On the complexity and diversity of miscarriage experiences
When my first pregnancy ended in miscarriage at 13 weeks, I was devastated. Over the years – and after experiencing two more pregnancy endings – I came to understand what anthropologist Linda Layne meant when she described the ‘taboos and silences’ surrounding miscarriage in her 1997 article ‘Breaking the Silence: An Agenda for a Feminist Discourse of Pregnancy Loss.’ Nearly 30 years later, much has changed. Miscarriage is no longer hidden from public view. Celebrities now openly share their experiences, and events like Baby Loss Awareness week have helped bring the topic into the spotlight.
However, as the silence has faded, it’s been replaced by certain dominant narratives. For the past 15 years, I’ve followed Layne’s lead by conducting anthropological research on miscarriage. During this time, I’ve seen a shift in how miscarriage is treated in both medical and non-medical settings. In the past, it was often seen as an unfortunate but routine event, something women were expected to recover from quickly. After my own miscarriages, I received no aftercare – I went straight back to work, and there was little or no recognition of any potential physical or emotional effects.
Thankfully, things have improved. Today, there’s more empathy in how miscarriage is handled. In my recent research, I’ve observed healthcare providers regularly giving women information about specialist counsellors they can contact. This kind of dedicated support shows a change in how miscarriage is understood – there is more recognition of its potential impact. Such changes are supported by recent UK government initiatives, which reflect the broader societal move to emphasise the seriousness of miscarriage. Last year, the UK government launched the Baby loss certificate scheme so that people could receive official recognition, and more recently, it announced that people who experience pregnancy loss before 24 weeks will have the legal right to bereavement leave.
I must note, though, that these initiatives typically don’t come with real material change such as paid leave for those experiencing early pregnancy endings. While I welcome increased support, I’ve also noticed a new problem, as these initiatives demonstrate: miscarriage is now framed as the loss of a baby, and the assumed emotional response is grief or bereavement. For some people, this is welcome and resonates with their feelings of loss. Yet for others, this framing doesn’t reflect their experience. As a result, they may feel out of step with the dominant narrative and with the care that is offered.
My most recent research into the ‘remains and remnants’ of miscarriage, broadly conceived, has included an exploration of how the physical remains of miscarriage are handled. This work has revealed that bereavement narratives and memorial practices promoted by charities and other groups play a dominant role in shaping public understandings and inform clinical care of miscarriage in England. Hospital practices around what happens to pregnancy tissue, however, can be inconsistent and contradictory with disposal practices producing foetal personhood. Most hospitals offer ceremonial disposal, such as cremation or burial, which reinforces the idea that a baby has died. But these same institutions may also use processes that don’t support that framing.
I’ve argued that structuring miscarriage care around the assumption of grief can be problematic. It doesn’t consider the complexity and diversity of lived experience. When hospitals focus on ceremonial disposal without offering real choices, this approach isn’t inclusive. Many of the women I spoke to did experience grief after miscarriage, but not all did. And that matters – because in focusing so heavily on grief and memorialisation, current care models risk making those who don’t feel that way think there is something wrong with them. Some women end up feeling alienated or abnormal when their response doesn’t match the expected one.
I’ve seen firsthand how current clinical practices can offer real comfort to those who experience miscarriage as the loss of their baby. Using the term ‘baby’, providing counselling, and offering options like burial, cremation, or memorials can be deeply meaningful for people in grief. But not everyone relates to their miscarriage in this way. Some people – even those who feel grief – find ceremonial practices like funerals or burial unsettling. They don’t necessarily see the biological remains as central to their loss. Others feel sadness, frustration, or disappointment, but not grief. And some feel relief. One woman I spoke to had planned to terminate her pregnancy, and her miscarriage meant she didn’t have to go through with an abortion with conflicted feelings. What my research consistently shows is that there is no single way to feel after a miscarriage. One woman, firmly committed to ending her pregnancy, was shocked by her unexpected grief after miscarrying before her appointment for an abortion. Another, who had an abortion, was devastated – and went on to mourn and memorialise the loss of her baby.
These stories reveal a crucial truth: when care systems assume a ‘right’ or ‘normal’ emotional response to miscarriage or abortion, they risk excluding and even harming those who don’t fit the mould. Miscarriage care needs to be more flexible, more inclusive, and more responsive to the wide range of experiences people have – not just the ones we expect them to have.
The Feminist Miscarriage Project was born out of real people’s stories – like those described above – that reveal just how blurry the boundaries can be between miscarriage, abortion, and other forms of pregnancy endings. These categories, while useful in some contexts, often fail to reflect the complexity of lived experiences. One of our central goals is to challenge and rethink these fixed labels, and to explore how care, advocacy, and academic work on pregnancy endings might be more connected, inclusive and responsive to diversity.
Take the National Bereavement Care Pathway for example: it’s a national programme designed to guide healthcare providers in delivering compassionate, consistent care to those who experience pregnancy loss. While this kind of support is essential for those who are grieving, it must be accessible to all who experience pregnancy endings – no matter the stage of gestation or the circumstances of the end of the pregnancy. Counselling and sensitive hospital services like cremation can bring real comfort to those who need them. But my research has shown that when healthcare assumes every miscarriage is a bereavement, it can do more harm than good. Many women I spoke to didn’t relate to this model of care. Some even experienced distress when faced with language or practices that presumed grief or treated their pregnancy as the loss of a baby.
As Vic wrote in her first blog post, ‘the contemporary challenge is less about “breaking the silence”, and more about making feminist interventions into how miscarriage is spoken of – by complicating, challenging, and adding to the narratives already circulating.’ That’s exactly what The Feminist Miscarriage Project is working to do: to broaden the conversation, to include a diversity of voices and experiences, challenge dominant assumptions, and to ensure that every experience of pregnancy ending – whether marked by grief, relief, or something else entirely – is considered and respected.