The campaign blew up—there are now tens of thousands of posts using the hashtag on social media to share stories—and Dr. Zucker's since become a prolific, outspoken advocate of people who have experienced pregnancy loss.
She's now expanded her message and mission with a new book, I HAD A MISCARRIAGE: A memoir, a movement ($19), which details Dr. Zucker's transformative journey from treating women coping with miscarriage to experiencing a pregnancy loss herself. It aims to chip away at norms that have rendered miscarriage even more difficult for people to experience and offers compelling evidence of the healing power of opening up about loss.
She spoke to Well+Good about her new book, how you should *actually* approach someone who's suffered a miscarriage, and more.
WELL+GOOD: You've written a lot about pregnancy loss. What inspired you to expand your efforts into a book?
Jessica Zucker: I wanted to write this book as the antidote to what I see swirling in our culture around pregnancy and infant loss. My hope is that this can somehow make a dent in the trifecta of silence, stigma, and shame surrounding this topic. I have published so many pieces on the topic, but with the book, I wanted to create something that was a culmination of a lot of my perspectives and my experiences.
I also wanted to dare myself to go deeper into my own experience. My first New York Times piece that launched the "I had a miscarriage" campaign was personal... The book does that manyfold, using my own personal story as a way to show that loss can, of course, touch all of us.
It seems like the book is not only trying to normalize miscarriage but also to normalize grief around miscarriage. You had a dramatic loss, but I feel like some of my friends who've lost babies early on in their pregnancies feel less "allowed" to openly grieve.
We don't need to police grief, and we don't need to engage in this comparing and contrasting of loss. We shouldn't have to prove our pain through the number of weeks we were pregnant, or through how traumatic, dramatic, or lack thereof it was because regardless, people start to imagine the family. I get messages on Instagram all the time from people who found out at six weeks that there was no heartbeat, and even six years later, 16 years later, whatever it is, they still have a lot of feelings around that. And we bring our histories, of course, to our losses. So if somebody, for example, has a history of loss—losing a parent, losing a friend—and they haven't processed it, their pregnancy loss may stir up so much more for them.
I tried to make clear in the book as well that some people have excruciatingly painful journeys in the aftermath of loss and others don't... So I think that's a central message that I hope is conveyed in the book, which is to say that we don't know how someone feels until we ask them.
I also talk in the book about this feeling [in American society] that as long as you get what you wanted in the end [a new healthy pregnancy], there's no reason to talk about the 'mess' along the way. It's like, why? We're so uncomfortable talking about grief in general. But I think miscarriage—and sometimes stillbirth—it's a world in and of itself in terms of grief because nobody knew that developing baby. And that's so much of why when somebody does go on to have a healthy pregnancy afterward, the former loss is not discussed, it's not acknowledged, it's not asked about, like "Oh do you still have feelings about your miscarriage?" or, "Are you scared in this pregnancy because of the miscarriage?" or, "Do you ever wonder who that person would have been?"
If we invited people to talk about it, if it was normative and integrated into [our] culture to talk about our feelings around loss, I actually think that the grief and the hardship would soften sooner. I don't want to say evaporate because for some people, it doesn't. But I think it's time that we, as a global community, begin to ask ourselves why this continues to be something that we whisper about. It's not serving anybody, and the reported self-blame and feelings of body failure and shame and, "What did I do to deserve this?"... we have to be done with that. We just have to, if not for ourselves then for the future generations to come so that people understand that it's a normal outcome of pregnancy, even though it's a sad one. But since it's not integrated normally into the conversation, people think it's abnormal. People think that something's wrong with them, or people think they should be hush-hush about it.
Do you think some aspects of wellness culture contribute to self-blame? There are certain pockets of wellness where any malady is blamed on the individual experiencing it, be it cancer, COVID, etc.
I don't know if they [those who self-blame] would consider that a result of wellness culture in general. But it's interesting that you bring up wellness culture, because I feel like that bleeds into the notion of toxic positivity—that if you're just looking on the bright side, or if you're always focused on silver linings, or if you're saying "good vibes only," or whatever, somehow that's going to elevate you as a human or protect you from bad things happening. And I think that kind of rhetoric puts all the more pressure on people.
I sit with women who are like, "I'm just going to think positively, and I'm just going to hope," and it's like, "Okay, but what are you really feeling?" Within the context of my four walls, they can go there, but in life in general, people are much more encouraged to keep up these airs of positivity because somehow that will create a better womb life or a better environment to get and stay pregnant.
So yes, I hear women saying, "Did I lose the pregnancy because I had a sip of wine? Did I work out too much? Did I not drink enough water? Was I not taking enough vitamins? Should I have gone to acupuncture? Should I not have gone to acupuncture? Should I not have had sex or masturbated?" And when we think that maybe we did something wrong, that morphs into shame. Because [society] isn't standing there with open arms saying, "of course it's not your fault." ...But short of, for example, a hardcore car accident, you can't do anything to disrupt a pregnancy in the way that people think that you can.
Has stigma around miscarriage shifted since you began your work, and if so, how?
It's hard for me to judge whether the stigma and the shame have shifted because I'm so deep in this world. But I continually have new patients coming in who still feel the feelings that I'm hoping to help. So I want to say I've seen significant progress, and I think we have a long way to go. That's the best way to put it. Unfortunately, I feel like because this topic is seen as being "dark," my efforts can only take me so far. So unless someone like Chrissy Teigen, for example, talks about my book, a lot of people aren't going to know about the book, because a lot of people don't talk about the topic.
So I am deeply grateful for celebrity types who are forthcoming about their experience with pregnancy and infant loss and postpartum depression—any efforts to destigmatize through sharing helps. For people who believe that having money or fame or beauty or status somehow protects you, celebrity sharing helps crack that open—that this can happen to anybody. And maybe that, in itself, is normalizing.
It's not enough, though. I don't know what it's going to take. I don't know if it's just the way our culture is set up, that we mother and we live in such a private way that we don't share publicly unless it's good news on Instagram or something.
Sometimes people don't want to talk about it, though, or you assume they don't, especially with respect to miscarriage. How do you suggest approaching a loved one's pregnancy loss?
Everyone's so different. Some people might be totally put off by you asking because they might be swept up in the cultural norm, which is to sweep it under the rug. I see that even in my office, people just try to be like, "It's fine. I'm good." It's because we're groomed to just make things okay, push it away, push it aside, and move forward.
Shying away from platitudes is the wisest choice you can make. So, staying away from sentences that begin with "at least"—"at least you can get pregnant," "at least you have a healthy child," "at least you have a thriving career," "at least you were ambivalent about having another." And then other phrases like "everything happens for a reason," "God has a plan," "God doesn't give you more than you can handle," "It wasn't meant to be." These are incredibly unproductive and I would even say that these phrases shove women into the outskirts and further alienate them in a time when they need to huddle close [for] support...
Sticking with the simplest, compassionate, caring, loving, and supportive words offers an invitation for somebody to share how they are rather than assuming or trying to manage her feelings or cleaning them up somehow. So just, "How are you doing? I'm here for you. I'd like to hear about your experience, if and when you want." And then the main thing I like to drive home is that we need to invest in consistency when it comes to this stuff. Oftentimes, within a month or less, people are no longer checking in about the loss and if anything, people often start to ask if you're going to try again, and that becomes the focus.
And so it would behoove close friends and family to check in later and just not be afraid of the topic [of pregnancy loss]. Sometimes people say to me, "Well, I just don't want to bring it up in case they're not thinking about it." And I think that's an excuse to not have to wade into uncomfortable waters. If you ask and she doesn't want to talk about it, she'll tell you. The fact that you're brave enough to ask allows her to know that you're there for her no matter what she's feeling.
On the other side of things, what do you wish you had known when you miscarried, that you now know as a result of your work?
I wish I knew that miscarriage has the potential to shift your life lens. I wish I knew that grief knows no timeline. I wish I knew that post-traumatic stress disorder (PTSD) can situate itself within pregnancy loss and life after. I wish I knew about the potential of my milk coming in [after the miscarriage] so that I was better prepared for the physical and the emotional aspects of that enormous event. I wish I knew that navigating pregnancy after pregnancy loss for me would entail nine months of walking on pins and needles. Lastly, I wish I knew—and what I came to learn—is that community and storytelling are a potent salve.
What was most helpful for you, in terms of support, in the wake of your own miscarriage?
It was a combination of things. Of course, therapy was helpful. But I would say that actually writing about my experience, and then putting it out in the world—which then led me to connect with a global community of loss parents or loss moms or fellow grievers—that is really what made a dent in my journey afterwards. And I know it's probably what compelled me to create the "I had a miscarriage" campaign and to do what I do, because connecting with people around the world, people that I don't know, and hearing their like-minded feelings or stories, it was just so intimate and so reassuring and so grounding to know that other people felt these exact same things. We don't have to have the exact same experience, but the feelings are so common.
If there was anything more concrete, I think I really appreciated the people who were brave enough to circle back and ask about it, and even people wanting to see a picture of the baby or people following up with me when I was pregnant in my next pregnancy. It just felt so helpful for people to notice and authenticate or validate the fact that my experience was traumatic, and that I was still somehow putting one foot in front of the other.
What words of hope or compassion or comfort would you offer to those in the throes of pregnancy loss?
Because the research shows that a majority of women do blame themselves [for miscarriage] or sort of turn this on themselves in some way or another, I would want to reiterate and drive home just how incorrect that is. I would, of course, validate the feeling around it—I don't talk my patients out of feelings, I offer them alternatives. I say, "Let's think together for one second—what if you did absolutely nothing wrong?" And there's chilling silence between us, usually, because they've never even thought to think that and be let off the hook and be able to have that energy back just to grieve.
And then, when you look around—because it can be hard to be out in the world in the freshness of grief—and you see young kids or families or whatever, there might be an intense feeling. And so of course I always reiterate that you should feel whatever it is you're feeling, but then try to also check in with yourself remind yourself of the statistics that exist—10 percent of clinically recognized pregnancies end in miscarriage, one in 120 pregnancies ends in stillbirth [at 20 weeks or later], and 12 percent of women struggle to get pregnant to begin with. Looking in on other people's lives, we often think that somehow they're so much easier and they got there unscathed, but given the statistics, it's actually way more likely that the people that you're looking at, and wishing you were, in some way may have struggled, too. That's not to invalidate the experience of that bump envy or whatever is going on, but it's a way to feel connected and to remember that you are not alone.
And then I think it's important to know that time helps and time and effort in combination or in concert help all the more. Meaning, the sooner we lean into our grief, rather than trying to stave it off, the sooner we swim through to another side. We're not going to go back to who we were previously, maybe, but we will emerge. And when we try so hard not to feel our feelings, they actually stick around a lot longer. So, I invite people to lean into grief, even if it feels like you're gonna drown. And grief knows no timeline. Take all the time you need.
This interview was edited and condensed for clarity and space.
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