Literary Mama writing about the many faces of motherhood
Lost and Found: A Review of About What Was Lost: 20 Writers on Miscarriage, Healing, and Hope

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Edited by Jessica Berger Gross (Plume, 2006; $15.00)

On the message boards I frequented in the mid-1990s after surviving both a miscarriage and my daughter's stillbirth, Ms. Perfect Pregnancy was the term given to a mom-to-be who was blissfully unaware of the possibility that her pregnancy could result in anything other than a picture-perfect happy ending.

Sure, Ms. Perfect Pregnancy had her worries, but they were luxury worries as far as those of us on the boards were concerned: whether she would be able to exchange the stroller she had been given for the stroller she really wanted, whether the stretch marks that had begun to erupt on her belly would resemble a labyrinth by the time her baby arrived, whether she'd do something freakish and unexpected during labor. Meanwhile, we obsessed over early pregnancy symptoms (Were they still there? Were they real?), hCG numbers (Were they multiplying at just the right rate?), and ultrasound visits (Would a heartbeat appear on an otherwise dark and foreboding screen?); would history repeat itself or would our dreams of a healthy baby come true?

As time went on, Ms. Perfect Pregnancy stopped being anyone real. She came to represent that phantom everywoman who lurked around the corner in every department store aisle, pregnant and blissfully unaware of what it was that she still had and what it was that we had lost.

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About What Was Lost is a brilliant title for a collection of essays about the depth and complexity of the losses associated with the death of a baby prior to birth or during early infancy. It recognizes that no single description can do justice to the very personal circumstances of such an experience: While miscarriage is a common experience, every miscarriage is unique.

The title also hints at the fact that "what is lost" is more than the pregnancy and the baby that might have resulted -- although that, of course, is the first and most obvious loss the woman experiences. As she begins to process that most immediate loss and begins to work her way through the layers of her grief, pain, and other emotions, the woman who has just experienced a miscarriage or other similar perinatal loss or infant death realizes that there are other issues and losses to deal with: all of dreams she had for the child she was carrying, her own dreams about becoming a mother and gaining entry to a special group of women in our society, her feelings about her body as a life-carrying vessel, her plans for her life as a pregnant woman and a mother. As Jessica Jernigan writes in "Unplanned," "I hadn't just lost a baby. I also lost everything I had discovered when I still had her: the joy, the wonder, the knowledge of the absolute and astonishing goodness of being alive. I lost motherhood, too, and the awesome sense of certainty it gave me. I lost a future that I had wanted more than I've ever wanted anything." These are the types of losses that this collection of essays explores.

Some readers may object to the word "lost" as applied to the death of a baby, even though the term "perinatal loss" is often used interchangeably with "perinatal bereavement." As Rebecca Johnson writes in "Risky Business," "I preferred the truth to that anodyne answer, 'We lost him,' as if he had wandered off at the mall." However, in the case of this book, the term "lost" is applied much more broadly -- in terms of the many losses a woman experiences when her baby dies. Regardless of what readers think of the term "lost" in other bereavement contexts, its use is quite justifiable here.

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The contributors to About What Was Lost are established writers with a flair for literary nonfiction. This distinguishes the collection from previous miscarriage anthologies, which have consisted of compilations of more narrative accounts of miscarriage from mothers who wanted to share their stories.

The writing is spectacular and thought-provoking. Consider Julianna Baggott's description of her feelings about her body after her miscarriage: "It was a miscarriage, and I was the carriage. I imagine myself rattling over cobblestone, a wobbly thing on wooden wheels." Miranda Field describes what it was like waiting for her period to return: "I wait, but not patiently. I wait the way an animal waits to be let out of a room."

Given the likelihood that the readers of this collection will relate to the emotions being described, the contributors to this collection might have been tempted to settle for easy and pat clich├ęs rather than finding fresh ways of writing about a pain that is both unique and universal. Luckily for the reader, they find new phrases and metaphors to describe the experience of miscarriage. In "Misconception," Andrea Buchanan describes her grief in terms of her reaction to an art installation project entitled Strange Fruit:

Then, as we came closer, I saw that it wasn't just fruit strewn about the room, it was dead fruit. . . .Some were laced with surgical stitches. Some had glittery buttons, some had jaunty bows. As I finally entered the room, I found myself crouching to the ground with the rest of the tourists, unable to stop myself from touching the yarn and bows and buttons, the futile attempts to infuse the dead things with life again.

Much of the writing is spare, such as Sylvia Brownrigg's haunting essay, "The Scattering," which starts with the simple paragraph, "It was such a small box." Miranda Field begins her essay "My Others" with this stark sentence: "What happens is the child I'm waiting for dies inside of me, but I continue to carry it." The icy voice -- the brave face so many women adopt after miscarriage -- gives way only when the author entrusts us with her grief in the second paragraph that begins: "I fall through many floors of silence."

Other authors use wry humor as a way to describe their experiences. In "I Went Out Full," Dahlia Lithwick describes the intermingling of life and death on a maternity ward: "Allowing all the women who miscarry into the world of obstetrics is like letting Dracula into the Enchanted Castle. . . . The nurse who jabbed at me over and over with an IV needle, in a fruitless attempt to find a vein. . . . wore a nametag that read, 'Hope.' Miscarriage is nothing if not a festival of ironies."

Women who were shocked by the sheer physicality of the miscarriage -- heavy bleeding, labor-like contractions, and passage of tissue -- will find plenty of poignant descriptions to validate their reactions. Ditto for women who were shocked by the sometimes brutal advice offered by friends, relatives, or healthcare providers or were angered by the insensitive gynecological terms that are used to describe miscarriage and stillbirth ("A missed abortion sounded like I meant to terminate the pregnancy, but then somehow forgot to keep the appointment," writes Jen Marshall). This is the kind of book you want to read with a pen in hand, so that you can mark your favorite passages, knowing you will want to return to them again and again.

The book isn't afraid to tackle controversial issues head-on, nor to challenge stereotypes about how you're supposed to react to pregnancy under various circumstances. The book makes it clear that just as you can experience grief in the aftermath of an abortion, you can experience joy in the face of an unplanned pregnancy: so much for one-size-fits-all responses to anything reproductive. In "I Went Out Full," Emily Bazelon and Dahlia Lithwick discuss how powerfully they were affected by their miscarriages the previous year. The politics of reproduction is one of the topics they touch upon during this dialogue:

I wonder if the politics of reproduction have made feminists lose sight of what should be just as important a concern -- the effect a miscarriage has on many women's psyches. Pro-choice women have trained themselves to think that life beings at viability; when we miscarry, we're disturbed to find ourselves mourning a child rather than a mass of developing cells.

While editor Jessica Berger Gross has done an exemplary job of including stories that represent a variety of types of losses -- early miscarriages, late miscarriages, the loss of a twin, a stillbirth, a pregnancy termination, recent losses and losses from long ago -- the contributions appear to be drawn almost exclusively from middle- to upper-class America. It would have been fascinating to find out "what was lost" for women who have experienced miscarriage or stillbirth in a same-sex relationship, while living in poverty, while attempting to survive an abusive relationship, and so on.

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As the author of a number of pregnancy books, including a guide to pregnancy after a loss, I thought the introduction was the book's weakest link. While Jessica Berger Gross does an excellent job of explaining her own motivations for creating this collection of essays, she undercuts her credibility as the book's editor by presenting a rather dated picture of the way miscarriage is dealt with in the current generation of pregnancy books. Her assertion that pregnancy books have little to offer in terms of miscarriage support no longer rings true:

In search of answers, I went back to the same stack of pregnancy books I had so eagerly consulted months before for relentlessly cheery advice on everything from a balanced prenatal diet to maternity underwear. But such books concentrate exclusively on healthy pregnancies; not wanting to scare readers, they offer little information on what might go wrong, or advice about how to handle the emotional fallout if it does. In fact, the one piece of advice pertaining to miscarriage that these books do offer is that newly pregnant women should wait until the end of the tenuous first trimester to announce their pregnancy so that they will be spared the possible 'embarrassment' and discomfort of sharing the sad news of a miscarriage.

While there will always be pregnancy books that subscribe to the Ms. Perfect Pregnancy School of Thought, increasingly, pregnant women are seeking out guides that provide a more realistic view of what pregnancy is really like. Most pregnancy books today include information about miscarriage and grief and a discussion about when to share your news with other people in your life. Increasingly, pregnancy books offer advice on coping with the challenges of trying to conceive after a loss, pregnancy after a loss, and the postpartum experience after a loss.

The introduction would also have benefited from Gross's contextualizing Rebecca Johnson's powerful essay, "Risky Business," which explores her reaction to a miscarriage after she had already lost her infant son:

It surprised me how little I grieved over that [miscarriage]. In the months after Luke died, other women had tried to empathize with me by offering up their own experiences with miscarriage. They meant well, but once I had been through both, I knew there was no comparison. At six weeks, there had been no body or face, no head with hair or feet with toes. I had not lived with the child for six months, growing accustomed to his periods of wakefulness and sleep. I had not given him a name or planned his future. I had not watched him lose the fight to live.

A key tenet in the field of perinatal bereavement is that it's not the length of the gestation but the extent of the attachment that determines the extent of the bereavement. A note to this effect from Gross would ensure that a reader who had experienced a miscarriage would not feel like her loss was being minimized in comparison to Johnson's.

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So what would Ms. Perfect Pregnancy think of About What Was Lost?

While she was wrapped in her perfect pregnancy cocoon, she'd be oblivious to the book's existence, not even seeing the book's dark cover in a sea of pregnancy book cover pastels.

But if Ms. Perfect Pregnancy were to find herself bumped off the plane to her dream pregnancy destination, as so many of us have been, I'd like to think she'd want a book like this: a book that would tell her that it wasn't her fault that her baby died; that she wasn't stupid for thinking that if she followed all the pregnancy rules, she'd end up with a healthy baby. After all, you can play the pregnancy game perfectly and still lose it all. Pregnancy is, at best, a crapshoot -- a winner-take-all kind of crapshoot. And if you think nobody likes a loser, you should try being the pregnancy world's equivalent of a loser -- the previously pregnant; the ex-pregnant; the no-longer-with-child. It's a pretty awful place to find yourself, and you need to link up with other women who really-and-truly understand what you are going through -- and who will be going through that experience for some time yet to come.

That's what About What Was Lost delivers -- a collection of hearts, souls, and minds speaking frankly and openly about what was lost and what was found.

Ann Douglas is the author of Trying Again: A Guide to Pregnancy After Miscarriage, Stillbirth, and Infant Loss and The Mother of All Pregnancy Books. Her daughter, Laura, was stillborn due to a true knot.

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