers to bid goodbye to the souls of these babies that never saw the day of light?
[Read Related: Let’s Start Breaking the Culture of Silence About Miscarriages]
An article written by another BGM contributor, Aneet Alang, provided me with much comfort just days after my last miscarriage. She summarized it well in her plea for the South Asian community to come together in solidarity as opposed to silence for women, couples and families experiencing grief related to pregnancy loss. Alang writes,
By keeping this loss silent, we take away the opportunity for women to be able to share their pain and grief, to know that we are not alone and that there are many others who have faced the same loss and found the courage to move forward. By being open we can support one another.
I don’t know what lies in store for me or my family in the future but I do know this: The more a community is informed and educated about pregnancy loss, the more comfort and compassion they can show for those experiencing grief due to this hardship. The more we stay silent about this topic or gloss over feelings by telling people in our community to “just pray” or “just be more positive,” the more women are given the message that they are not allowed to speak, share and mourn. Avoiding a topic out of discomfort or lack of information does not encourage healing or recovery either physically or mentally. Let us come together to be the best we can be for ourselves, for families silently enduring pain related to pregnancy loss and for the next generation, whether we have the privilege of meeting them or not.