In a deeply personal opinion article in the New York Times, the Duchess of Sussex, Meghan Markle, recently revealed that she and Prince Harry miscarried their second child. When someone we love dies, we talk about it, have funerals, hold memorials, reminisce, and receive heartfelt condolences. But when a family suffers a miscarriage, all too often, they suffer in silence. In many cases, the pregnancy hasn't yet been shared with the family's usual support networks, so they may feel isolated in their loss.
If people do know that a couple was expecting, they may or may not view a miscarriage as the true death of a loved one or bereavement that will be followed by an actual phase of grief, with many viewing a foetus as a collection of cells rather than a baby. However, for many women, motherhood begins the moment they see a positive pregnancy test, and begin bonding with the tiny feotus they are nourishing in their womb. While the death of a loved one in the traditional sense can be viewed as grieving a past with that person, a miscarriage may be viewed as grieving a future with your child, and even perhaps the loss of parental and family identity. Some understand this, but as with many instances of death, they may simply not know what to say. Their clear discomfort may make a bereaved person feel as though they should avoid talking about their loss, or avoid people altogether until they find their new normal in the aftermath of their loss.
In the current issue of the Journal of Paramedic Practice, Reed et al highlight that paramedics are often called out to miscarriages, and may be the first health professionals on scene in cases of sudden and unexpected death in infancy, and other forms of neonatal loss (p. 472). Their literature review and focus group reveals several issues and themes of interest. Not only is there a lack of uniform guidelines for paramedics attending miscarriage and neonatal death, but the paramedics did not feel adequately prepared to provide appropriate care and emotional support to the parents experiencing the loss of their child. Furthermore, the experience can be emotionally distressing for paramedics themselves.
Miscarriage is much more common than many people realise, because it is too ‘taboo’ to talk about openly. Unfortunately, there is a sense of societal taboo around death, dying and grief in general, but this is especially so when it comes to miscarriage, stillbirth, and death of an infant. However, when someone close to me lost her baby during childbirth, and opened up about it in a candid post on Facebook, numerous women who had also experienced the loss of a child seemed to come out of the woodwork, many acknowledging that they had never before publicly shared their loss. They felt empowered by reading the post, and felt brave and safe enough to then open up about their own painful stories of loss.
In writing about her miscarriage, Markle has done the same—she is contributing to the slow breaking down of an unwarranted and isolating societal taboo. It is natural to not know how to respond to a person's grief after a loss, particularly as grief is so personal and different from person to person. However, Markle pertinently highlights that, often, all that is required to make a person feel supported is to ask simply, ‘are you okay?’ Reed et al point out that being informed and listened to throughout the process is essential to parents' experience. I would add that after a loss, a person wants to have that loss acknowledged, and not ignored—but the first step to openly sharing and recognising infant loss, is to break the taboo.