Living in Your Body after Miscarriage
Pregnancy loss is common: One in four known pregnancies ends in miscarriage, approximately one in a hundred results in stillbirth, and still more are terminated because they are medically risky to either the mother or the baby. And yet most people who lose a baby do their mourning in relative silence, without support or guidance from a community attuned to their pain.
Psychologist Jessica Zucker, PhD, built her career as a reproductive and maternal mental health specialist helping people navigate pregnancy loss and the grief that follows. Years into her psychology practice and sixteen weeks into her second pregnancy, she had a miscarriage of her own. While she wasn’t ready to share her story right away, she knew she wanted to talk about it and create the community she and others have lacked. It started with an Instagram account and a hashtag: #IHadAMiscarriage.
Now, in addition to her clinical work, Zucker writes extensively about the pain and politics of pregnancy loss and advocates to end the silence, shame, and stigma surrounding miscarriage. She calls out how women have been taught over time to remain silent about their suffering. She unpacks advice that isolates us, like the idea that we should wait to share pregnancy news until we’re “in the clear.” And she offers a voice of fellowship to those who have lost pregnancies themselves.
Zucker’s new book, I Had a Miscarriage, chronicles her own pregnancy loss story—including the trauma and sorrow of her own miscarriage event, the pursuit of sex and pleasure in the throes of grief, and the mixed excitement and fear of getting pregnant again—along with those of other people who have been through the same. It’s heartbreaking. And, as Zucker brings together a community of people healing from their own miscarriages, hopeful. In this excerpt, Zucker explores what it means to mourn a pregnant belly as the body shrinks back to its not-pregnant state.
From I Had a Miscarriage
Our bodies prepare for parenthood during pregnancy. Milk ducts swell. Bellies expand. The uterus rises. Muscles stretch. If that pregnancy is then lost, the next course of action is decided by the body, and the body alone. Depending on where we were in pregnancy, our bodies might take some time to fully comprehend and adjust to the nature of the loss. Milk arrives for a baby that did not. Hormones plunge us into the depths of the postpartum experience without an infant to serve as a breath of fresh air.
In my case, I don’t know what I thought would come of my tender breasts, which had become swollen over the sixteen weeks of my pregnancy, but it shocked me to find them engorged with milk following my miscarriage. How is the body to know when “liquid gold” no longer has purpose—that it can’t one day sustain the little being that no longer inhabits the womb? Our bodies don’t know, until they know.
The unexpected sensation began as I was on a drive just two days after my miscarriage. I peeked under my shirt and into my bra as I felt my nipples abuzz. What is going on? I thought to myself. Why are my breasts hard as rocks? My breasts began to leak—milk streamed down my now-softening belly. There was no hungry newborn to receive it. No need for a pump to collect it. No point in lamenting its waste—who it was meant for was gone. Another unforeseeable layer of grief. Another reminder of what was and then what wasn’t.
Of course, no one else saw me in that moment alone in my car. What the world around me saw instead was another choice my body made of its own volition: to rapidly shrink back to its prepregnancy state. Other people saw a woman who was, as Sara had pointed out, back in her prepregnancy jeans just a few days later. I’ll admit, I was genuinely troubled by how fast my prepartum body returned. It seemed not only odd but cruel—as if my body was trying to erase a pregnancy I hadn’t yet let go of, even after my body had.
I suppose other people at the very least found my body’s return to “normal” noteworthy as well—as it happened, Sara was not the only one who commented on my size. “You don’t even look like you were pregnant,” they’d say. And what they perceived was true. I didn’t. But I still wanted to be. I assume these people thought they were saying something…nice? As if acknowledging my body had already rid itself of the physical evidence of a pregnancy that did not last would aid my mind in purging itself of its memory too. But their words hardly registered as a compliment. What people didn’t see was how this speedy size change of mine added yet another dimension to my grief. Having been pregnant for four months and so suddenly having no outward evidence of that time seemed to erase for others the excruciating pain I was in. But I wanted proof. At the very least, I needed proof.
I wanted to look pregnant. I wanted to be pregnant.
Sometimes women want to maintain their newfound pregnancy shape so much so that they mourn each and every crevice as it morphs into something else. They want to be pregnant still—to hold on to the form that housed a life for however long—and maintaining the size of a pregnant body becomes part of both the longing for a pregnancy that was lost and a vital part of the grieving process too. Shape change, another complex element of the bereavement process, can be poignant.
Keiko came to my office when she was freshly pregnant, at seven weeks along. She reported a recent rise in anxiety—steadily increasing ever since she peed on a pregnancy test and those parallel lines appeared. I asked if there was a history of mental health issues in her family, and she shared that her maternal side is dotted with depression, anxiety, and an aunt who was recently diagnosed with bipolar I. Keiko had struggled with anxiety symptoms since her twenties, manifesting in a variety of ways socially: in intimate relationships and in her career trajectory. This was also Keiko’s first pregnancy.
Throughout her life, Keiko had been apprehensive about becoming a mother. She spoke of her fears of being “overbearing,” “underloving,” “perfectionistic,” and “hypercritical” in motherhood, and hence, wasn’t sure she wanted to enter the maternal arena at all. She didn’t expect she’d have an easy go of getting pregnant once she decided she was open to it. So when she became pregnant quickly, she found herself all the more inundated by worry about how she’d fare as a mother. During our time together, we traversed childhood issues, examined familial bonds, and unpacked relationship concerns. We explored her equivocations—their roots—and what she imagined the maternal role might entail. We were making progress.
When Keiko went in for a routine visit at the start of her second trimester, there was no heartbeat. Her devastation was far-reaching and she soon found herself engulfed by previously unexperienced levels of anxiety. Cloaked in a cocoon of sadness, Keiko upped her sessions with me. We began meeting twice a week.
Keiko focused on her physicality. “There’s so much confusion going on in my body,” she shared. “I mean, about my body. Well, both, I guess…”
Understandably, Keiko found it hard to pinpoint the words to capture this particular grief. This full-body shift. This one-day-pregnant, the-next-day-not transition. This instant transition from pregnant to not pregnant without the grueling-yet-often-rewarding hours of labor, and a newborn, to show for it.
“Yes, there is so much change going on in the body during pregnancy and when it’s lost. Tell me more about yours,” I said, hoping to encourage further exploration.
“I see changes I don’t want to see. I feel changes I don’t want to feel. How can I miss a baby I didn’t even know and barely thought I wanted?”
As Keiko’s size morphed from being on the precipice of robust to a postpregnancy state, she scrambled to maintain a semblance of the past. Her guilt had internalized, folding in on itself with reckless abandon, and in an effort to maintain what she thought made her a “good woman,” she yearned to appear pregnant, even though she no longer was.
“I’m embarrassed to admit this, but I’ve been trying to keep the weight on. I’ve been eating my feelings. I’ve eaten nothing but carbs since the D&C. In search of comfort, I guess, and maybe to help pad the anxiety. I want to hold on to that puffy belly. I want to keep it close. I don’t want to see it go,” she shared.
“You want to be pregnant still,” I said, with great understanding.
“I really, really do! I ask my boyfriend to rub my belly every night, still. I find it soothing. It makes me feel like something is still growing in there, like he’s nurturing it.”
In our next session, Keiko shared body-image concerns she’d navigated in her teenage years and how pregnancy— and the loss of it—stirred these visceral memories. She thought she’d “made peace with the past” but found that her miscarriage reignited ancient, loaded feelings, setting off even more anxiety.
“I grew up being compared to my sisters,” Keiko shared. “I was usually the one who came up short. I wasn’t as pretty, or as good in school, or as comfortable in my skin. Or at least that’s what my mother always used to say. The thing is: being pregnant made me feel so beautiful and womanly, so purposeful. The change in my shape made me feel more confident. It’s weird because I didn’t even think I wanted to be pregnant, but now I realize how much I took to it. I’d look in the mirror and feel proud—things were changing, and it was all me.”
We’re struggling with more than just what we see when we look in the mirror. Research has found that after a miscarriage, women often report feeling a sense of alienation from their bodies. Sometimes they even report feeling “defective” and like “less of a woman.” Add to that the possibility of not feeling at home in your skin from hormonal changes that began when pregnancy commenced, and you’re looking at one of the more challenging situations a woman can face when it comes to how she feels in her own body. For some women, this discordance is so intense that they begin feeling that their body has committed a betrayal.
Phoebe is one of those women. She began messaging me on Instagram, after I put out a call on the @IHadaMiscarriage account saying that I’d like to talk to people about their feelings toward their bodies following pregnancy loss, for an article I was writing. (I occasionally put out calls like this when I am working on a piece.) She wrote that since 2016, she has had four miscarriages, and has no children.
“I used to think I was very attuned with my body. The first time I got pregnant, I felt very in touch with every little change, every tiny fluctuation,” she wrote. “All my losses have happened before twelve weeks, so I’ve never had the opportunity to celebrate that my body can make and sustain a pregnancy into the so-called safe zone. Honestly, I can’t think of anything to celebrate or to even like or appreciate about my body at this point. I feel so betrayed by it. It feels like it can’t possibly belong to me, or it wouldn’t have strayed so far from what I want so badly,” she explained. “It’s like I’m a stranger in my own skin. I feel physically unrecognizable. I’m infuriated and on the brink of defeat.”
And for those who do not identify as the gender they were assigned at birth, who do not ascribe to the gender binary, or who have body dysmorphia as it relates to their identity and/or sexuality, this feeling of bodily betrayal is often compounded. From being misgendered by medical professionals to the physical signs and symptoms of pregnancy warring with their gender identity, the body becomes something of a minefield.
But these bodies are our homes—whether we like it or not—and they are the only ones we have. I choose to believe my body works, that my miscarriage in no way was evidence that it doesn’t. In fact, my body proved it was working the way it should be by releasing what it did. My body housed my babies, including the one I did not have the chance to know. It has labored to bring children into the world, and it has weathered the storm of a sixteen-week loss. My body also went on to become a home to my rainbow baby. If we say our bodies have failed us, we leave out all the wisdom, all the health, the transformation.
Whenever I hear about feelings of bodily alienation, failure, or body-image struggles pre- and post–pregnancy loss from patients, I listen for historical information or clues from the past that might better help me understand what’s informing their current impressions. I know culture is complicit here, too, of course. And I am also keenly aware that explaining to a bereaved patient that they mustn’t hate their bodies, or breaking down the very science of conception to prove these losses are no one’s fault, is futile. Feelings aren’t facts, and so I go where they are while holding the hope that these feelings will evolve compassionately in time and with effort. I also know that urging someone to feel positively about their body when they simply don’t can be harmful. The pressure to embody something that is not authentic—like forcing body positivity—can impede the healing process. If and when people feel like they can’t disclose negative feelings, be it about their bodies or anything else, those feelings are left to fester.
We can’t control how our bodies will respond to a pregnancy, nor can we dictate how they will react to a loss. All we can do is try to treat them with compassion.
From I Had a Miscarriage: A Memoir, a Movement by Jessica Zucker. Used with the permission of the Feminist Press. Copyright © 2021 by Jessica Zucker.
Jessica Zucker, PhD is a Los Angeles–based psychologist specializing in reproductive and maternal mental health. Zucker earned a master’s degree in human development and psychology from Harvard University as well as a master’s of public health from New York University, with concentrations in global health and women’s reproductive rights. She traveled the world doing international public health work prior to pursuing her PhD in clinical psychology. Her first book is I Had a Miscarriage: A Memoir, a Movement.