Dr. Kate White is the author of the new book Your Guide to Miscarriage & Pregnancy Loss: Hope and Healing When You're No Longer Expecting. An OB/GYN and a miscarriage survivor, she is an associate professor of obstetrics and gynecology at the Boston University School of Medicine and the vice chair of academics in the Department of Obstetrics and Gynecology at Boston Medical Center.
Q: As an OB/GYN and someone who has experienced two miscarriages, what do you hope readers take away from your book?
A: I wrote this book because it’s the kind of guide I wish I had when I experienced my losses. Even as an OB/GYN, I wasn’t prepared for what the experience would be like. Through the book, I’m talking to people like me—who are experiencing all the stages of loss, grief, and recovery—and talking to the people who care about them.
I want readers who have experienced pregnancy loss to understand that even though miscarriage is very common, it’s not common for you. So yes, it IS a big deal.
And all kinds of ways of losing a pregnancy can be considered a miscarriage. If your pregnancy was in your fallopian tube, or was a molar pregnancy, or needed to be terminated because of a severe risk to your health…if it was a pregnancy you wanted, it’s a pregnancy you can grieve.
We also don’t “get over” a miscarriage. The loss is always with us, but we grow around our grief, and the days will start to get easier.
If a loved one is going through a pregnancy loss, the best way to support them is to simply be there, by phone or in person, to give them whatever they need. It’s not a problem you can fix, or reassure away, but you can help them feel less alone.
Q: You write, "You might not have known miscarriage is so common because no one really talks about it." Can you say more about this?
A: Many of us believe that if we read the pregnancy books, and avoid eating and drinking the “wrong” things, and stay as healthy as we can, that we deserve to end up with a healthy pregnancy. Because we followed the rules, right?
But we can’t control when a pregnancy ends, any more than we can totally control when one begins.
So, when your pregnancy is lost, it can feel like the deepest betrayal of your body. And you may feel utterly broken, and on some level ashamed. When you are feeling such crushing emotions, it can be hard to talk about your loss with anyone.
Consequently, many people don’t share the story of their miscarriage with their friends or even family members. So, even though almost one in three pregnancies are lost to miscarriage, most people don’t realize how common it is. I’m glad that public-facing people like Michelle Obama, Chrissy Teigen, and Meghan Markle are breaking the silence around loss.
Q: What are some of the most common perceptions and misperceptions about miscarriage?
A: So many patients come to me, after their miscarriage, wondering if something they did caused the pregnancy to end. I tell them that they weren’t too stressed, or too tired. It wasn’t that they lifted something heavy, or had sex, or a glass of wine.
The fate of a pregnancy is often determined in the first few days after fertilization; if those early cells don’t replicate perfectly, the pregnancy is often doomed. You did nothing to cause the miscarriage.
Also, not many people know that they may have a choice in how to manage their miscarriage. If your loss is diagnosed by an ultrasound, you may be able to choose to wait it out (for your body to pass the pregnancy on its own), to use medication to start the process, or have a procedure to remove the pregnancy.
There’s also a misperception that early miscarriages are no big deal. But when you lose a pregnancy, you lose all the hopes and dreams you had for the child you were hoping to give birth to, and for what your family would become.
There is no relationship between the duration of your pregnancy and the grief you feel when it’s over. You might have been pregnant for eight days, eight weeks, or eight months…any way you feel when the pregnancy is over is valid.
Q: How would you describe the healthcare system's approach to miscarriage, and do you see any changes ahead?
A: The U.S. healthcare system needs an overhaul in how it treats people experiencing pregnancy loss.
Too many people receive the diagnosis of a miscarriage in an emergency room—not the ideal environment for a painful, private conversation. Doctors too often focus on the logistics of treating the miscarriage, and not attending to the emotional needs of the pregnant person experiencing the loss.
Finally, doctors and nurses need training in how to talk about miscarriage with patients, as a loss means different things to different people.
I hope that as more people come forward to talk about their miscarriage experiences, that the healthcare system will adapt to focus on what people need, and not on what’s convenient for doctors.
Q: What are you working on now?
A: I’m currently finishing my second book, titled Your Sexual Health. It’s essentially all the secrets that your gyno wants you to know.
Unlike Your Guide to Miscarriage & Pregnancy Loss, this new one is much lighter in tone, with a little humor. I hope it helps the reader understand their body and lets them see their body in a way that leads to acceptance, and even peace. After all, you only get one body, and it’s your partner for life!
Q: Anything else we should know?
A: It’s often not just the pregnant person who experiences the miscarriage. Their partners get little to no attention from the medical team. No one checks in to see how they’re doing. And they often feel pressured to be a strong, supportive partner, and sometimes don’t allow themselves to grieve. And kids and grandparents aren’t immune to grief either.
So, we can’t forget that it’s often an entire family that is going through the pregnancy loss.
--Interview with Deborah Kalb