By Kim Hooper and Meredith Resnick, LCSW
If you’ve had a pregnancy loss, someone has probably said this to you: “Everything happens for a reason.”
This is a myth. Some things defy linear cause and effect, and happen without any one specific reason at all. Perinatal loss is one of them.
Last week, results of a study on the preconception health of dads-to-be, published in Human Reproduction, and the headlines that followed, reminded us we resist the randomness of pregnancy loss. What also caught our eye was the shift in the long-held focus of responsibility for these random losses from women to men. However, by focus, we actually mean blame.
“‘Fertility Is a Team Sport’: Father’s Health Tied to Pregnancy Loss” in the New York Times implied this in a sly, campy way.
After analyzing nearly 960,000 pregnancies between 2007 and 2016, including health information on both parents for an average of about four years before conception, researchers found that if the dad-to-be had diabetes, high blood pressure, or was obese, there was increased risk that the mom-to-be would lose the pregnancy. If he suffered from only one of these conditions, there was a 10% increase in the risk of pregnancy loss; that rose to 15% if the father was diagnosed with two of the conditions, and 19% if he suffered from all three.
However, we know that the vast majority (up to 70%) of pregnancy losses are caused by chromosomal abnormalities with the embryo that have nothing to do with either parent. Most pregnancy losses just happen, even if both people are at the peak of health. If you are a man with one of the underlying conditions identified in the study and your partner miscarries, chances are it’s not your fault. Or hers. Chances are it just happened.
In her book The Myth of the Perfect Pregnancy, Lara Freidenfelds explains that the majority of miscarriages are caused by chromosomal abnormalities that render the embryo incompatible with life. They are largely random and unpredictable. “All in all,” Freidenfelds says, “early pregnancy losses are part and parcel of childbearing. However we think about pregnancy, we need to take miscarriage into account.” But the perception we seem to hold both societally and individually is that miscarriage is a rare freak occurrence.
The buzz around the latest study data seems to say Look, men may be to blame too. As if that’s better than the situation when women bore the blame. What would be ideal is if we resisted the urge to blame at all. What would be better is if journalists took note to avoid click-bait headlines (“Health of Fathers Linked to Miscarriage and Stillbirth, According to a New Study” [Forbes]; “Dads’ Health Linked to Odds of Pregnancy Loss in Moms-to-Be” [U.S. News & World Report]) that reinforce the narrative that pregnancy loss is controllable. By implying it’s controllable, we’re implying it’s someone’s fault.
When men are told that they “should try to get themselves in shape” before attempting to conceive, this implies they can now “share the responsibility” of the pregnancy (and its loss). Up until now, much of the insinuated blame has been placed squarely, wrongly, on the shoulders of women who are told they have an “incompetent cervix” or an “irritable uterus.” Even classifying patients as “high risk” and “low risk” is not helpful. If a woman is “low risk” and loses the pregnancy, she is likely to experience additional trauma as she wraps her mind around what went wrong. If she is labeled “high risk,” her pregnancy will be stressful from the beginning. We need to accept that pregnancies always carry risk, period.
When terrible things happen, our brains try to organize the experience to help us prevent whatever happened once from happening—hurting—once again. Miscarriage, stillbirth, any type of pregnancy loss eludes this logic because the cause of so many losses is out of our control.
The media is reflective of our collective insistence on attaching reason to outcomes. We want things to make sense. We don’t want to accept that some tragedies are random—because if they are, that means we are vulnerable to them. As Ralph Lewis, MD, writes, “We are a meaning-seeking species… The brain’s language centers have a natural proclivity for coherent stories—grand narratives with an overarching point and a satisfying end. Things must happen for specific reasons; they must have a point. The brain is not satisfied with pointless randomness.”
This is a study of cause and effect. The study is the study; the data is the data. Research, particularly extensive, long-term studies enable us to understand pregnancy loss with a clinical eye. We need to remember that, in a field that will never find one single cause for pregnancy loss, what remains are its effects—the sorrow, the guilt, the shame, the loneliness, the anger. As a society, we need to get more comfortable with the randomness of loss and the resulting grief. We need to support those who suffer.
We need more headlines, and studies, too, about that, more dialogue about what to do when a loss happens, no matter the reason.
This post was written by Kim Hooper and Meredith Resnick, co-authors of All the Love: Healing Your Heart and Finding Meaning After Pregnancy Loss.
