Illustration: Eleanor Hardiman


Breaking the silence of a missed miscarriage

When Amy Abrahams had a miscarriage, there was no blood, there was no sign. But there was pain and there was grief

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By Amy Abrahams on

“I’m sorry, there’s no heartbeat,” the sonographer said, while I stared at my baby on a monitor, trying to comprehend what I had just been told. The baby was a fuzzy white oval shape floating in a circle of dark – there, on the screen, it seemed more real than ever. How could it not be alive? I didn’t understand; I’d had no signs. I felt fine. I looked at the sonographer again. “You’ve had what is called a ‘missed miscarriage’,” she said, and handed me some tissues.

I’d gone for a scan at seven-and-a-half-weeks pregnant. My husband had been working in New York and I was flying there the next day to join him for three weeks. I had no real reason to worry about the pregnancy, I just wanted to shush some anxiety bubbling away. Sitting in the waiting room of the clinic, I had imagined calling my husband to say I’d seen our baby’s heartbeat, I’d imagined us both crying on FaceTime. But this – this lifeless being now resting within me – I had not imagined.

A missed miscarriage is also known as a silent miscarriage. Silent because there are no symptoms. Silent, because you only find out during a scan. Silent, because your body often still thinks it is pregnant and continues to pump out hormones. I knew about miscarriage, of course, and I knew the statistics – one in four pregnancies sadly end early, but I did not know that miscarriage could be like this. I thought pregnancy loss would be deep red blood and intense pain like in the films, I thought it would be primal. I thought I would stand up and see blood and scream and know. But I had none of that.

What I also did not know was that a missed miscarriage must be managed. There is admin to the loss. You can either wait a few more weeks and see if it happens naturally; take pills that force your cervix to open and your uterus to contract thereby pushing out its contents; or have an operation to remove what is there. The options were listed to me like I was choosing wallpaper. Words were fashioned into sentences I’d never heard before, such as “evacuation of retained products of conception”, the cold name given to the surgical treatment. Waiting naturally could take days or weeks, the sonographer said. There was no way to know.

I walked out of the clinic and staggered down some streets until I reached Regent’s Park, where I sat on a bench by a lake and howled unselfconsciously as brown mallards, trailed by ducklings, glided on the water in front of me.

I was desperate to be with my husband, so, after calling my GP and going for another scan in my local hospital – where I was gently told, for a second time that day, that there was no heartbeat – I got the sign-off to fly and see if the miscarriage happened naturally in New York.

I felt I owed it my pain. And, yet, if I cried too much, I wondered if I was being overly sensitive to grieve something so small

The loss clouded over us each day we were there. Everywhere I went, I carried a packet of sanitary towels with me, determined not to be caught unaware. And whenever we travelled, my husband and I would note the nearest hospital in case something went wrong. And yet my body continued to feel pregnant, my breasts still swelling, my clothes increasingly gaping at the buttons. I began to resent my body – which, just a few weeks earlier, I’d marvelled at – because now it mocked me with its ignorance.

Meanwhile, my emotions whirled like storms and tornadoes. Sadness weaved its way between every moment. How do you act when you have a baby no longer alive still inside you? I did not know. Some days, my mood was heavy, grey skies above me for hours on end; other times, particularly after a big cry, I felt calmer, more accepting. Sometimes, I even allowed myself to forget – I laughed with friends, went to galleries, enjoyed sushi and gelato and wine – but guilt would soon hit as though I’d betrayed my baby. As long as it remained inside me, I felt I owed it my pain. And, yet, if I cried too much, I wondered if I was being overly sensitive to grieve something so small.

But that’s the thing about attachment – its sturdy roots grow quickly and bed down deeply. In a month of pregnancy, my husband and I were planning our baby’s birth, picking a hospital, thinking about names, downloading apps. I imagined my belly swelling, my bump kicking and my family growing. I felt pregnant before the test even said “yes”: bloating, nausea, exhaustion. I knew I wasn’t “just me” any more. Attachment formed deeply because this baby was longed for. The loss – however early – was a rupture right in my core.

With no sign of the miscarriage occurring naturally and our return flight looming, I had to accept I’d waited as long as I could bear. The anonymity of being abroad had given me some space to escape, but the prospect of returning home to our family and friends, to whom I had been hoping to reveal happier news, and to our flat with an eagerly bought pile of pregnancy books waiting on the shelf, lit up the reality in garish technicolour. I knew I would not be able to function in this state back home.

So, three days before we flew back, I stepped outside a quiet Brooklyn café, where I’d been sitting among hipsters on laptops typing at screenplays, and phoned my hospital to book the operation. I explained my situation anew to the nurse, revealing the details in clipped, cold facts I hoped would freeze any geysers of emotion. While I spoke, I found myself staring at a playground on the other side of the street, a delight of children on their lunch-break screaming and running and laughing in the sunshine. I looked away and aimed my face towards the sky instead, hoping its bright rays would dry my eyes before the tears tumbled out.

Back home, four weeks after diagnosis, and what would have been a few days off my 12th week of pregnancy, I went into hospital for an operation under local anaesthetic called a manual vacuum aspiration (MVA), which involved a suction device emptying out my womb. It was unpleasant and invasive, but over in just 20 minutes. My husband by my side the whole time. While it did not hurt much, I was relieved to finally feel something physical, and an hour later, I was discharged – a hollow ache within me. My body no longer shared.

A study found that four in 10 women reported symptoms of post-traumatic stress disorder (PTSD) three months after the pregnancy loss

I lay on the sofa that night, trying to process the events of the past two months – pregnant, then not pregnant, a wait, an operation. Hardly anyone even knew I was expecting – so, would I now tell them this? It was a conversation I felt ill-equipped to have, yet the alternative – more secrecy – felt overwhelming.

No one really talks about miscarriage. Or, if people do, it is to reassure you that you will be fine. But I know I will be fine. I know I can try again. I know it’s common. I know I am so, so lucky to have conceived – however briefly. But this will always be my first pregnancy. Sometimes, we just need to sit with the pain, listen to the sobs, allow ourselves to feel. Sometimes, we just need to say, this happened. This is shit. This is my story. Just because something is common, does not mean we don’t get to hurt.

I decided to post something about it on my Instagram and was overwhelmed with messages. Comments of support saying I was “brave” for sharing, but also private messages of understanding. Women I’d been friends with for years telling me things I’d never known. Someone told me that they thought “it was not the done thing to talk about” and had shouldered this pain all on her own.

But this taboo surrounding miscarriage is risking women’s lives. A study by Imperial College London found that four in 10 women reported symptoms of post-traumatic stress disorder (PTSD) three months after the pregnancy loss. A conversation about miscarriage is not “brave” – it is vital. And it should not just be the responsibility of women. GPs must continue to ask women about their wellbeing, friends should check in, workplaces must be generous with compassionate leave.

I write about miscarriage not to frighten hopeful mothers-to-be, of which I am still one, but because we need testimony of our experience. Because in the silence of loss grows shame, which feeds loneliness – and women should not have to feel alone. And because the Insta-fied version of motherhood we now often see – all chic outfits and breezy, easy fertility – helps nobody. We need to have the space to share, even if we then choose not to. We need to know that our worth is separate from our wombs.

Not everyone needs to shout loudly, but if you can be open, there’s value in vulnerability. Miscarriages may sometimes be silent, but we don’t have to be.


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Illustration: Eleanor Hardiman
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