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The Truth About Miscarriage: Being In 'Gestational Limbo'


Now we go Behind Closed Doors. That's the part of the program where we talk about issues that people usually keep private. And today, we are focusing on miscarriage. And if you've ever gone through it or know someone who has, then you know it's devastating - and surprisingly common. The National Institutes of Health report that 15 to 20 percent of pregnancies end in miscarriage.

And you might think if it's something that that many people have experienced, then we'd know more about it. But many women feel that there is still surprisingly little understanding of what it's really like, and the emotional and physical challenges that come afterward, which is one reason freelance journalist Sarah Shemkus recently wrote about her personal experience in an essay for Slate. It's titled "Losing the Baby: My Week of Gestational Limbo." And she's with us now from member station WGBH in Boston. Thanks for joining us. I'm very sorry for your loss, by the way.

SARAH SHEMKUS: Thanks for having me, and thank you so much.

MARTIN: What made you decide to write this piece?

SHEMKUS: Well, when I first got the news that my pregnancy was not going to be viable, as they say - I'm a reporter, so my natural instinct was to just research. And I didn't find anything. I found some stories about the symptoms of miscarriage, and some stories about the emotions that you might have after, about how long it's OK to grieve, when you can try again. But there was really very, very little about what the actual experience was like - the feelings that kind of go beyond those basic sadness and guilt feelings. And I was a little irritated about it and a little angry and also, I just have a tendency to vent and process things through writing. So I just started writing.

MARTIN: One of the things you said in your piece is that, well, first of all, you say that the primary thing that people get wrong is the time frame. The impression is that this is this single, catastrophic moment, and it's not true.

SHEMKUS: Exactly. I mean, to be clear, it is true for some people. There are definitely several people who have responded to my story who said, you know, I had the kind of miscarriage you see in movies; where you cramp suddenly, and a rush to the hospital, and it's over quickly. But I also heard from tons of other people who had it like me, or even longer. One person wrote to me, said it had taken a full six weeks, the whole process, for her. It's - miscarriage refers to that whole period of time, my doctors tell me; that is, the pregnancy coming to an end, to the part where the - what they call the products of pregnancy are released from the body.

MARTIN: You said that you were in what you called gestational limbo for a week, feeling neither pregnant nor truly unpregnant. Talk a little bit about that, if you would.

SHEMKUS: Well, for the first few days, it was a little weird. I hadn't actually thought to ask the doctor about what the term miscarriage applied to. And so I didn't even really have a word for what was going on, just the sense that I wasn't actually going to have the baby. Maybe it's just 'cause I'm a writer, but not having a word was strangely disturbing.

Also, this all happened right around Christmas. So Christmas Eve, my family was getting sushi. It was just very weird to think, you know, can I eat sushi now? It felt almost kind of like, callous to be like, well, at least I can eat the raw fish now. But at the same time, it felt silly to avoid it for this reason. It was just very confusing, and the very small decisions like that kind of took on a whole new dimension.

MARTIN: So there was that feeling of confusion, but you also talked about this pervasive feeling of foolishness. What - could you talk about that? What do you mean by that?

SHEMKUS: By the time I had the ultrasound that indicated that I was having a miscarriage, it looked like the development of the embryo had stopped probably three or so weeks previous. So there was like, a whole big span there where I was picking baby names, and telling my best friend I was pregnant, and looking at onesies on Pinterest. And to look back at those days - just kind of like, the optimism when there really wasn't anything to back it up - just kind of made me feel silly.

MARTIN: Did you feel guilty, too, like you must have done something wrong? This is something that I know a lot of people say that they feel, or they feel like other people are going to think they did something wrong. You must have done something - you know.

SHEMKUS: Weirdly, I didn't actually feel that a lot, which is strange for me 'cause I'm usually prone to that sort of thing. It came - at the beginning, you know, there were waves of it a little bit - what should I have done differently? Oh, my God, did I have a glass of wine before I knew I was pregnant? Was that the problem? Should I not be trying to have a baby at my age? I'm 36, so I'm at what they call advanced maternal age, where miscarriage is even more common. But that actually faded a little more fast - quickly than I would've expected.

MARTIN: Is this one of those things that where you're just not sure how long are you allowed to feel about this, or how - does that make sense? Like, am I allowed to feel sad about a person who I haven't even met yet?

SHEMKUS: Strangely, I actually had a bit of the reverse. I had a little bit of, how long am I supposed to be sad? This all happened so early in the pregnancy that I'd never heard a heartbeat. I'd never seen a successful ultrasound. It just wasn't that hard for me to start recovering. And when you read the forums and things online, you hear about people who are mourning for months. And I - you know, so I really more had thoughts of oh, my God, am I a callous person? Am I heartless that I'm getting over this faster than all these people online seem to think is normal?

MARTIN: Women are always asking themselves, like, am I doing this right? And I wonder, is that a gender thing, or is that something about the experience of having a baby that kind of prepares you for people - everybody telling you you're wrong? I mean, what do you think?

SHEMKUS: I think that there is definitely something where women in our society are expected to kind of present themselves a certain way - be happy at this time, and be self-sacrificing at this time. So I think there's probably a little more sensitivity among women. But I think the whole process of being pregnant, planning for a baby, not having a baby, the hormones, all the physical changes kind of make it all a very sensitive moment where it's easy to become uncertain.

MARTIN: Well, if there's not a lot out there to prepare women, I'm guessing there's even less to prepare men. So if you don't mind my asking, how did all this affect your husband? How - what was going on with him through this?

SHEMKUS: He really stepped up to support me. He was, you know, the day that it was the worst during the actual kind of bleeding and pain part of the miscarriage, he, you know, brought me hot chocolate on the couch, and went and got us pizza. And he was very solicitous. It's an added dimension of difficulty for him because he can't go through it physically. He said to me at one point, I'm sorry that you're the one who has to - whose body has to do this. And that's harder for me on one hand, but at least I, you know, can feel what's going on in my body. And I'm not exactly in control of it, but I'm very aware of it. Whereas, there's this kind of disconnected, what-can-I-do feeling for other people.

MARTIN: It occurred to me that one of the things that's tricky about miscarriage these days is that people, they know not to start telling people until farther along - right? - in the process. Like, after the first trimester is just when, generally, people start telling people. And also, a lot of times, you're not showing before that, and so you're not talking about it. But then, something's going on with you, and you don't know what to say. And they don't know what to say.

SHEMKUS: At the point that it happened, only my immediate family, my husband's immediate family and like, each of our our best friends knew at that point. Obviously, we told them first. But over time, it became clear that there were other people we needed to tell. And it's kind of weird to both reveal a pregnancy and a miscarriage all kind of in one breath. People - it's kind of a whirlwind for the people you're telling. I think something about the fact that I just came right out and said it - that I just said, I had a miscarriage; that I didn't kind of get into hush, somber tones or try and talk around it; I think the fact that I was direct let other people be more direct, and feel less like they had to walk on eggshells around me.

MARTIN: Is there something, word of wisdom, that you would want to offer for people who are experiencing this themselves, who have experienced this themselves - or really, also for all the people who are around the person who's lost the baby, or who's just gone through this and want to be supportive? Any other final words of wisdom you'd like to offer?

SHEMKUS: I guess what I've really learned about supporting people who are going through this is that, well, one, that there's no easy answer. I went through days where I, you know, wanted to just talk about it in really frank and open terms, and days where I just wanted to pretend it wasn't happening at all. And if you had tried to talk about it with me, I would've like, snapped or cried, or something. But I think it's important to reach out to just say, you know, hey, how you doing? And then, I'm so sorry to hear about what's going on with you. And then kind of go from there. Read the response, and see if they want to talk more.

MARTIN: Well, thank you again for writing this piece. And again, I'm sorry for your loss. But thank you for sharing your experience with us.

SHEMKUS: Thank you very much. Thanks for having me.

MARTIN: Sarah Shemkus is a freelance journalist. She recently wrote an article for Slate, titled "Losing the Baby: My Week of Gestational Limbo." Transcript provided by NPR, Copyright NPR.