“We Need To Have More Open Conversations About Miscarriages, Abortions And Pregnancy”
Social psychologist Hilary Davies shares her experience and lays out the need for open conversations about miscarriages, abortions and pregnancy.
**Trigger Warning: This personal experience piece discusses sensitive topics such as abortion, miscarriage, pregnancy and grief. Please proceed with caution and take care of yourself while reading this content.**
Five uncertain days
About a year ago, I found out that I was pregnant. I was not in a stable relationship with the man involved. It was still the early days of starting up my first business. I was not financially stable, and my living situation was not conducive to raising a child. The logical decision was to terminate the pregnancy. But even at that early stage, there was a deep internal desire and instinct to keep this pregnancy. Whilst I was grappling with what felt like an impossible choice, the decision was taken out of my hands. I miscarried. In the space of five days, I found out I was pregnant, registered the impact on my future, experienced the miscarriage and felt the emotional loss. Those five days of turmoil, fear and uncertainty felt like months.
After the initial rawness of my experience wore off, I found myself talking openly about it to friends, family and colleagues. To my surprise, this opened up new layers of conversations on a topic that until then, for me, remained relatively unspoken. It has led me to reflect on how we respond to pregnancies, especially the unplanned ones, and the subsequent miscarriages and terminations that may follow. Once I started peeling back the layers of conversation, I was shocked by the frequency and similarity of this common experience, and the lack of open dialogue we have around them.
Miscarriage, by the numbers
This isn’t a debate on the moral standing of abortion. In South Africa, abortion is regulated and protected by the Choice On Termination Of Pregnancy Act of 1996. It gives us the freedom to choose based on our own morals and lived experiences. Grounding into the freedom that we are bestowed with this Act, I’m sharing my experience. It’s a small step to normalise conversations about miscarriages, abortion and pregnancy.
Globally, the prevalence of miscarriage is estimated at 10-25%. One recent WHO source putting the number at one in four pregnancies. Per the WHO Department of Sexual and Reproductive Health and Research, 30% of all pregnancies end in abortion, either through choice or for medical reasons. In South Africa, 461 000 pregnancies ended in abortion between 2015 and 2019.
The official figure, however, is known to be underreported. This is because of social stigma, financial barriers and access issues that result in women seeking abortions that are not recorded in official statistics. Research shows that including unreported and illegal abortions, the total figure could be more than double the official data. Adding to this the miscarriage rate of 20% and the number of births each year – just under one million live births annually? It can be estimated that up to nearly half a million women each year could experience a miscarriage or abortion in South Africa.
READ MORE: No, Women’s Fertility Isn’t Suddenly Doomed At Age 35
The power of conversation
With these numbers in mind, how do we – both as individuals and as a society – support women in these experiences? I believe in storytelling as one of the intrinsic ways that we seek to connect to each other. Through this, we learn from others’ experiences, normalise our own and form connections and safety with similar experiences. Storytelling is one of the most direct ways we can meet our psychological need for belonging and acceptance. So if topics of miscarriage and abortion remain taboo and unspoken, what is the impact of that on women? How does the experience of pregnancy, miscarriage and abortion shape our emotions, lives and relationships?
“Storytelling is one of the most direct ways we can meet our psychological need for belonging and acceptance.”
During those turbulent five days, my emotional response was an uncomfortable cocktail of shock, overwhelm, anxiety, vulnerability and fear. My body was processing the sudden and dramatic spike in hormones that occurred from around the time of the first missed period, followed by the sudden and dramatic drop that came after the miscarriage. Physically sore and emotionally exposed, I went into a state of numbness that protected me against the very heightened feelings. In a bid to avoid anything that felt uncomfortable, I threw myself into work. Within ten days, I was on an overseas work project that kept me busy. Through this, I could avoid any feeling of discomfort.
Dealing with grief
After about two months, I slowed down enough to start dealing with what happened to me. Two major things hit me: grief and shame. The loss of a pregnancy can trigger layers of grief – whether it’s planned or not. The pregnancy itself, the longed-for future of a family, the life plan unfolding, and many more. For some women, miscarriages deeply affect their relationship with their bodies and the deep, evolutionary sense of purpose some of us hold linked to motherhood and childbearing. My grief was for something I didn’t even know I wanted. In my mid-thirties, fiercely independent and career-focused, a baby at this stage was almost disruptive. But suddenly a new future unfolded before me that I had never considered with any serious thought. I started to plan and dream – and then just as suddenly as it arrived, it was gone again.
Stages of grief
Brené Brown identified three elements of grief in her research. The first is loss: the actual process of losing either a person or thing, as well as the loss of a ‘sense’ such as a sense of normality, a belief about a person, or an understanding. The second element is longing: an involuntary yearning for something. The third element is feeling lost, experienced as a disorientation of ourselves in our physical or emotional world. Things stop making sense the way they did before the loss happened. All three of these were present for me in the months after the loss of my pregnancy.
It was only in January this year, with time alone and having taken a break from work, that I was ready to start feeling the grief. Robert A. Neimeyer, a leading researcher in grief, wrote, “A central process in grieving is the attempt to reaffirm or reconstruct a world of meaning that has been challenged by loss.” The process of reconstructing could only be started when I created space between the acute grief I felt and was ready to start integrating it back into my life. Part of that reconstructing is in establishing a connection with others through shared storytelling – one of the components that make support groups so impactful in grief healing processes.
READ MORE: Here’s How To Actually Practise Mindfulness And Unlock Inner Peace
Why we need conversations about miscarriages, abortion and pregnancy
The need for connection after a loss is a common response to sadness, as it helps us feel seen and held in compassion. The connection also helps overcome the isolation that accompanied my other major response: shame. Shame is the sense that we, as our unique selves, are flawed or unworthy. It can be triggered by events in our lives where we feel we have fallen short. Shame thrives on secrecy, self-judgement and isolation. We continue to perpetuate the stories that we tell ourselves about our failures or inadequacy.
In the context of pregnancies, shame is worsened by the social taboos that still exist around unplanned pregnancies, the judgement around abortions, and the sometimes perceived failure of our bodies during a miscarriage. In my case, I felt irresponsible for getting pregnant outside of a relationship. I felt that I would be judged for the situation I found myself in. I felt ashamed that my body was unable to keep the pregnancy. None of this is logical, but in my own mind, the conversation became a dark spiral. The inability to talk openly about these experiences only worsens them.
The remedy to this comes again from connection, from feeling understood and from empathy. The fastest way to eliminate shame is to put it in broad daylight, to expose all of the gremlins that are waiting to catch us. But to do this, we need to create safe spaces where conversations can be had without judgement that leads to further shame. Through this, I was also able to show myself empathy. Slowly but surely, I rebuilt my trust in myself and my body.
Support is key
It took me three months of running away from the feelings before I could address them. But I was lucky in the support I had around me when I was ready. What became abundantly clear was that rather than dealing with this on my own, I needed to lean on my support, through family and friends, to help me process my feelings and reactions. By sharing my experience, I managed to reframe the self-judgement and self-blame that I’d had with for months. Research by Martin Seligman into resilience factors helps us address this with the three P’s: personalisation, permanence and pervasiveness. Through hearing other’s stories and sharing my own, I recognised that this was not all my fault. It was not a permanent pain that I couldn’t work through. It was not pervasive in all areas of my life.
These conversations developed in me a sense of belonging and connection with women that helped me feel safe and accepted. It also helped me accept myself and what had happened, turning the blame into compassion. With that, I was able to give myself a break – literally and figuratively. Easing the pressure on myself and taking some time off to rest and recover from the events was the single most important thing I could do.
Connections create healing
It’s taken me a year, a lot of conversations and hours of embodiment practices, but I can now reflect on the events of last year with a gentle sadness and deep acceptance. Despite the loss, I’ve gained invaluable wisdom from it. For starters, I know for the first time that being a mother one day is a deep desire that I hope to be lucky enough to fulfil. My miscarriage has given me clarity on my future that I’ve never had before. Although I don’t plan to start a family in the next few years, the decisions I make now around my business, my health and my lifestyle are already helping me prepare and build that future life.
This experience has also given me a newfound respect for a woman’s body, what she is capable of and how she continues to be judged, talked about, misunderstood and misrepresented in our society. In general, our understanding of our own bodies, cycles and needs often falls below par. Education about our cycle, how to work with it and adapt our daily lives to optimise it, is one of the most empowering gifts we can give ourselves.
“I felt that I would be judged for the situation I found myself in. I felt ashamed that my body was unable to keep the pregnancy. None of this is logical, but in my own mind, the conversation became a dark spiral. The inability to talk openly about these experiences only worsens them.”
Men should join, too
The men in our lives also play a key role in how we heal and recover from experiences of pregnancies. We often focus on the women’s experience in these matters, even though they can have a significant impact on the men as well. Creating space for conscious conversations about each person’s experience is a powerful way to process it together, through being vulnerable and present with each other. Successfully navigating these conversations can, as well as help with healing for both, ultimately create a stronger trust and sense of belonging within the relationship.
READ MORE: Why Toxic Positivity Is Harmful And What To Say Instead
Open up
Every woman’s experience when it comes to pregnancy, miscarriages and abortions is different. Mine is neither unique nor representative. How we feel, respond and process this depends on a myriad of factors. On reflection though, one thing I can say for certain is that we need to be having more open conversations about these very normal and very common experiences that women have. We need to speak about it so that we can ask for the support that we need – from our loved ones, from work, from our friends. So we challenge the shame and isolation that women face. We need to speak so others feel safe as well. We need to speak about it so that we can tell our own stories, and through that find the sense of belonging and support we need through these challenging times.
If you find yourself or a loved one going through this, I encourage you to embrace the vulnerability to be open about the experience. Take time to rest. Be compassionate and gentle. Ask for help. Share your feelings. Lean into the support around you, or seek out the support you need, rather than withdrawing into the pain. Together, through the shared experiences and storytelling of women, we can normalise our experiences to create safety and acceptance, that allows us to heal.
Hilary Davies
Hilary Davies is a social psychologist specialising in Diversity, Equity, and Inclusion (DEI) coaching and consulting. Her focus is on gender equality and organisational transformation. She is passionate about supporting women’s development by addressing the invisible barriers that impact their lived experiences. Hilary is the founder of 328 Women’s Coaching. It’s a programme designed to help women deepen self-awareness and catalyse growth in both their personal and professional lives. For more information, visit www.hedcoaching.com or learn more about coaching at www.328.co.za.