When bumps don't turn into babies

Why dismantling the long-standing taboo surrounding miscarriages - when neither society nor culture grants you the resources to deal with the deep loss of an unborn child - continues to be an uphill battle

Now you're pregnant, now you're not. What are miscarriages, if not cruel? A couple of years ago, a close friend quietly mentioned, during the course of a phone call, that she'd miscarried and lost her baby. I'm ashamed when I recall I had nothing more to proffer at the time but an 'Oh...', and sorrowful silence that she then broke to assure me in a sad, c'est-la-vie sort of way, before switching the subject. It bothers me now, because of what I know now: that miscarriages are far more common than we think (in the UAE alone, experts last year estimated one in four women is likely to suffer a miscarriage in their lifetime), and that too many endure this particular form of bereavement in silence - simply because most cultures just do not account for the deep loss that comes with the passing of an unborn child, let alone help you deal with (or respond to) it.
'Acknowledge the devastation'
When Alexandra Sullivan moved to the UAE about eight years ago, she did so in the immediate aftermath of having her twin boys, Elliott and Emmet, die in her womb - despite tests that indicated all was well. The Swedish expat remembers going through multiple stages in trying to process the intense grief that followed - her anger phase being particularly "profound and prolonged". When she couldn't find a support group for the cause, she started the Facebook page called Little Angels - Love Through Loss, through which she connects with other would-be parents in the city who are grappling with the loss of a pregnancy, no matter what stage it was in. "Coming back to an empty house after you've lost your baby is a most traumatic experience," says the 33-year-old. "I see parents at hospitals or homes, sit and talk, cry, whatever they need - just for them to know they have someone to talk to when they're ready."
Talking is the release we often don't know we need, she says. "Parents often tell me: this grief is so overwhelming, what can I do to make it go away? They are pushing it down, trying not to feel it, but that only makes it grow bigger. You can throw yourself into work as a survival mechanism, and that's fine - but, at some point, it's going to surface. That's why I say, when it comes up, let it. It's important to acknowledge the devastation."
The stigma surrounding the subject has roots in many areas, she feels. And not least of the lot is the self-flagellation - the guilt that comes from wondering whether you could've prevented the loss of the child if only you hadn't exercised, continued to exercise, not eaten that crab, not slept on that side - combined with a thousand other 'what if's. "It's a woman's job to be pregnant, so when it falls through, we blame ourselves," explains Alexandra, who is currently studying to specialise in grief counselling.
But there's also fear. "Losing a baby is one of the worst things that can happen. Children are not supposed to die. It scares people. People distance themselves from those who've had a miscarriage because the latter represent what could go wrong, and we don't want to burst our happy bubbles."
For those who've lost babies, there's also an undeclared loss of community. "There's a sense of feeling misplaced in social gatherings," agrees Alexandra, "because it's not exactly a subject you can bring up at a dinner party. The problem is: having people pretend nothing has happened doesn't help. Only talking about it can make us feel less excluded than we already are."

SPEAKING OUT: (from left to right) Alexandra Sullivan, Danielle Noble and Dimitri Van den Reeck (centre)
A whole other kind of 'MeToo'
When it comes to miscarriages, the most common cultural response in generations past has been: move on. And yet, one only needs to wander onto online parenting forums to find scores of women who've never been able to forget the children they couldn't see to term - some as many as 22 years on! What people today may be doing differently, however, is developing rituals to help them process their grief a little better. They celebrate Baby Loss Awareness Week together in October, rallying around each other and lighting candles in memory of their babies. Others plant trees, while yet others create memory boxes. Many in the West have even taken to importing Japanese Jizo statues (believed, in Buddhism, to be protectors of unborn children).
If there's anything this generational shift indicates, it's that we are increasingly realising that society's overridingly dismissive attitude towards miscarriages is most unhelpful. "It may look otherwise on the outside, but a woman who has lost a baby will never forget that child," says Danielle Noble, co-founder of the Abu Dhabi-based support group Footprints in the Sand, which aims to provide comfort to families going through miscarriage, stillbirth or neonatal loss. "As soon she knows she is pregnant, she is dreaming about what her life will be like with her child. You can't move on from that - you learn to live with it and rebuild your life around that grief, but you never forget."
But despite the uptick in the number of people willing to discuss their experiences, miscarriages remain, for the most part, shrouded in silence. "For whatever reason, it is still expected that women don't announce their pregnancy until the magical '12 weeks'," says Danielle, who lost two children to miscarriages herself. "But, what this means is that, a lot of times, they undergo miscarriages [before the 12 weeks are up] and feel like they can't tell anyone, because no one even knew they were pregnant."
Ironically, most women who did break the mould to share their experiences will tell you: they often inadvertently set off a whole other kind of 'MeToo' movement in doing so. "Only once you tell your story do you realise how many other women have suffered the same way too," notes the Australian expat.
Emotional rollercoaster
As a nurse, Anitha (name changed on request) often found herself providing care to women who'd suffered miscarriages. It was support that was backed not just by medical expertise - but by the personal experience of having lost three babies over the course of five years herself. The first occurrence took place a year after she'd gotten married at about eight weeks, followed by a second miscarriage the following year at the close of the first trimester.
To date, she does not know what caused the second - but she remembers it as the one that almost cost her her life. After about three years of undergoing treatment, she was overjoyed to find she was pregnant again. However, despite precautions, she went into early labour after about 20 weeks. The loss of yet another pregnancy - especially one that had managed to progress as far as it did - left her emotionally raw. "We really dreamt of our baby the third time, especially because we'd waited and hoped for so long," recalls the Indian expat. It didn't help when people suggested it was perhaps time to stop trying for any more children.
Anitha continued to seek treatment, however, and last year, gave birth to a healthy baby, marking almost a decade since the couple started trying. While she knows her story is not how everyone else's will end, she says sharing it is her way of giving other women the hope that they're often desperate for. To anyone still trying, her takeaway is simple: listen to your doctor. "Sometimes, we pick and choose from the medical advice we receive," she says. "The fourth time around, however, I did everything my doctor asked of me: including taking extended leave from work and complete bed rest. It's been a very difficult journey, but it's made me a much stronger person today."
Men and miscarriage
Nine times out of 10, when the conversation turns to miscarriage, men get left out of the picture. No one asks how they're doing, because "men don't talk about their feelings". But though it might seem personalities like Mark Zuckerberg and Gordon Ramsay missed that memo (considering both recently took to their social media platforms to share their own stories of heartbreak and pregnancy loss), what's actually happening is a welcome shift away from what Dubai-based Dimitri Van den Reeck calls 'toxic masculinity'. Says the 37-year-old, "Most societies have this idea that men are not supposed to feel these emotions [of loss] in the same way or talk about it with friends - you're just supposed to get on with it. But I think that to discount men's grief in that scenario is harmful, and anyone - celebrity or non-celebrity - who challenges the notion that a father's role is merely to bring home the bacon has my vote."
To date, the Belgian-Greek expat says he can still get emotional thinking of the daughter he and his wife Laura lost at Week 13 seven years ago. They'd gone in for a scan - only to discover the baby no longer had a heartbeat. The news was so devastating, Dimitri says it took the doc a good half hour to communicate to him that there was nothing he could do. "Up till then, I was still trying to figure out if there was an escape hatch, asking if we could do surgery, what options did we have... I was ready to spend all our savings, if required, to save the baby." He still remembers the words she used: "Not compatible with life".
When it finally did sink in, he tried to focus on minimising the trauma for his older daughter and comforting his wife. "We'd already been through IVF traumas for the first pregnancy, so this just felt like an additional blow when we'd already been on our knees before." It took them both a year of mourning - in very different ways - to come to terms with what had happened. But the thing Dimitri says really got them both through the experience was being able to talk to each other about it.
What added insult to injury, however, was society's approach at large. "When someone loses a child after birth, you have a funeral and the sympathy of people who understand why you're struggling emotionally. But a miscarriage is a non-entity for most, given the same emotional gravitas as not receiving a delivery you'd ordered. It's not a 'loss' and, therefore, does not need to be mourned. So, the woman may take time off - but it will be sick leave, not leave for the death of a family member. Men are given none. That's not a criticism of my personal employer - it's that no one thinks it necessary."
A funeral brings some measure of closure, but without that collective acknowledgement, Dimitri says he is still haunted by how trivially things were dealt with at the time. "I was in such shock, and we have no traditions or ceremonies to fall back on. But I had this horrible realisation later that our baby was taken out of my wife and I have no idea what they did with her. To date, I ask myself how I let that happen. But it's treated as such an oopsie-daisy, everyone move on."
If you ask Dimitri how many children he has, he'd really rather answer "four" instead of three - but he doesn't express it that way in order not to freak people out. The irony - that he makes it smaller so others won't feel uncomfortable - is not lost on him. But he and his wife don't play by those norms; at home, they call their baby girl by name and remember all her would-be milestones.
To other guys going through a miscarriage, he says, "Talk, be there, listen. We had a daughter at the time already, so it really helped us to put a lot of our energy into her. But if you don't have that, I'd say throw that same energy into your partner. You can rage against the situation together - don't let it be something you feel like you have to deal with on your own."
Contrary to the macho-guy definitions that encourage the stereotype of the male preference to bottle up emotions, Dimitri says it's important not to wait till things blow up to communicate with your partner. "Of course, there are days when you'll get on each other's nerves, or just want to be alone. But if you can learn to turn to each other and see a friend, you'll come out of the experience stronger."
RESPONDING TO LOSS
If there's one thing that women (and men) who've been through a miscarriage are unanimous about, it's their reluctance to broach the subject with most people - simply because the latter tend to come back with the most inappropriate responses. Danielle Noble of Footprints in the Sand breaks down what not to say - and why.

"You can have another baby" or "At least you have other children".
This is one of the most hurtful things to say. I don't want another baby; I want the baby that died. One child can never replace another - and even though another baby may bring joy back to your lives, it never takes away the grief of having lost one.

"At least he or she died before you got to know them."
This doesn't make a loss less painful - not when you spent hours dreaming of all the 'could haves' and 'would haves', imagining who your child would have been, what they would have looked like, what their personality would have been.

"At least you know you can get pregnant" or "At least you're young and have plenty of time".
When you're going through the trauma of loss, none of these things seem like positives. This doesn't address the deep feeling of loss and the anxiety and fear about what the future will look like. No one knows what a struggle it might have been to get pregnant the first time!
While there is no one right thing to say, Danielle suggests the following guidelines:
. Acknowledge that this is a significant loss, and that it is common/normal.
. Give the person space and time to grieve.
. Let them know you are there to listen if they want to talk, cry or vent.
. Let them say their baby's name, and tell you his/her story.
DID YOU KNOW?
In years past, you'd be hard-pressed to find medical professionals who were equipped to offer the emotional support patients needed after a miscarriage. But while there's much more that can be done in the UAE, some hospitals have made commendable effort to provide more of the emotional support families need. The Corniche Hospital in Abu Dhabi is one such example, having implemented a bereavement programme with a dedicated space for families to spend time with their babies who have died, and one-to-one support through the grieving process.
karen@khaleejtimes.com