Rachel Whalen had her second miscarriage in a gas station bathroom, driving with her husband to their summer vacation. She felt a contraction, reached down and caught the fetal tissue.
“I had this perfectly round, gelatinous orb in my hands,” said Whalen, 34. She had miscarried once before at home. That time, she flushed the fetal tissue down the toilet in her own bathroom, which was heartbreaking. This time, it felt even harder.
“At the gas station I was like, ‘Wait, do I do that here? How do I walk out of here with this?’” she recalled. “I didn’t know how to take it with me, so I flushed it.”
Up to 20% of known pregnancies end in miscarriage ― that is, the loss of a pregnancy before 20 weeks ― which is why it’s often said that everyone knows someone who has had one. And more people finally realize that. October is now Pregnancy and Infant Loss Awareness Month. There are social media campaigns, like #ihadamiscarriage, and many support groups. There are even miscarriage sympathy cards to support those who have lost a pregnancy. We have come a long way in helping women — and men — through the experience.
Yet one part of the conversation that has remained in the shadows is what Whalen calls the “ugly” side of miscarriage: the specific and really physical aspects of what happens to a woman’s body while she is losing a pregnancy. What happens to the fetal tissue? What does it look like? How much does a woman bleed? Miscarriage loss is not just an emotional event; it’s also a physical process, but we rarely acknowledge that fact.
“I have written about my experiences in terms of yes, I had a miscarriage. And yes, I flushed,” said Whalen, who went on to have a stillbirth at 30 weeks and now has one living child. “It’s a part of my experience that is so hard to articulate, even now. So many things about my grief I can talk about smoothly, but not this. It’s not something you get the opportunity to talk about all that much.”
“Yes, I had a miscarriage. And yes, I flushed. It's a part of my experience that is so hard to articulate, even now.”
Mental health experts who address issues of pregnancy loss say that women need space to share the more physical aspects of what happened. Research shows that the impact of pregnancy loss is longer lasting than typically acknowledged. A study published in January found that nearly 20% of women who had an early pregnancy loss demonstrated symptoms of post-traumatic stress disorder nine months after the fact, while 17% showed symptoms of anxiety and 6% showed signs of depression. And that research by no means suggests that the emotional fallout ends at the nine-month mark; it’s simply when the study ended.
Early pregnancy loss can vary wildly in terms of physical symptoms. The cramping and bleeding of a miscarriage may be fast and fierce and totally unexpected, or a woman may know her pregnancy has ended and then wait weeks for her body to pass the tissue naturally. Some women have surgery to remove the tissue.
“The physical experience of miscarriage is often very traumatic for women, who often feel as if a part of them has died and question whether they could have done something to prevent the loss,” said Rayna Markin, a psychologist and associate professor at Villanova University. “But it is often difficult for women to process this trauma because they receive strong messages from society that these details are too disgusting to talk about and should be silenced. This can make many women feel a sense of shame around their bodies and their experience.”
At a societal level, talking about the experience of miscarriage can help bring it out of the shadows, Markin said, normalizing the experience and counteracting feelings of shame.
Yet there are reasons to be cautious about publicly sharing the specific physical details around pregnancy loss. For one, it can be triggering for other women who have experienced a miscarriage. It can also cause stress for expectant women.
“I do think that one of the reasons why we don’t talk about this is that we don’t want to scare other women,” said Jamie Kreiter, a Chicago-based therapist who specializes in perinatal mood issues and runs the private practice Nurture Therapy.
Some women might find it helpful to share their experiences, Kreiter noted. Others might not. “Healing comes in all sorts of ways,” she said.
Diana Stone, editor-in-chief of Still Standing Magazine, which is aimed at families dealing with child loss and infertility, said it can be difficult to find a good balance when sharing these types of stories on social and mass media. She said that some women are “re-traumatized” by hearing others’ accounts, even though that isn’t what people intend when they share their personal experiences.
Stone’s suggestion is to lead into the subject gradually and make it clear upfront that a given post or article could contain upsetting details. She also believes that medical professionals could help by talking with pregnant women fairly bluntly about the possibility of pregnancy loss and what that might entail.
“They should trust that women are capable of — and willing to — accept these kinds of talks,” she said. “Because I think once that conversation starts, then it’s easier to have with our friends, with our daughters, and future generations.”
Whalen tries to be sensitive to all of this nuance when she shares her story publicly. At several points in her conversation with HuffPost, she repeated that she is not arguing that talking about the physical aspects of one’s miscarriage is a necessary step for healing. And she is careful and deliberate about how and where she shares the details of her own story.
At the same time, she has been struck by the women who have reached out to her for guidance because they’re in the midst of a miscarriage and have no idea what to expect. And by the women who have thanked her for sharing the frank truth that she flushed what she hoped would be two of her children down the toilet. They had thought they were the only ones.
“I want to talk about it because that is how I heal,” said Whalen. “Even now, having this conversation, I’m chipping away at it.”