When Mayor Michelle Wu revealed in an interview with the Globe Monday that she had suffered two miscarriages before becoming pregnant with her third child, she joined a growing list of public figures who have chosen to speak out about the experience.
“I feel so lucky now, especially that I know kind of what the alternative can be,” Wu told the Globe, after discussing the relief she felt upon entering her second trimester. “In some ways, because of that, it is both more exciting and also more nerve-racking.”
Wu is mother to two boys, Blaise, 9, and Cass, 7. She is expecting her third child, a girl, in January with husband Conor Pewarski.
Other public figures who have come forward to speak about pregnancy loss include the singers Pink and Halsey, actress Brooke Shields, former first lady Michelle Obama, Chrissy Teigen, Meghan Markle, the Duchess of Sussex, and most recently social media influencer Kylie Kelce, wife of NFL football player Jason Kelce, who shared news of her miscarriage earlier this month.
Their public declarations are part of a larger movement that is also playing out on social media aimed at reducing a longstanding stigma that has forced countless women to endure their losses alone.
“Despite all advances in medical care, miscarriage or early pregnancy loss remains incredibly common,” said Dr. Kate White, chief and chair of obstetrics and gynecology at Boston Medical Center, who says about one out of every three pregnancies ends in miscarriage. About two-thirds result from a genetic abnormality, she said, and most occur in the first trimester.
The risk factors and the causes are often unknown.
Yet despite its frequency, the shame and stigma that surrounds miscarriages is often so profound that many feel unable to share the news with friends and family, she said, which makes it feel like “it’s very rare as opposed to something that is very common.”
Getting through the trauma of losing a baby is hard enough, even with that support. That’s something White knows firsthand. As an OB-GYN, White has spent years watching her patients suffer. She also experienced two miscarriages of her own, one at five weeks and one at seven months.
“Of course, I understood the science behind it,” she said. “But no one prepared me for what it was going to be like to have the loss, the grieving afterwards, what it meant for anxiety in the next pregnancy. And I’m a doctor who should be plugged into the best of the best resources, the best health care that there is. And I still felt like something was lacking about the care that I got. The medical system did not know how to talk to me.”
Those experiences inspired White to write a “letter to all of the women” she had taken care of, and those she can’t reach. In 2021, she published “Your Guide to Miscarriage and Pregnancy Loss.” When her 70something mother told her friends about the book, she said, many responded by revealing the losses they had that they still carried with them decades later — stories some of them had never before shared with anyone. Some had lost marriages.
Through that experience, she learned that the stigma and shame are a modern phenomenon. In the 1800s, it was not only common to lose a pregnancy, but babies often died in infancy or early childhood. As a result, she said, people talked about it much more, and leaned on their family and their community for support.
“It was seen in some ways as a victory if you were able to give birth to a baby that then lived for at least a few years because there were so many ways that a pregnancy could be lost or that a baby could die,” she said.
As time passed and medical care improved, however, a misconception took root that if an expectant mother did all the right things, ate all the right food, stayed healthy, and went to the doctor, it was possible to “guarantee” a good outcome. This shift, which White believes began to take root in the 1970s, ′80s, and ‘90s — with the advent of new technologies — added to the agony for the women who experienced miscarriages.
“Now it wasn’t just the loss of a pregnancy, it was your body betraying you — it was ‘maybe you did the wrong thing to make this happen,’” she said. “And so it became something that was laden with shame. Because you felt like you had control, the question became, ‘How could this happen? It must be your fault.’”
Like White, Amy Henderson Riley also has both personal and professional experience with miscarriages.
In the late 2010s, Henderson Riley was working as an assistant professor of population health at Thomas Jefferson University in Philadelphia, but was also grappling with devastating personal tragedy — she had recently experienced her sixth miscarriage.
While online one day, she discovered scores of women like her were taking to Instagram to share their stories under hashtag #ihadamiscarriage. The discovery led Henderson Riley and her colleagues to publish a 2019 paper in the journal Obstetrics and Gynecology exploring the phenomenon. Part of the appeal, she said, was the anonymity of the internet. But the larger motivation was simply the need for validation.
“They found that their own family and friends were not being supportive, but strangers online provided a support network that they weren’t finding in their own lives,” said Henderson Riley, who would eventually experience two more miscarriages, but now has a 4½-year-old daughter and 2-year-old twin girls.
Thanks to public declarations like those made by Mayor Wu and those posting on Instagram, White and Henderson Riley are hopeful the “pendulum” is beginning to “swing back.” White has noticed a generational shift in the way people talk about miscarriages, led by people in their 20s, who came up using social media and sharing the “good, the bad and the ugly of life,” with their friends.
“I think we have taken a shift from everything is perfect and polished and flawless towards this is life, this is messy, it is real,” White said. “And I think people are realizing that grieving alone makes grieving so much harder,” she said.
Some on the front lines of maternal health care say the current battles over abortion access are also changing the dialogue.
Dr. Erika F. Werner, chair of obstetrics and gynecology at Tufts Medical Center, said she has noticed the tenor of the discussions she is having with her patients around the topic of miscarriages changing, as antiabortion activists have sought to ban the abortion pills mifepristone and misoprostol, which play a key role in miscarriage management.
“Knowing that women in some states are having trouble accessing miscarriage management is making women in states where they can easily access miscarriage management more aware of how their care could have been different,” she said. “For the first time in my career over the last few years, I’ve had patients thank me for miscarriage management. They’ll say things like, ‘Thank you so much. I know not everybody has access to this.’ And never in my career has anybody ever said that.”
Niki Griswold of the Globe staff contributed to this report.
Adam Piore can be reached at adam.piore@globe.com.