Women Blame Themselves for Miscarriages. This Test Could Change That.
“I’ve had three miscarriages and one ectopic pregnancy and every single time I blamed my body,” says Danielle Campoamor, 33, a mother of two in New York. “My self-hatred became so severe I couldn’t look at myself in the mirror. I starved my body as if I was paying a penance. I spent so much of the mourning process asking what was wrong with me. What was wrong with my body.”
The shame associated with miscarriage can be overwhelming. As a psychologist specializing in women’s reproductive and maternal mental health, counseling patients like Campoamor who blame themselves for their pregnancy losses is as common as loss itself. The women in my office are often riddled with guilt; revisiting every minute detail of their lives in search of the reason behind their miscarriage. In the haze of grief, they point the finger at themselves: Was it something they ate? Did they workout too often? Had they done something catastrophic in the weeks before they even knew they were pregnant?
Having access to concrete answers could change a lot.
At least half of all miscarriages are the result of an abnormal number chromosomes in the embryo, according to The American College of Obstetricians and Gynecologists. It’s the most common cause of pregnancy loss. But getting access to the genetic testing of fetal tissue is complicated and costly—genetic testing is rarely offered to anyone who’s experienced less than three miscarriages, and can cost thousands of dollars. A new rapid genetic test, developed by Zev Williams, M.D., Ph.D., director of the Columbia University Fertility Center at New York Presbyterian Hospital and his team, hopes to change that. The new test would take just hours to complete, and cost less than $200. Williams expects the test to be available within a year but will need to be approved by medical regulatory agencies.
Campoamor says that kind of info would have made all the difference when she was mourning her losses. “What I wouldn’t have given to have access to a test that would’ve let me know that my body didn’t let me down, that there was a problem with the pregnancies from the beginning,” she says.
A 2015 national survey published in the Journal of Obstetrics & Gynecology found that 47 percent of people who’ve had miscarriage feel guilty, and 41 percent felt like they had done something wrong to cause the pregnancy loss: Seventy-six percent of Americans believe pregnancy loss is caused by a stressful event, 64 percent believe it’s caused by the pregnant person lifting a heavy object, 28 percent believe previously using an intrauterine device causes miscarriages, and 22 percent blame the use of oral contraceptives, according to the survey. “I blamed my IUD. I blamed my decision to use birth control at the age of 15. I blamed my job, my work load, a harmless argument with my partner, running at the gym. I looked for any reason—anything—to blame for my losses,” Campoamor says. There’s no evidence that any of these things contribute to miscarriage but the stigma persists. “Years later, I still have to work to not blame myself, what I ate, how much water I did or didn’t drink. The self-blame just lingers.”
The same survey found that 78 percent of the participants “reported wanting to know the cause of their miscarriage, even if no intervention could have prevented it from occurring.” That’s precisely why this test is poised to be such a game changer. Getting women answers could help dissolve the feelings of shame and failure that so often shroud a miscarriage. A 2019 study found that one in six women experience long-term post-traumatic stress following a miscarriage, and 1 in 10 women meet the criteria for major depression directly following a loss. Bypassing the mystery can potentially lead to a smoother, less complicated emotional journey following loss.
The test won’t answer every question about a miscarriage. For starters, it requires tissue from the pregnancy to test, and doctors may not always have the opportunity. If a test reveals that there were no genetic abnormalities, it could trigger even more questions—and self-blame—about the cause. But even that can be helpful. “In the minority of cases where the cause of the loss was not genetics, it allows us to look for the cause sooner—before waiting for the women to have multiple more losses,” says Williams. “If a cause is discovered, it can be corrected so the couple can have the best chance for success in the next pregnancy.“
As humans, we like to know why. I’ve sat across from hundreds of women and heard the desperation in their voices as they search for a reason why they didn’t carry a pregnancy to term. This test could help mitigate some of the psychological fallout of pregnancy loss by separating fact from fiction; science from a pervasive cultural misunderstanding that fuels self-blame and self-hatred.
“After each loss I felt like I was in the dark,” Campoamor says. “Like I was just feeling my way through grief, trying to hold onto something, anything, before I floated away. Information about why it happened, why my body didn’t hold onto those pregnancies, would’ve felt like a lantern. It wouldn’t have assuaged my pain, but it would have lit a path through it.”
Jessica Zucker is a Los Angeles-based psychologist specializing in women’s reproductive health and the author of the forthcoming book I HAD A MISCARRIAGE: A Memoir, A Movement (Feminist Press, 2021).