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    Perspective

    Why we need to talk about miscarriages

    As one woman learned, there are powerful reasons not to hide the experience.

    booties for baby on the old wood background; Shutterstock ID 273627851; PO: crib stuff
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    “Is this your first?”

    It’s an innocent question, one that’s followed me ever since it became obvious to strangers that the bulge in my belly was a pregnancy and not just the aftermath of a big meal. But I still pause every time I hear it.

    Usually, I just nod to avoid saying anything specific. “We’re really excited,” I reply. I smile and let it go.

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    Because it isn’t my first pregnancy. There was one that came before. The one that isn’t easy to talk about.

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    In July, as Mark Zuckerberg took to Facebook to announce that he and his wife, Priscilla Chan, were expecting a daughter, he used the opportunity to mention that they had experienced three miscarriages. “You feel so hopeful when you learn you’re going to have a child,” he wrote. “You start imagining who they’ll become and dreaming of hopes for their future. You start making plans, and then they’re gone. It’s a lonely experience.”

    He said that he told his story publicly to make it easier for others to do the same. “We hope that sharing our experience will give more people the same hope we felt and will help more people feel comfortable sharing their stories as well,” he wrote.

    So here’s mine.

    My husband and I first found out I was pregnant on a spring afternoon. I’d been feeling achy and out of sorts and had jokingly told him the night before that I was probably pregnant. A test confirmed we were expecting. “We’re ready for this?” I said. It was a half-question, half-certainty. “Of course,” he responded.

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    For the next few weeks, we tiptoed into the prospect of parenthood. We kept things to ourselves, and I contemplated starting a group called Pregnancy Anonymous, where I could meet with other women in their first trimester, that precarious three-month window before a fetus is considered viable. At 11 weeks in, we decided to tell our parents. It was appropriate timing, we thought: Mother’s Day.

    The bleeding started three days later. In the hospital basement, the ultrasound attendant looked grim as she scanned my uterus. It was such a hollow silence.

    For the next few days, as my body processed the loss, our families channeled their short-lived excitement into support. But more remarkably, the calls started coming. Aunts, friends, co-workers, and loved ones all reached out to share their own miscarriage stories. I called one of my closest friends to tell her all that had happened. “I was pregnant, but now I’m not” was the best way I could phrase it.

    “Me, too,” she said, throwing me completely off kilter. Her own miscarriage had happened just a few days earlier. Over the next few weeks, we bonded over the parallels we found in our shared pain.

    It was, I realized, a shadow sisterhood. By some estimates, 1 in 4 pregnancies don’t survive to term. A survey published in the journal Obstetrics & Gynecology found that 55 percent of respondents in the United States believe that miscarriage occurs in 5 percent or less of all pregnancies. This, despite the fact that 15 percent of those surveyed said that they or a partner had actually had one. I found it incredibly odd to realize that so many people close to me had experienced this loss and yet so few discussed it openly.

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    Miscarriages are difficult to talk about, but we should find more ways to have the conversation. We need to correct persistent misconceptions about their cause that can lead women to blame themselves. Seventy-eight percent of survey respondents said they believe miscarriage occurs in the wake of a stressful event, and nearly two-thirds attributed the loss to lifting a heavy object. In fact, most doctors acknowledge that these factors, and many others, including contraceptive use, do not play a part in miscarriage.

    “From a research point of view we’re really at the early stages of discovery,” says Dr. Zev Williams, a coauthor of the journal article and director of the Program for Early and Recurrent Pregnancy Loss at the Albert Einstein College of Medicine, Montefiore Medical Center, in New York City. “In half of all cases of recurrent miscarriage, we don’t know why it’s happening.”

    We should talk about miscarriages to help address the feelings of shame and isolation parents feel. In the survey, 47 percent of respondents felt guilty over the loss, and 41 percent reported feeling that they had done something wrong. Further, it found that 41 percent of respondents felt alone, and 28 percent felt ashamed. “We in the medical community may be inadvertently contributing to this when we advise people, ‘You’re pregnant, but don’t tell anyone yet,’ ” Williams says. “The subtext is: If you have a miscarriage, you don’t want anyone to know.”

    But we’re not alone. And for that reason, I’ve made it a point to be honest about my own experiences whenever the appropriate opportunity presents itself. And while it might seem strange to think that Mark Zuckerberg, who has enabled nearly 1.5 billion of us to overshare online, would be the one to prompt a public conversation about miscarriage, I commend him for taking that risk.

    As I write this, in the 39th week of my pregnancy, the life inside me is kicking. But the life and the loss that came before, and the lessons that came with it, remain just as precious.

    THE FALLOUT FROM SILENCE ABOUT MISCARRIAGE

    > 47% of survey respondents felt guilty

    > 41% felt alone

    > 28% felt ashamed

    Source: “A national survey on public perceptions of miscarriage,” June 2015

    Related:

    Facebook’s Zuckerberg says wife is pregnant with a baby girl

    Janelle Nanos, editor of BetaBoston, became a mom in late August. Send comments to magazine@globe.com; follow Nanos on Twitter @janellenanos.