The concept for this piece began long before I decided to get a puppy. It continued to evolve as the newborn pups grew to 4 weeks of age and began to show signs of an illness. My friend, who was also choosing a pup, and I found ourselves to be inappropriately bereft. We each were in constant contact as the puppies contracted the illness, became sicker, and, one by one, died. Each of us wondered why it was that we were so upset about this until we realized that neither of us had had a chance to hold our baby, to feel her heartbeat or to say good-bye; but with the puppies, we did.

“Well, at least you know you can get pregnant.”

“You should feel lucky that you already have a child.”

“You must have done (thought/ate) something wrong to bring this on.”

“It’s because you don’t believe in G-d.”

“It’s because you don’t believe in the right G-d.”

“You shouldn’t feel bad; it’s so common.”

“You should feel lucky that you don’t have to have a sickly child.”

Above are many of the not-so-useful things that women have had to hear after suffering the terrible loss of her pregnancy. She is often told how she should feel or what she did wrong in order to cause her miscarriage. Change the “you” to “I” and know that that very same list has already occurred to her.

“Don’t tell anyone until you’ve heard the heartbeat.”

“Don’t tell anyone until you’re at least 12 weeks along.”

I’ve asked why women feel the need to wait until this deadline. Most say it is because this is when the majority of pregnancies are believed to be safe and because of that safety, friends and family won’t have to stumble over what to say if she had a miscarriage. But, what about her? Is it in her best interest to have to pretend that all is well? Before? After?  What about those who have suffered losses further along? 20 weeks? 30 weeks? Full-term? What do we call these women? Can we call them mothers? Do they want to be referred to that way? Do they consider themselves moms?

From the moment a woman knows she is pregnant, she is changed. Whether the pregnancy was planned or unplanned, wanted or unwanted, she must now deal with the fact that her body, and her mind, will evolve. She has many decisions to make. The woman who chooses to carry the pregnancy makes changes in her diet, her habits, and her alcohol intake. All the while, the little bundle of cells in her uterus is growing, multiplying, and adhering itself to her uterine wall. Very soon, the only self-disposable organ is formed as the placenta begins to grow. This organ develops to protect and nourish the growing fetus. And, the woman’s uterus begins to expand in order to accommodate all of this. First the size of a walnut and sitting just behind the pubic bone and the bladder, at about 20 weeks it has grown to about the level of the belly button. At 40 weeks, the due date of the full-term pregnancy, the uterus extends to, and can push upon, the woman’s diaphragm.

Of course, all of this occurs with concomitant feelings, both physical and emotional, described in as many ways as there are women. At times, evidence of internal movements can be seen externally; lumps and bumps and kicks and rolls and outlines of feet and a head can be witnessed as they are felt inside. Finally, at approximately 40 weeks gestation, and after much hoping, expecting, texting, planning, and wondering, a new life is born. The woman, has the most important job in the world; she is now a mother.

But, what happens when things don’t go this way? What about the countess women who have lost pregnancies at any point along this journey? Who are they? What do we call her? How does she define herself? How does society define her? What happens to all of those hopes and dreams and plans? What about the woman who, for a multitude of reasons, felt that she could not carry the pregnancy? What does she feel? Is she allowed feelings of loss – even though she made what, to the outsider, appeared to be a choice? Does she feel guilt? Does that guilt haunt her? And, what about the woman with a still-born child. Is she called “mother” if she has no living children?

Motherhood and all of the stages children go through are so integrally related to a mother’s definition of self and the way in which she associates with others: “My daughter just entered the terrible two’s.” “My son is starting to drive.” “I’m the mother of the groom.”

Full-term, stillborn babies are often named and buried during the ceremony and ritual of funeral and in a manner that is consistent with the family’s religion and beliefs. But, what about the early miscarriage? In this society, we have no ritual to commemorate such thing. Instead, women are often sent home to “rest and try again in a few weeks.” Worse, she is often forced to endure the helpful voices of friends, family, and, of course, herself.

There are instances in which a woman may have made the difficult to decision to terminate a pregnancy. Therapeutic abortion is chosen as an option for many reasons; rarely are they easy. The result of rape or incest, or due to a congenital anomaly are the most acceptable reasons in our society. But, whatever the reason, the woman is often perceived as having made a choice, robbing her of the opportunity to grieve.

It is shocking to learn the actual number of pregnancies that end in miscarriage. It is even more shocking to learn of the number of woman who have silently suffered through a miscarriage. Why do we force women into secrecy? The most common cause of miscarriage is chromosomal abnormality – not something that is in a woman’s control. This is obviously nothing she can be “blamed” for. Why, then, must she suffer alone, without support to deal with the pain. When women do open up and mention their loss, a cacophony of female voices can often be heard stating the duration and/or number of the pregnancies they lost, “I lost a pregnancy at 5 weeks.” “I had three miscarriages.”  There is an almost visible softening of postures and energy as each woman finds comfort in community.

Ritual is an important part of virtually every religion, culture, family, and community. There are rituals to commemorate the launch of a boat, the marriage of two people the entry of a human being into its life and the exit of the same. Sometimes the ritual is not a formal one. For example, the transferring of an automobile title serves not only the legal necessity of the sale but a cultural one as well: consider movies set in the 1950s and people “racing for pink slips.” It is not an overstatement to say that much of society is formed around the scaffolding of various rituals.

Although there are rituals for some of life’s most traumatic events (funerals, shiva, wakes) there are no rituals, in this country, for miscarriage, or the termination of pregnancy. One must wonder if the lack of ritual leads to the shame and secrecy associated with these things or if the secrecy has led to the lack of ritual. Spontaneous abortion is incredibly common. In fact, 10-15% of all pregnancies end in miscarriage. Oftentimes a woman does not know she has been pregnant. Instead, she thinks she is having a normal period. Therapeutic abortion is also fairly common and occurs for a variety of very personal reasons. With the loss or termination of a pregnancy often comes the end of the dream of what might have been. And, to make matters worse, many of the commonly observed rituals do not apply to the entirety of this population. It is for these reasons and personal experiences that I brought together my trainings in OB/GYN, Psychosynthesis, Psychology, Expressive Arts, and Psychosynthesis Coaching to create a practice called Honoring Love.

And, although my upbringing was in the Jewish tradition, I became a non-denominational ordained minister a number of years ago in order to perform nontraditional weddings. Recently I have discovered the importance of utilizing all of these skills to help clients to incorporate aspects of their own traditions into the ritual that we design together.  We are able to create a ceremony and afford each person the use of ritual intended to honor her loss and to provide closure.

Reference: The Japanese Art of Grieving a Miscarriage: https://www.nytimes.com/2017/01/06/well/family/the-japanese-art-of-grieving-a-miscarriage.html?fbclid=IwAR0OknFvRveoXG_MOU6zfqUWrWg_EQfzasZZaIk__8qskzQTApej_oaJrf4

* This piece originally appeared in the now unavailable Psychosynthesis Quarterly, December 2020. (Normalizing Grief Through Ritual, Psychosynthesis Quarterly, December 2020, Volume 8, Number 4, pp18-21)