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.
Historically speaking, regarding a first-trimester loss as the death of a person is quite new. Throughout most of history, "quickening
," or the pregnant woman's feeling of movement in her belly at around four months, marked the moment when a fetus was considered to be an "ensouled" child. Through the Middle Ages, natural philosophers (the precursors to scientists) regarded an embryo as a person once the body was fully formed and recognizably human. Until the 19th century, physicians generally understood early losses as misbegotten pregnancies rather than stillborn children.
A host of cultural and technological innovations have radically reshaped our experiences of pregnancy over the past century or so. Since the 1920s, advocates of modern prenatal care have focused attention on early pregnancy and turned illustrated fetal development timelines into a tool for encouraging bonding, not just science education. Starting in 1960, the birth control pill gave Americans
a reliable and precise tool for preventing unwanted pregnancies, which meant that pregnancies were much more likely to be planned and welcomed.