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Why is blame and silence attached to miscarriage?

25 February 2022

Culture and theology have failed to find a language for pregnancy loss, says Karen O’Donnell


São Joao as Santas Mulheres (St John and the Holy Women), 17th-century carving at the Monastery of Santa Clara, Coimbra, Portugal

São Joao as Santas Mulheres (St John and the Holy Women), 17th-century carving at the Monastery of Santa Clara, Coimbra, Portugal

MY FIRST miscarriage took place at about eight weeks. It was my first pregnancy. I had taken a test early — too early — and it came back negative. But I had tested again a few days later, and got the BFP (big fat positive) that I had seen so many women in online message forums hoping for. I told my mum and a couple of close friends.

So, when I began to miscarry a few weeks later, I did not do so in the shroud of the 12-week complete silence that is the cultural norm around pregnancies, at least in the UK. A late-night trip to the Accident and Emergency department of my local hospital brought me face to face with a junior doctor who had never dealt with a miscarriage before, and was, to add insult to injury, completely incapable of getting blood out of my tiny, unco-operative veins in to do the blood test that would reveal if I was still pregnant.

A kind nurse came in for the third attempt at taking my blood, and gently patted my hand. A couple of hours later, I was told I was no longer pregnant, there was nothing to be done. Go home. Take some paracetamol. Get some rest. See your GP if you feel unwell. It was the middle of the night. I was devastated.

This was my first encounter with the silence that surrounds pregnancy loss. My mum and my close friends were largely without words, but compassionate. “I don’t know what to say. I’m so sorry this has happened,” was whispered to me as they held me tight. “It’s so awful. It’s OK to be upset,” was said, as my good friend rubbed my back as I cried on my hands and knees in the kitchen. I did not mind these expressions of being lost for words.

But these expressions were also wrapped up in a wider silence. I had been part of a church for over a decade, including a small community group that I considered to be dearest friends. The people in this small group were told what had happened; the people in the church knew; and yet very few people said anything.

Where one or two people did break the silence, it was to share their own experience of miscarriage — stories I had never heard from women I had known since I was a teenager. It was to break their own silence.

OFTEN, these experiences of miscarriage had taken place during the first trimester — the first 12 weeks — of a pregnancy. In the UK, a pregnant person is usually offered an ultrasound scan at this point (sometimes earlier), and it is usually at this point that people announce that they are pregnant, often with a grainy scan photograph held up as proof.

The pregnancy is usually a closely guarded secret during these first 12 weeks, because people are aware that pregnancies are often lost during this time. Indeed, almost all miscarriages take place during the first 12 weeks. I find this pattern of silence most disconcerting: it is culturally accepted that one should wait until about the 12th week to make this announcement.

Yet it is an experience sadly very common during these 12 weeks that one might be in most need of care and support from family and friends. Why do we not tell people?

Sadly, this pattern of silences was replicated over the following few years every time I experienced a pregnancy loss. In fact, as I experienced repeated losses, fewer and fewer people spoke to me about it. And, once the immediate experience had passed, the veil of silence returned. I have never heard a sermon on the experience of miscarriage.

The Bible has little to say about it. There were no prayers or ritual to mark the experience. The assumption seemed to be that, eventually, I would give birth to a healthy baby, and these pregnancy losses would be forgotten.

That was not the case.

My experience is not unique. Many women turn to online forums in their experience of pregnancy loss to talk to other women who have experienced the same thing, precisely because it is something we do not talk about. In her ground-breaking feminist reflection on the experience of miscarriage, Linda Layne notes that the clearest indicator of the cultural non-existence of pregnancy loss is symbolised by the lack of greetings cards.

There is no cultural script for how to deal with this experience. There is no set of rituals to give shape to grief or words to silence. We do not know what to do; so, all too often, we do nothing and we say nothing.

This silence is not simply limited to the way in which we experience this kind of loss. Pregnancy loss is largely absent from history, too. Perhaps it comes as no surprise to find that pregnancy loss is similarly mostly absent from theology, too.

Compounding the historical and cultural reasons for silence on pregnancy loss is the simple fact that there is actually very little to say, at least from a medical perspective. It is very difficult to determine what causes most pregnancy losses.

IT IS important, therefore, to note that theological discourse has been equally silent in the face of pregnancy loss.

There are only three direct references to miscarriage or pregnancy loss (specifically, as opposed to infertility, which is referenced more widely) in the Bible, and all occur in the Hebrew Bible.

Two of these references are connected to punishment and blessing, while the third is slightly different. In 2 Kings 2.19–21 Elisha is told “the water is bad and the land is unfruitful.” He went to the spring of water and threw the salt into it, and said: “Thus says the Lord, I have made this water wholesome; from now on neither death nor miscarriage shall come from it.” The implication is that people had died and miscarried before this purification. Miscarriage here is incidental to the narrative, except that it is equated with death and considered something to be overcome.

In contrast, the other two biblical references to miscarriage are not incidental. In Exodus 23, a series of laws are listed for the people of God to follow. Attendant to these laws is the promise of blessing to those who follow the laws.

Thus, in Exodus 23.26 it says: “No one shall miscarry or be barren in your land.” Similarly, in Hosea 9 — a chapter on the punishment from God for Israel’s sin — verse 14 says, “Give them a miscarrying womb and dry breasts.”

In both references, fertility and successful pregnancy is a sign of God’s blessing, and therefore miscarriage is a sign of God’s punishment to those who do not keep the law. Losing a pregnancy is, in these Hebrew scriptures at least, a punishment from God.

Pregnancy loss is absent from the New Testament; so we do not have any reference to miscarriage outside of the Hebrew legal prescriptions.

IT IS difficult to take this as a starting point. I cannot argue that a God who is love would punish me for some sin by causing me to miscarry. Of course, pregnancy loss as a punishment from God might seem easy to dismiss, but perceiving of miscarriage as punishment, or, at the very least, the fault or consequence of the pregnant person, is sadly very common.

When I began to lose my first pregnancy, I spent many hours playing back the previous few days to work out what I had done wrong: what had I done to cause this loss? I blamed the glass of wine I drank before I knew I was pregnant, high stress levels from my job, or tempting fate by telling a couple of people I was pregnant long before the hallowed 12th week of the first trimester.

As I lost subsequent pregnancies, even though I knew rationally it was not my fault, it was hard to resist this urge. For subsequent pregnancies, all I wanted to do was sit in my bed for nine months, cocooned away from the harmful things my body might interact with that might cause another miscarriage. In fact, when I found out I was pregnant for a second time, I begged my doctor to sign me off work until the 12-week mark had passed. She refused.

This perception of pregnancy loss as my fault became further compounded when I experienced ectopic pregnancies that were lost because the embryo implanted into my fallopian tubes rather than my uterus. Again, the temptation was to blame myself, to blame my dysfunctional body for causing this loss.

This theological silence is caught up and tangled into the simple fact that pregnancy loss is very difficult to make sense of. Pregnancy loss raises some of the most challenging theological questions about the nature of God, God’s relationship to the world, divine providence, and theological anthropology. There is no simple theological response to the experience of pregnancy loss.

It is also worth noting that successive generations of theologians throughout Christian history have been unconcerned with pregnancy loss as a site of theological discourse. Of course, many of these theologians will have been caught up in historical silences.

Many of them will have had very different attitudes to pregnancy loss. The devastating trauma that can be associated with such loss can be characterised, to a large extent, as a relatively modern phenomenon.

This historical silence is, however, compounded by the fact that up until the mid-20th century, theology — like so many other academic disciplines — was a man’s world. In fact, I would argue that in many respects it still is. Theology is dominated by men, particularly white men. And these white men are largely the gatekeepers of what is considered “proper” theology, and what kind of theological discourse is worthy of respect within the academy.

For a large part of history, perhaps even to the present day, issues surrounding pregnancy — including pregnancy loss — take place within the sphere of women’s work and interests, and are, therefore, far removed from the masculine world of theology.

This is an edited extract from
The Dark Womb: Re-conceiving theology through
reproductive loss by Karen O’Donnell, published by SCM at £19.99 (Church Times Bookshop £16.99); 978-0-33406-093-2.

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