'This Is Us' Breaks Down The Stigma Of Miscarriage

By Christiane Manzella, PhD

Last night, like many “This is Us” fans, we at the Seleni Institute were anticipating a heart-wrenching episode focusing on miscarriage and loss. As clinicians, we know that this episode may have been especially hard for those individuals, couples, and families who have suffered a loss and we were pleased to see that the producers and cast took extra care to portray the impact of the loss on Kate, Toby, and their families with sensitivity and nuance, sending a message to those who have suffered loss that what they are feeling is normal and shared. That they are not alone.

Here are the important messages shared in the episode:

Your grief is real

“How could I be this sad? I never even met the baby or held him or her,” says Kate echoing something I hear all the time from my clients. The reality is—and researchers have found— that the grief a woman feels for her lost baby is not proportionate to the amount of time that baby was growing inside her, it is proportionate to the hopes and dreams and imagined future she was building in her head, to the attachment that was already forming for a prospective mother.

This is what people don’t understand when they try to offer reassurances such as “you can try again,” or “it wasn’t meant to be,” or “it’s time to move on.” Just like the OB in the episode who—demonstrating a common failing of the medical field—ignores the emotional implications of their loss and tells Toby and Kate there is no reason they can’t “return to their normal lives.”

Grief changes you forever

If you have experienced perinatal loss, you know there is no “returning” to life as it was before. Grief changes you forever. With the right kind of support, you can incorporate your loss and your grief into your life and go on to find peace.

That was beautifully illustrated by Kate’s mother, Rebecca, opening up about how she felt when she lost Kate’s brother Kyle during birth. In fact, fans of the show have pushed for more recognition of the loss that Rebecca endured so many years ago and this episode offered them a poignant glimpse into how she moved through her grief and what it means to her now.

Self-blame is a typical reaction

Rebecca also shared the blame she put on herself when she lost Kyle. Should she have taken that long walk? Did she sleep on the wrong side? Self-blame is such a deep part of the usual experience of miscarriage. Though in 80% of miscarriages there is no known cause, women often look for explanations or reasons to make sense of what has happened and that can feed into self-blame, when in reality, they did nothing wrong.

Partners lose babies too

Often support is directed primarily to the woman who has miscarried or had a stillbirth or death of a child to the exclusion of the partner who is grieving too. But, Toby, a remarkably self-aware character, won’t let that happen. When Kate yells at him that it didn’t happen to him and that she will be living with an intense cocktail of hormones and a body that “still thinks its pregnant” for weeks to come, he tells her he will support her through all of it. “But what is not fair for you to do,” says Toby. “Is to tell me that I wasn’t a part of this….It happened to me too. And it hurt.” No matter how closely a bereaved mother and her partner might be, communicating that kind of deep pain can be really scary, and we were really glad to see it modeled on the show.

Anger is a natural reaction to perinatal loss

As a society, we are not comfortable with anger, and it can be hard for other people to see and support women and families who are feeling anger after a loss, but it is important to do so. Anger—like the rage Rebecca shows when a woman takes the last bag of onions in the grocery store—is a normal response to loss and it needs to be heard. Rebecca screams “it’s not fair!” repeatedly. Of course, we know it wasn’t about the onions. What she felt wasn’t fair was the fact that she had lost a child and that she had no control over it.

Mornings are hard

My clients often share with me that when they wake in the morning, they have a brief moment when they have forgotten their loss. And then, it all comes flooding back in and they re-experience the first moment of loss, which is crushing. Toby poignantly shares that this happens to him the morning after Kate’s miscarriage and that he let Kate sleep in in the hope that she was dreaming the baby was still alive too.

There can be peace and purpose after loss

Of course, this being network television, the episode ends on a hopeful note arrived at much more quickly than it usually does in real life. But a more poignant demonstration of the resilience of humankind is seeing Rebecca, decades after losing one of her triplets, living her life with a grief that has changed from the acute pain it once was, to being part of the story of her life. That she has come through tragedy into a place of peace. Grief is part of their family story, yes, and there is a transformation—their family is strong and beautiful.

We know from the audience response online that the episode struck a chord with many people and we want to acknowledge what this episode shows: you are not alone and what you are feeling makes sense. And if you need support as you move through or remember your loss, we are here to offer it.

Seleni Institute is a global nonprofit organization dedicated to supporting the emotional health of individuals and families. With our partners, we treat, train, support, advocate and provide research funding for emotional health during the family building years. When we strengthen the emotional health of one person, we strengthen the entire community. You can find more support from Seleni on Facebook or on Twitter @selenidotorg.