Last month New Zealand broke new ground with a national policy of “Bereavement Leave” following miscarriage. This is a welcome development for all who care about workers’ well-being and workplace equity. But post-miscarriage leave policies need a different name. A language of “loss,” not “bereavement,” would better support the full range of experiences and understandings of miscarriage.
The term “bereavement” dictates a particular emotional and existential interpretation of what is in fact a complicated and ambiguous event for many who experience it. Putting the term into policy unnecessarily imposes a single interpretation, forecloses other possibilities that carry less emotional burden, and may even impose a new burden of guilt and shame on those who seek a different way to understand miscarriage.
“Bereavement” is a word used to describe what occurs after the death of a loved one. For some people, this describes their emotions and their interpretation of the situation after an early pregnancy loss. For others, the loss of a wanted pregnancy may be sad and disturbing, but not equivalent to the death of a child. Pressuring those people to accept this interpretation may exacerbate their distress.
When a friend or acquaintance of mine suffers a miscarriage, I always say, “I’m sorry for your loss.” This phrasing, commonly used for condolence messages, appropriately acknowledges the gravity of the situation for someone who regards their miscarriage as the death of a child. But it also holds space for other experiences of loss: the loss of a dream, or possibility, or expectation. It can acknowledge disappointment and sadness that may not be bereavement, but is nonetheless real and deserves recognition.
Ultrasound scanning of pregnancy became routine in the 1980s, creating a new pregnancy ritual of “meeting the baby” via scan, and in the 2000s, that ritual was transplanted onto a new routine scan at around 8 weeks’ gestation, when the miscarriage rate is still high. Home pregnancy tests, introduced onto the American market in 1978, have become more and more sensitive, catching so many unviable pregnancies (many of which in previous eras would have gone entirely undetected) that a person who tests at the earliest possible moment has nearly a 1 in 3 chance of miscarrying.
The result of all of these cultural and technological transformations around pregnancy is that even very early pregnancies feel more “real” to many of us than they did to our great-grandparents or even our parents. That means that for many of us, when we miscarry, we experience the grief of bereavement.
Some couples may accept this new cultural understanding of pregnancy and find valuable emotional support in understanding their sadness after miscarriage as bereavement. Others, though, may wish to hark back to a not-so-distant past, and regard the loss as a disappointment but not a death. In my case, my husband and I took consolation in knowing that my miscarriage would have been considered a false start rather than a deceased family member by our forebears.
Whatever a couple’s experience, some time for self-care and healing after a pregnancy loss is valuable and important. As governments and corporations consider following New Zealand’s lead, they should create policies that provide “leave for recovering from loss,” so that our legal frameworks do not trap us in just one definition of a complicated and difficult experience.