My miscarriage, my abortion

About a month ago, I wrote here about my struggle to decide what to do after I found out that my pregnancy wasn't going to be viable. This morning, I went on New Hampshire Public Radio's Word of Mouth to talk about that decision, miscarriage in general, and some of the ways that this issue connects to larger discussions in the public realm.

Word of Mouth doesn't have embedding available, but you can go to their website and listen to the full interview. One of the key things that I got to talk about today that I didn't mention in my previous post is the way that anti-abortion laws have huge (presumably unintended) consequences for women who miscarry. Case in point: Fetal personhood. If you give a fetus all the rights of a living human from the moment of conception, how do you deal with the fact that some 50% of conceptions end in miscarriage? Today, if a living human being dies and we don't know why, there's an investigation into the nature of their death, to make sure it wasn't caused by foul play. Under some of these proposed laws, women like me would have to spend the incredibly painful weeks after a miscarriage attempting to prove that we didn't cause it. That gets doubly difficult when you consider the fact that, quite often, nobody knows why a specific woman miscarried. Around 50% of miscarriages are caused by random chromosomal mutations. But we have no idea why that happens (or why it happens to some women multiple times), and that also leaves a big, hard-to-diagnose group of women who would have no way of proving that they didn't cause their miscarriage.

In fact, being able to choose to have an abortion—to get a D&C procedure instead of waiting for the miscarriage to happen naturally—was actually what enabled me to know what caused my miscarriage. Having a D&C makes it easier for doctors to collect enough fetal tissue that they can run a genetic analysis on it. Last week, I got back the results of the chromosomal analysis performed on my fetus. Turns out, he had a mutation, Trisomy 16, that was completely incompatible with life. That trisomy is the most common genetic cause of miscarriage. It's also completely random. Basically, my miscarriage was bad luck. Knowing that makes me feel so much better. It's almost hard to describe the relief. And I owe that to an abortion.

Read my earlier post about my miscarriage

Listen to the interview on Word of Mouth

Image: Load out for Bone Marrow Biopsy, a Creative Commons Attribution Share-Alike (2.0) image from thirteenofclubs's photostream

• [Cyran0]

  Maggie, I commend your courage in airing such a personal and heart-wrenching subject in public.

  You are a credit to journalism.

  • [Fang Xianfu]

     One of the things that’s struck me during this pair of posts is that I know next to nothing about abortion. I understand the major arguments of the people for it and against it, but I have no understanding at all of the actual experience of being in those situations. Being male, it’s questionable how much true empathy I can build, I suppose, but I still think that that’s been one of the most valuable parts of this series. The only way we can empathise with one another is by sharing our experiences with each other.

    So thank you so much for your bravery in talking about this, Maggie.

    • [Maggie Koerth-Baker]

      I thought about writing about the actual procedure, Fang Xianfu. But I had it under general anesthesia, so all I can really tell you about is what it’s like to get that administered and then the ridiculous things I said to the nursing staff as I was waking up afterwards. 

      • [Cyran0]

        Don’t feel embarrassed about things done or said coming out of anesthesia, I’m told I was even trying to help take out my own wisdom teeth, and other things said which will never be discussed again. ;P

        • [Antinous / Moderator]

          I tried to pick up the anesthesia resident, which was particularly awkward since I worked there.

• [Mike The Bard]

  Maggie, I’m so sorry.  My wife and I went through the same experience (not trisomy, but an unbalanced chromosomal translocation), and I know what a hard decision it is.

  I was pro-choice before our experience, and infinitely more so afterwards- especially after sitting in a support group and hearing other people’s stories.  These were all people who desperately wanted a baby, and I think the very phrase “pro-choice” belittles the gravity of the decision.  We made a decision based on what we thought was best for our child, not what was easiest for us.

  Anyway, I sympathize, and thank you for sharing.  I hope that your story helps more people understand exactly what it is that the abortion debate is actually about, beneath the partisan smoke screens, strawmen and rhetoric.

  • [Maggie Koerth-Baker]

    Thank you for sharing, Mike. It sounds like you had an even harder decision to make than I did. I, too, hope this (stories like yours and like mine) ads some nuance to the debate. All my best to you and your wife. 

• [ZikZak]

  Hm, what if the cause of the miscarriage is one of the other common ones: environmental toxins?   Do we get to charge the polluters with performing an illegal abortion and/or murder?  Or does it just default to blaming the woman as usual?

  • [Maggie Koerth-Baker]

    Environmental toxins actually aren’t that common of a cause of miscarriage ZikZak. At least in humans. Our miscarriage rate is more likely to be a function of how evolution works than something caused externally. (At least, that’s the general thought. Like I say, there’s a woeful lack of research on miscarriage.) For instance, it’s a translocation and a fusion of two chromosomes that is a big part of what makes our chromosomes different from those of chimpanzees. Humans have one chromosome that used to be two separate chromosomes (and still is in chimps and gorillas). 

    I really recommend reading Jon Cohen’s book “Coming to Term”. In it, one of the things he writes about is Love Canal, the disaster that’s kind of the standard bearer of “toxins cause miscarriage”. But, while the toxic spills at Love Canal were clearly a health problem, they weren’t really something that caused an increased rate of miscarriage. The idea that they did was a combination of some really badly done epidemiology and the fact that, at the time, doctors thought the incidence of miscarriage was much lower than it actually is. The realization that the natural rate is around 50% is something we realized only after we stopped relying on hospital reports to calculate the rate. 

    • [ZikZak]

       didn’t know that, thanks.  I’d be surprised if no toxins had any effect, but it’s good to know that they’re not proven to be a common cause.

      • [Erynn Schwellinger]

        More likely to cause defects and issues later on than miscarriage. Which would be a whole other crime.

• [Deb Johnson]

  You’re incredibly brave to talk about it.  It’s tragic and sad when you lose a baby.  My last chance at a baby was when I was 42 – we got to 12 weeks and the heart stopped beating.  I then waited for the miscarriage.  It was sad and tragic that I had to go in for a D+C – we decided after that that 2 girls was enough, and our time was done.  I still wish I’d had another chance at being mum.  I hope that  you’ll have another chance too.  ((((hugs))))) and strong thoughts.  Thanks for talking about a touchy subject.

  • [Maggie Koerth-Baker]

    Deb, thank you for sharing your story. I know how hard that is. It makes me incredibly happy to create a space where people feel like they can talk about painful things they can’t talk about most of the time. All the best to you and your family.

• [thunderhammer]

  I’m curious where that 50% of conceptions end in miscarriage stat comes from?  I know there was a study, I think in the 80′s that found that something like 24% of pregnancies ended in a basically undetectable miscarriage before the woman missed a period – before the woman would normally even notice, basically (this was found by giving them pregnancy tests really early).  Then there’s the “background” miscarriage rate of roughly 10-12%.  And then there’s fertilized eggs that never implant or are rejected before any pregnancy hormones have a chance to kick in and as far as I know there’s no way to measure how common that is…  

  • [Maggie Koerth-Baker]

    It’s based on a meta analysis of several different studies. And it’s a rough estimate. I’m pulling this from Jon Cohen’s book “Coming to Term” which looks at the science of miscarriage in really great detail. I recommend checking it out if you’d like to know more about how this is studied and what we do and don’t know. 

    • [Dennis Abbeduto]

      I don’t know if this is covered in the mentioned book, but I wonder if modern access to highly accurate at-home pregnancy testing figures in. I may be mistaken, but I thought I read somewhere that what some women think are simply late  or missed periods are actually very early-term miscarriages.

      • [Maggie Koerth-Baker]

        Yup. That’s one part of why it feel like there are more miscarriages today than there are in the past. Because more women know sooner when they are pregnant. 

        • [Erynn Schwellinger]

          The false positive… It’s not always false.

        • [Maggie Koerth-Baker]

          Actually, it’s almost never a false positive. If you get a positive pregnancy test and then you aren’t pregnant it was almost assuredly a very early miscarriage. 

• [Faith]

  Maggie – thank you again for being so open and honest about your experiences. I understand why some have to hide and I don’t blame them at all, but if we all talked about or even just told about our painful and harrowing experiences, perhaps they wouldn’t be quite so harrowing (not to mention, perhaps men would stop passing laws against things they know nothing of.)

• [Joel Phillips]

  I’m not sure that this is a great argument against foetal personhood.  It would be possible to establish a foetal personhood law that did not typically require great investigations into the cause of “death” – just as if some dies in a care home aged 90, there is typically no investigation beyond a doctor signing a death certificate.  

  Not saying that personhood is a good idea – I believe that it’s a terrible one, but it’s important not to use arguments against it which are easily defeated.

  Thanks for being so public about this.  I know lots of people who have miscarried and for most of them, they only realised how common it was when they began to confide in friends and family and discovered that they’d often had the same experience.  In many cases, getting a sense of how normal and commonplace was really helpful.  

  • [Scott Slemmons]

     As far as I know, there have been no personhood laws that have taken that sort of approach. They’ve all had only one approach — declare every unborn baby, fetus, fertilized egg, to be a person, with all associated rights. You can’t have that without having to do an investigation of every miscarriage. Maybe someday, the personhood advocates will put out a bill that addresses those concerns, but I don’t think it’ll be anytime soon. Their primary goals are to (A) ban all abortions and (B) punish women who have sex.

    And thank you, Maggie, for sharing, and best of luck to you and your family.

    • [Joel Phillips]

      Yeah, but my point was that 90 year-olds are persons and when they die, most of the time a doctor just signs a death certificate without any significant investigation.  So even if foetuses were persons with all associated rights, there would be no need for their deaths to provoke an intrusive investigation in most cases.

      For supporters of foetal personhood, this is an easy win, which makes them appear reasonable which, in turn, makes it easier for them to pretend that their primary goals are not banning all abortions and punishing non-procreative sex.  

      There are many much better arguments against personhood: it’s unnecessary; it creates an unresolvable dichotomy between the rights of women and the rights of the foetus; it’s biologically illiterate; it leads to policies that result in harm to women.

      • [Maggie Koerth-Baker]

        I think the fact that they (so far) have not even considered this and/or are so poorly educated on women’s reproductive systems that the connection hasn’t occurred to them is an important thing to call out. 

        Worse, some of them have considered it, and have demonstrated quite emphatically that they do not give a shit about us. Georgia state representative Terry England defended a bill that would have banned any abortion procedure after 20 weeks. When someone pointed out that his bill would prevent women who had a stillbirth from removing dead fetuses from their bodies, England basically said that women should have to wait for their bodies to naturally expel those fetuses because that’s what the animals on his farm do. 

        http://thinkprogress.org/health/2012/03/12/442637/georgia-rep-compares-women-to-animals/

        • [Saltine]

          I’m from the rural South, and I have lived in the Delta and in Appalachia, where pro-life sentiments are common. You should add to sheer mean-spiritedness willful ignorance. Many of the pro-life types I’ve met and talked to would greet ANY discussion of the biology of reproduction with some, generally scriptural, equivalent of fingers in ears and LA-LA-LA.

          The ignorant part, but maybe not the willful part, goes for the college students I’ve taught who are pro-life. Many of them have no knowledge of the actual religious dogma of their own faith, of extreme statements by people like England, nor any beyond the dimmest understanding of reproductive biology.

          I know I sound like an arrogant silent-P Rick, but this really is my experience of people on this issue. I keep listening, and my heart keeps getting broken by what hear.  It’s horrible that people want to control the lives of others on the basis of so little knowledge. But I guess that’s how it always is. 

          I honestly believe than education has a slim chance of changing people, especially as education tends to introduce a little empathy too.

      • [CH]

        “it creates an unresolvable dichotomy between the rights of women and the rights of the foetus; it’s biologically illiterate; it leads to policies that result in harm to women.”
        Um… I don’t think those points are in any way relevant for those who want legal personhood from the point of conception.

        I don’t know about your country, but in my country anybody dying at home is getting an investigation, no matter what age. So, my guess for what would happen if foetuses were given personhood is that any woman miscarrying in a non-hospital setting would have to prove that they actually had a miscarriage and not an abortion (probably by having a doctor’s examination).

        But how do we know if a foetus needs protection if we don’t know who is pregnant and who isn’t? Perhaps there should be a monthly mandated pregnancy test? Oh, and of course a national register of women between menarch and menopause? Not to mention a list of “known miscarriers” so the Foetal Protection Agency can make crack downs on fertility clinics and take into custody the embryos.

        That last bit is hyperbole… but… if foetuses had legal personhood, wouldn’t a doctor transfering an embryo into the womb of a woman who has had several miscarriages and no live birth be on pretty shaky legal ground? And what about all the embryos who most probably aren’t viable (not multiplying in an expected manner), and wouldn’t currently be transfered? I guess they should all be transfered, too. Or at least get a decent burial!

        • [Maggie Koerth-Baker]

          YES. And that’s another excellent point. 

          These people don’t JUST want to take away your right to decide what to do when you don’t want to be pregnant. They also want to control your choices when you have lost a pregnancy you wanted, AND when you can’t get pregnant and want to be. 

          The biggest thing I want women to understand about this: Even if you want babies … craptons of babies … and don’t think that elective abortion is okay, you should still be pro-choice. Because these people are out to get you, too. We stand together here. 

• [l337n00b]

  I listened to the interview and read your post from before that I had missed.  When you talk about fetal personhood laws that would leave women fighting to prove they didn’t cause their own miscarriage it turns my stomach.  When my wife had a miscarriage it was hard enough to convince her that it wasn’t her fault, asking her to prove that to a legal system is a terrible way to compound a tragedy.

  I loved that fetus and I still have a place in my heart for it years later.  I am sad that it had such a short life and that it never got to experience the world and learn and grow.  The idea of using that love as a weapon to persecute a woman who choose an abortion is horrifying.  As if lawmakers and courts could possibly believe more in the personhood of that fetus than my wife and I did.

  And a big thanks for talking about the Shittiest Secret Society.  For many women miscarriages do carry a huge amount of self-blame and shame.  Stats and facts are very helpful for some women, but not everyone responds to them.  Destigmatizing miscarriage has to mean talking about it.

• [Dovanna]

  I think the majority of people who are absolutely against abortion don’t understand how complex of an issue it is. Proper reproductive education is sorely lacking over here in the states.

  What you’ve described in your most recent article is something I never knew- that you could have your fetal tissue tested to find out exactly why the miscarry happened. Schooling taught be about safe sex, but nothing about pregnancy complications and how common miscarries actually are (a stat I only learned of about in my twenties). 

  This is important information for women who choose to be childfree or reproduce, and I wish it would get more press.

• [Substance McGravitas]

  Yet another thank you comment.

• [Susanna King]

  Maggie, I had a situation very similar to yours, though it happened earlier in my pregnancy. In my case, the doctor determined at 10 weeks that I was going to miscarry – there was no heartbeat and the ultrasound confirmed her diagnosis. 

  I was given the option of a D&C or “letting nature take its course.” Since I was planning on flying home for Christmas in a few days, I opted for the hospital procedure. It was a blessing to have that option available at that time. The hardest part was talking to people about it, but I learned that more women than I would have thought – women I’d known for years – had also had miscarriages. They just didn’t talk about them.

  My doctor told me we could start trying again a month later, and I got pregnant again right away. That time, I ended up with a healthy pregnancy, resulting in our son, who is now six.

  • [Erynn Schwellinger]

    So many pregnancies end in miscarriage that probably over half the older women any of us know have had one – knowingly or otherwise. Many know. It’s just never, ever mentioned. Because what can someone say?

• [tw1515tw]

  I know two people who have suffered a miscarriage. The first said a major problem was she was grieving, but other people didn’t recognise she was grieving. When it happened to my friends, I sent them a condolences card, and later they were very appreciative of the (small) gesture.

  So my condolences are with you Maggie, in this difficult time.

• [KvH]

  I’m curious about the 50% of conceptions being miscarriages statistic. I’d heard that a large number of conceptions don’t ever implant and the woman wouldn’t even know it had happened. Am I mis-remembering something? If not, is this scenario part of the miscarriage statistic?

  Thank you for being so open and talking about this.

  • [Maggie Koerth-Baker]

    So, it’s complicated. Any number is a rough estimate. As I mentioned above, I’m getting this from reading Jon Cohen’s excellent reporting on the several different large studies that have been done on miscarriage frequency. 

    My understanding: 
    >50-75% of conceptions end in miscarriage
    >30-50% of implanted pregnancies end in miscarriage. 

    The numbers drop significantly each week you’re pregnant. It’s really common to have a miscarriage in the first week of pregnancy (like my first miscarriage). It’s much less common to have a miscarriage after you’ve detected a heartbeat … roughly after the 6th week, as in my second miscarriage. 

    • [CH]

      The first number should probably have a “or failed implantation” added to it. If I have understood correctly, the definition of miscarriage is a loss of an early pregnancy, which means that anything before implantation (pregnancy) is not counted as a miscarriage. Before that it is “just” implantation failure (BTDT).

      • [Erynn Schwellinger]

        Pregnancy is considered to take place from conception, not implantation, though I never personally understood the logic in this. Hell, pregnancy calculations take place from the missed period – and the egg and sperm don’t even have to have met at that stage in things.

• [AquaDad18]

  Thank you for talking about this, Maggie. My wife had two miscarriages.  One in the 90′s and one in the 2000′s.  Gratefully, we have two healthy boys, 20 years old and 10 years old. But each miscarriage was devastating.  I felt so helpless trying to console my wife. I can’t even imagine what she was really feeling during that time. She could not express it to me and even if she tried, I was incapable of picking it up (being male and absolutely stupid in these matters). Counseling didn’t help us at that time.  Some of those statistics you shared might help. Maybe.  I hope that talking about it openly, like you are doing here, will someday help minimize the unanswered “mysteries” and alleviate the shame and pain surrounding it.

• [Mister44]

  May I ask what the little orange thing that says “time out” is for?

  • [Susan Carley Oliver]

    Mister44, according to the photo’s caption it is actually a tray prepared for a different procedure, one called a “bone marrow biopsy” (yep, they withdraw a bit of one’s marrow to test for diseases of the blood). My guess is that the “time out” labels refer to points in the biopsy checklist that require the participants (physician, techs, even the patient sometimes) to take time out to verify important pieces of information like patient identification, type of procedure to be performed, location of procedure, etc. During a time out, all participants are supposed to literally stop what they are doing and give full attention to the questioner and to the answer.

• [chgoliz]

  I am glad that you have found some measure of peace in getting a factual answer about the cause, Maggie.  Take care of yourself.

• [thisbikeisatardis]

  thank you again for continuing to share your story. best of luck to you and your husband next time. 

• [deathisastar]

  Maggie – thank you for having the courage to address this very personal but common issue. You’re doing a great service to women. And I’m a guy.

• [Heather Perry]

  Your posts are exactly in line with my feelings when I was faced with this decision last summer. At 8 weeks I  discovered I had a blighted ovum, and was given the option of miscarrying naturally or having a D&C done. The D&C was absolutely the right choice for me, and freaked me out quite a bit afterward at the idea of the alternative – knowing I’d miscarry soon but waiting around for (possibly) several weeks for the inevitable to occur. The experience has made me even more pro-choice than I was pre-pregnancy. Thank you so much for writing so openly and honestly about your own experience.

• [imaginedpigeon]

  Thank you Maggie for sharing your story. All the implications of Fetal Personhood upset me, too. Someone very close to me has been trying to have a baby for the last year, and she has had two miscarriages that each had to end in D&C. It’s heart wrenching. By Ohio law, doctors were required to offer her a death certificate, even though she was less than eight weeks along both times. It was like adding insult to injury even to be offered a death certificate. It’s hard enough already. I know she reads BoingBoing and I hope that she’s read these articles and that they have helped her in some way. Thank you again for sharing this very personal issue.

• [Kara Trott]

  I have been cautious to speak about these things as well, even though I feel strongly that women should always be offered a choice without shame.  Thank you for showing us a way to speak out and share, in a way that we may not be totally attacked in doing so.  

• [Nicky G]

  I find a few of the comments in this thread a little concerning, although I certainly acknowledge I may be misinterpreting some of what’s being said. But let’s not forget, pro-choice vs. anti-abortion is not women being pitted against conservative/religious men. MANY vehement anti-abortion folks are, guess what, conservative/religious women. I sometimes pick up on what I perceive, anyway, to be a hint of an anti-male undertone in abortion debates, which I think severely clouds the issue. Many men support pro-choice, and many women do not. And vice versa of course. I suppose that’s obvious to anyone with a brain, but there are definitely times where I think that some folks might not realize this…

  • [wysinwyg]

    There’s good psychological and neurological evidence that human beings do not make moral decisions rationally but by relying on moral intuitions.  That is to say, some people think about the abortion issue by thinking about a cute baby and saying to themselves “OMG, how could anyone murder such a precious, adorable little thing!” 

    The fact that most people don’t actually think about moral issues but just feel them explains why we see that there is no opinion so stupid that we can’t find someone who believes it. 

    I tend to think the men in question — and people making decisions about reproductive health laws are overwhelmingly men — don’t care either emotionally or rationally.  They’re venal cynics who know that pushing emotional buttons gets them votes.

    TL;DR: there are better targets for your “concern.”

  • [Origami_Isopod]

    Some women support the patriarchy. What else is new. But who benefits?

• [Krismom KStar]

  Maggie, I was only recently introduced to your articles, including the original entry on your D&C decicion… certainly a heart-wrenching one. Thank you for choosing to share it with everyone…

  I know very well the sadness of miscarriage and the pain of any type of “abortion” (totally agree with some who have said this term is a strange to hear being used in a different way than what we’ve come to think of it as meaning… even being pro-choice, I hated hearing the doctors throw this term around when it referred to babies I had wanted so so much!). My partner & I lost 3 angel babies before finally being able to bring our healthy son to term – for my pregnancies, the abnormality may have been a progesterone defficiency.

  I agree that much more needs to be done with breaking the silence surrounding pregnancy loss and I thank you for doing your part. It takes a lot of courage to share this story…

  ~krismom

• [stay78]

  Maggie-

  I want to thank you for being so brave and sharing your experience.  I am very sorry for you and your husband’s loss.  However, I am extremely grateful you’ve decided to speak out about your experience thereby comforting other men and women who’ve made the same difficult choice.  I believe Abortion is NOT a debate about killing babies, but rather a debate about women’s health.  Thank you again for speaking out!

• [Doobie]

  I know at least 2 women who have experienced ectopic pregnancy – which is particularly scary (fetus implants itself in the fallopian tube, not the uterus).  I keep wondering if people who are trying restrict access to abortion have had any experience with complications in pregnancy.

  Thanks for your post.

• [Sidney18511]

  Well according to the republicans that want to put fetal personhood laws into effect, a woman who has had a miscarriage, could be charged with murder. Her uterus would become a crime scene. Did you jump, drink, smoke, not eat properly? Did you stay up late, fight with your hubby, lift something heavy? In fact since woman don’t know when they become pregnant, all girls at the start of menstruation will have to be monitored monthly, lest we allow something to happen to the new person growing inside. If a woman is n
  Known for not taking good care of their health, well they will be locked up, watched, force fed, and monitored until the person is born. Doesn’t anyone realize how crazy just the idea of personhood his? These teapots are nuts, and if they take over, well, we are screwed!

• [MsMaryFromDuluth]

  I came across this post by chance, and in a weird way it’s fitting. In 2003, I was pregnant for a second time by my son’s father (my son is thirteen today). He was a meth addict and I became terrified/convinced that our “new” baby would have crack baby syndromes and things of that nature, so I chose to have an abortion (and believe me it’s painful physically). I also, live in Minnesota.

  After that decision my relationship with my son’s father fell apart, mainly because of his drug/alcohol problems and we broke up. To this day he still believes I was lying about the pregnancy and that it wasn’t his child (I wasn’t with anyone else).

  Today I’m happily engaged to the man of my dreams, my best friend, and we’re getting married next June. The sad part is he was told he cannot have children because of his medications for a specified disease I’d rather not mention.

  I used birth control for the first three months we were together, but I figured since he had been told he cannot have kids, I was safe…and then…nine months later…I got pregnant. That’s where I am right now. I just hit seven weeks this week.

  My decision to have an abortion next Friday is based on several reasons the first being how physically heavy I am. I weight 250 lbs. I refuse to have a pregnancy in this weight bracket (I had toxemia with my son and almost died).

  The others are, my insurance is HORRIBLE. I work full-time and work for an insurance provider. You’d think I’d have good insurance. Nope! I’d have to pay for a c-section almost out of pocket (which I have to have a c-section because of my last birth), and with that being said — I can’t afford that.

  My final decision is that we aren’t married yet and there’s not a way we can move the wedding up, plus my fiance is still in college full time and can’t financially contribute to our life right now. He does get disability monthly because of his disease, but that covers only the rent.

  IF it were not so expensive to have a baby, I’d make other choices. Right now, I can barely afford to live/pay my student loans/take care of my one child…and after all, this was an unplanned pregnancy and we were told HE CAN’T HAVE KIDS.

  Ugh.