The 12-week pregnancy rule makes the pain of miscarriage worse – The Guardian
Most of us will be familiar with the “12-week” rule – the longstanding social convention that dictates that women mustn’t tell anyone they’re pregnant before the 12-week mark, “in case something happens”. It’s time to talk about the insidious effect it has on women who suffer a miscarriage early in their pregnancy.
An estimated 650 babies are miscarried every day in the UK, with the vast majority occurring during the first trimester. Most of these losses will be suffered in silence, because it’s considered so socially unacceptable to reveal that you’re pregnant before 12 weeks – let alone that you were pregnant, but now you’re not. It’s baffling that in 2019 we seem so wedded to an anachronistic superstition about tempting fate that shames women into keeping quiet and heaps blame on the woman who dares to “tell” and subsequently loses her baby – as though we were still in a bygone era where the stigma of miscarrying could mark you out as cursed. Social mores around the 12-week rule are brimming with contradictions: it’s fine to broadcast the minutiae of our daily lives on Instagram, yet disclosing that we’re pregnant, even just to close friends and family, is somehow transgressive.
As a result, the first trimester is a sort of Schrödinger’s pregnancy: you’re legitimately pregnant when it comes to dos and don’ts such as taking folic acid, but if you miscarry you’re often told that it wasn’t a “real” pregnancy anyway. Before I went to the operating theatre to have my dead baby surgically removed from my uterus, a nurse remarked that until the invention of home pregnancy tests, most women probably wouldn’t have known they were pregnant at that stage, and would have assumed their miscarriage was a heavy period.
While it’s certainly thanks to modern ultrasound technology that my husband and I had seen our baby’s beautiful heartbeat twice before I miscarried, a host of early pregnancy symptoms and having to pass a not-insubstantial gestational sac would probably have tipped me off.
We’re often told that miscarriages are no big deal because they’re really common; so is divorce, but you don’t often hear anyone say, “Sorry your husband left you – but it’s really common, and you can always get married again.” Yet for something so common, it can feel so incredibly lonely, precisely because the 12-week rule perpetuates the notion that early pregnancy loss is something to hide and we shouldn’t make a fuss.
This establishes a hierarchy of grief determined by the stage of gestation, that glibly dismisses early miscarriages as “just a ball of cells”, deeming only later losses worthy of mourning. But the meaning of any pregnancy is deeply personal, and we can’t neatly fit the impact of losing it in its own discrete box. Ellie Jesky experienced miscarriages on both sides of the 12-week line. “The moment you get that positive test, however much you know that it’s precarious and that things can go wrong, it’s your baby,” she told me. “You plan and imagine what their life will be like. And then when that’s totally ripped away in an instant it’s a genuine loss, regardless of how far along.”
The consequence of this culture of secrecy and lack of compassionate discussion is that many women grieve for their miscarriages in the shadows, weighed down by heavy feelings of guilt and failure. Desperate for answers beyond unsatisfactory explanations such as “it’s just one of those things”, “it’s nature’s way”, or “it wasn’t meant to be”, we’ll seize upon any excuse to blame ourselves. Most early losses are due to chromosomal abnormalities; but according to Prof Arri Coomarasamy, director of Tommy’s National Centre for Miscarriage Research, fewer than half of women who suffer repeated miscarriages ever find out why.
The decision about how, when and if we share our experiences of fertility, pregnancy and loss should be a personal choice, not an enforced obligation. Miscarriage will always be a sad reality in many people’s lives, but greater understanding and empathy could alleviate much of this pain.
We’re starting to see more open discussion around miscarriage in public discourse. I’m hopeful that the more comfortably we can each own our story the more we’ll feel empowered to seek support when we suffer losses at any stage of pregnancy. “Even if we can’t cure miscarriage,” says Dr Jessica Zucker, a psychologist specialising in women’s reproductive health and creator of the #IHadaMiscarriage campaign, “why don’t we at least attempt to cure the conversation?”
• Katy Lindemann is author of a forthcoming book that shares real women’s stories about the emotional experience of infertility and pregnancy loss