With more women sharing their stories, the conversation around pregnancy loss is livelier than ever before. This is step one—breaking the silence so women feel less alone. Now it’s time for step two—changing the terms within the conversation so women feel less shame.
Recently, Peanut announced what they’re calling the Renaming Revolution, and I am here for it. The current language around pregnancy loss perpetuates the idea that women are somehow at fault (even though we know that the vast majority of pregnancy losses are caused by chromosomal abnormalities and genetic issues). With each of my losses (I had four), I kept a list in the Notes app of my phone of all the terms I heard that didn’t sit well with me. In All the Love: Healing Your Heart and Finding Meaning After Pregnancy Loss, my co-authors and I take a closer look at these terms.
Miscarriage
Mistake. Mismanage. Misconstrue. All of these terms insinuate a failure of some kind. Emily Bazelon wrote, “Mis-carry: The word itself creeps with guilty error, as if you’ve carelessly dropped something you were meant to hold.” There should be no insinuation of failure, no suggestion of “guilty error” when we talk about the loss of a baby. The term “miscarriage” also “denotes the woman as a carrier of a fetus and nothing more,” says Adsa Fatima, who advocates for women’s health. The emphasis is on the embryo the woman “failed” to carry when, as Fatima says, “[The mother] should be cared for, and her well-being should be put at the center.”
Suggested alternatives: Pregnancy loss. Baby loss. Death of a baby. Loss of a baby in the womb.
Early pregnancy failure
According to a national survey, nearly half of people who had a miscarriage said they felt guilty (and 41% thought they had done something to cause their loss). It’s hard not to be feel guilty when your loss is described as a “failure.”
Suggested alternative: Early pregnancy loss.
Cervical insufficiency/incompetence
As women, we are taught from an early age to tie our worth to our bodies. So, while the diagnosis of “cervical insufficiency” or “cervical incompetence” is meant to describe a medical issue with a specific body part, many women take the words “insufficient” and “incompetent” to heart and feel responsible for their loss.
Suggested alternative: Early dilation.
Irritable uterus
No woman wants the word “irritable” attached to any part of her.
Suggested alternative: Active uterus.
Termination
This cold, harsh term is insensitive when we’re talking about job loss. When we’re talking about pregnancy loss, it’s just unacceptable.
Suggested alternative: Ending a pregnancy.
Spontaneous abortion
This is defined as “noninduced embryonic or fetal death or passage of products of conception before 20 weeks gestation.” In other words, PREGNANCY LOSS. Let’s save “spontaneous” for our post-Covid vacations, and avoid the term “abortion” (with all its political connotations) when talking to women who desperately want their pregnancies.
Suggested alternatives: Pregnancy loss. Baby loss. Death of a baby. Loss of a baby in the womb.
Not viable
This is another cold, harsh term that should be confined to the workplace—“that’s not really a viable option, Janet.”
Suggested alternative: Not healthy enough to live.
Expel the embryo
I heard these words while the doctor was explaining options to deal with my missed miscarriage. “Expel” is such a violent word for such an experience that feels so emotionally fraught and fragile.
Suggested alternative: Help your body let go of the baby.
Fetal demise
These words were the diagnosis on my surgery packet before my dilation and evacuation (D&E) when I lost my son at 17 weeks. The reality for me was that my baby’s heart had stopped beating. He had died. The clinical term made it seem like an impassive clinical event.
Suggested alternatives: Baby loss. Death of a baby. Loss of a baby in the womb.
Products of conception
When my son died at 17 weeks, we wanted an autopsy done and were told, by phone call, that “the products of conception were lost at the lab.” I said, “The products of conception? You mean my son?”
Suggested alternatives: Baby. Remains of the baby. Baby’s body.
Pregnancy tissue
Also called “pregnancy matter.” This is deeply invalidating of the connection a woman often feels with her baby. As Miranda Field wrote, “It was a body, though no one ever said that word, only ‘matter’ and ‘tissue,’ rendered shapeless, ungraspable.”
Suggested alternatives: Baby. Remains of the baby. Baby’s body.
Advanced maternal age
I suppose this term is better than “geriatric pregnancy” (which I’ve still heard), but it’s still shaming. I saw it in my patient charts (since I was thirty-five), and it felt like a preemptive explanation, like, if something went wrong, my age was the reason. It made me wonder if I was foolish to consider having a child at my age. The truth is that there is nothing magical about the age 35. Each woman’s fertility is unique to her.
Suggested alternative: Just get rid of it. Women know how old they are. End of story.
High risk/low risk
Being classified as “high risk” (due to age or another reason) can make the pregnancy stressful from the beginning. On the other hand, being labeled “low risk” and then experiencing a complication can be blindsiding. The truth: Pregnancy always carries risk. Always. Losses happen to all kinds of women.
Suggested alternative: Get rid of it. It only benefits insurance companies.
Changing the language of pregnancy loss can start with women themselves—the way we talk about our losses and describe the associated medical events/diagnoses. My hope is that journalists will start to adjust how they talk and write about pregnancy loss, too. And, eventually, healthcare providers will follow suit.
When I asked a fellow loss-mom, Georgie, about her experience with doctors, she said, “Medical people are trained to think things through medically and often have the emotions of a ruler. They may offer words of condolence, but more often than not, they’re looking at you like a textbook, not an emotional being.” In her memoir, Mira Ptacin expresses a similar thought: “The doctors and specialists stopped sounding as if they were talking about a baby, but rather about something made out of metal.”
Doctors see pregnancy loss every day. It’s easy for them to dismiss emotions and fall back on clinical terms. We, as patients, can educate them though. We can own our truths and remind our providers that we didn’t just lose an embryo or a fetus—we lost a dream.
This post was written by Kim Hooper, co-author of All the Love: Healing Your Heart and Finding Meaning After Pregnancy Loss.
