An Interview with Dr Jessica Zucker

An Interview with Dr Jessica Zucker

  Illustrated by    Barbara Amaral

Illustrated by Barbara Amaral

We interviewed Dr Jessica Zucker, creator of the #IHadaMiscarriage campaign to encourage women to share their stories of loss and end the shame associated with miscarriage.
She also shared stories from her community with us, which you will find at the bottom of this post.

Tell us a bit about yourself, your background and your job.

I am a clinical psychologist and writer based in Los Angeles. I specialize in women's reproductive and maternal mental health and have done so for over a decade. It wasn't until I experienced a 16-week miscarriage firsthand that I could truly grasp the anguish and the circuitousness of grief I had heard my patients speak of for so many years. I have a background in public health and worked in international women's reproductive health in such places as: India, Nepal, Africa, Israel, and the Netherlands. Bringing this global viewpoint to my clinical practice as well as my writing has widened my perspectives on pregnancy, loss, and rituals (and lack of them) surrounding grief. My miscarriage ultimately gave birth to a passion for changing the way our culture manages pregnancy loss: the silence, the shame, the stigma.   

How did the #IHadaMiscarriage campaign originate?

After my 16-week miscarriage, I became that much more interested in the recent research which has found that a majority of women report experiencing feelings of shame, self-blame and guilt following pregnancy loss. Patients had reported these feelings during our sessions together, but after undergoing this profound loss myself, I became incensed by these unfortunate research findings. Why do women feel so alone, isolated, and badly about themselves when the science clearly states that pregnancy loss is not a fault of their own? Approximately 1 in 4 pregnancies result in loss and a majority of these are due to chromosomal abnormalities. If this many pregnancies end, why would women feel inclined to think they did something wrong, rather than viewing this as a natural (albeit incredibly sad) part of the pregnancy process? This theoretical and cultural conundrum inspired me to pen an essay published by The New York Times challenging these very notions. By using myself and my story--in all its detail--to illustrate the importance of sharing our experiences and questioning the way our culture handles this ubiquitous topic, I hoped to inspire others to question their feelings of self-blame. With this essay, I launched the #IHadAMiscarriage campaign in an effort to put a face to these stories that exist worldwide. To own what is ours, to dispel myths, to galvanize community, to clear the cobwebs of antiquated silence. The outpouring of compassion and candor was uncanny. It was deeply heartening to witness women of all generations sharing things they previously felt they shouldn't. There's something profoundly liberating in that.

What were the next steps of the #IHadaMiscarriage campaign?

The following year, in 2015, in conjunction with Pregnancy and Infant Loss Awareness Day (October 15th), I launched a line of pregnancy loss cards in an effort to go beyond the essay and into something more concretely accessible. A tool for connection. A tangible way for people to convey their care. Though pregnancy and infant loss cards existed previously, my cards aimed to capture the messiness and complexity that is grief. These cards received over 300 pieces of press and continue to be sent all over the world on a daily basis. They provide the antidote to, "I just didn't know what to say." Due to the enduring stigmatization of pregnancy loss in our culture, loved ones are stymied when it comes to providing support. These cards say the very thing people want to hear and span the gamut of emotion: from sadness to isolation to fear to anger. In 2106, I created a line of tees and enamel pins with the hope of encouraging intergenerational conversations about pregnancy loss. Pregnancy after pregnancy loss can be fraught, and these garments are intended to spark community and connection. 

Why do so many women feel they can't or shouldn't speak openly about their miscarriage? 

Unfortunately, we live in a world brimming with platitudes. When it comes to pregnancy loss, too many well-meaning strangers and loved ones alike say things like: "Everything happens for a reason", "At least you know you can get pregnant", "Be grateful for what you have", "God has a plan", "At least you weren't very far along". When we are met with comments like these, it can be tempting to shut down or worse, to feel ashamed of our grief. In addition, women often fall silent in their grief because of how complicated it can be to justify or understand it. For example, when a grandparent dies we are well-versed in how to respond. When it comes to pregnancy and infant loss, because we don't have standardized rituals in our culture to honor these losses, we stumble. We go numb, we turn inward, we feel alone. So the more we speak, the closer we get to making sure that future generations don't feel this sense of alienation in the aftermath of something so common. Miscarriage is not a disease; there is no ultimate cure. All the more reason why we must embrace this topic and find a sturdier way to support women and families as they face reproductive hardships.

Is is difficult for you to hear, process and share so many stories that may be very painful and personal?

It really isn't. It is an honor. In hearing more stories, I am better able to understand even more how very necessary it is that we become comfortable talking about loss and grief in all its forms, in all its complicated emotion. I am blown away by the courage and strength of all the women I come into contact with through my work.

What has been the most rewarding part of conducting this campaign?

Truly, there is no succinct answer to this question. Every day there are rewards as I witness a shift in the cultural dialogue, receive notes from women around the world about their journeys and how this campaign has helped them, and as I watch a new generation of women coming up who will no longer adhere to the silence, but instead will speak their truths with ease as a result of our brave work.

If you don't mind, please tell us about your own miscarriage.

My first pregnancy was smooth and uneventful. I became pregnant straight away - the labor and delivery were seamless. About 3 years later, my husband and I decided to expand our family. Again, I got pregnant easily but at 16-weeks along, I began to spot. I went directly to my doctor's office and all looked well. Two days later the spotting increased and I began to roil in pain. I didn't realize until retrospect that this was the pain of imminent labor/delivery. That Thursday on 10/11/12, my baby emerged while I was home alone. The trauma of this experience - having to cut the cord myself (coached over the phone by my doctor), subsequently hemorrhaging and needing to get myself and the baby to my doctor's office immediately - changed everything. The loss of blood was so great, I required an unmedicated D&C. So, the trauma and the physical and psychological pain continued - an elongated nightmare I was unable to wake from. The resulting grief was unfathomable, as was the fog I lived in for many months. I could barely feel my feet on the ground. Four months later, I became pregnant again. I walked on pins and needles for 9 months until my daughter was born on a misty day in mid-December 2013.  

What was most helpful in processing this loss and healing from it?

Writing. As a psychologist, I feel like I should probably say that therapy was the most helpful part of my healing process but I really think that I wrote my way back to health. Therapy, no doubt, supported this process and provided a much-needed haven for me to fall apart and to explore the crevices of pain, anxiety, and relational disappointments. But as I wrote about my experiences, I found understanding and with it a community. I couldn't have asked for a more potent salve than that of perfect strangers' vulnerability. Connecting through heartache gave way to hope.  

What advice would you have for someone looking for the best way to support a loved one who recently experienced a miscarriage?

I would simply say things like, "I'm deeply sorry for your loss.", "Grief knows no timeline, take all the time you need.", "I'm here for you, always." We want to remain open to hearing whatever it is she feels without rushing to change something, attempting to make her feel better. Ideally, your presence and your empathy enable her to feel whatever it is she is feeling. Period.

It's important to let people know you are there for them to explore their feelings, vent, or to even do something completely distracting together, if that's what they'd prefer. Don't assume what she feels. Ask her instead. Shy away from platitudes. Don't compare and contrast loss stories. Try to be the loving force you imagine you might want if you were in her shoes.

Is the attitude towards miscarriage moving in a positive direction?

I think the tide is really beginning to change. The more we share our stories of heartache and hope, the sooner we normalize the pain of grief. With this shift in our cultural narrative, we begin to witness women feeling connected rather than isolated during these life-changing experiences. This is the goal. Death is part of life and the more readily we integrate these concepts, the better off we are at conversing about them and doing right by each other. There is no shame in loss and without secrecy, shame continues to get pulled back. Shame will eventually get disbanded if we keep at these efforts long enough.

Dr. Jessica Zucker, California
Clinical psychologist specializing in women's reproductive + maternal mental health
Website // Instagram // Shop

Read more of her writing on NYT, Washington Post, Refinery 29, and this illustrated NYT feature. Additional works can be found through her website.

Stories shared through #IHadaMiscarriage:

Shared by @habe_mccoy, Springfield, MO

"There are no instruction manuals for grief. There is no step by step guide, because it is different for everyone. I don't know who first coined the phrase, "healing is not linear," but I love it... Healing is not linear, especially not for grief from an abortion. From ending a wanted pregnancy. No one tells you what to expect because hardly anyone knows this situation firsthand. They don't tell you that you will feel emptier than ever when your period finally returns. And that it will be brutally heavy. And painful. And your body will ache. But, oh. Your heart will ache so much more. That it will feel like you're bleeding out all of your hopes and dreams. That your soul feels empty. Emptier than your womb. That you will ache and ache and ache, for who knows how long. No, healing is not linear. Not even close." .
{23+ week termination based on medical/ life-threatening fetal complications. December 28, 2016}

Shared by @heartspeaches, Brooklyn, NY

"I was 39 weeks 5 days, and getting antsy in the August heat. SO ready for our baby boy Winter to arrive. As we walked into the doctors office that morning of August 11th, everyone smiled at us, they knew our happy day was near. Our lives changed forever that morning, when the sonogram technician left the room to come back in with 3 doctors staring in shock at the monitor, "We're sorry there's no fetal heartbeat." Shock, denial, fear and strength overcame me. I had to deliver my Son. The next morning 8/12/16 at 8:04am I delivered Winter Robert Feddock 7lbs 6.9 oz and 21 inches long. He was beautiful, peaceful & magical. We got to hold him and spend time with him. Moments we will remember and treasure the rest of our lives. Winter had a "true knot" in his umbilical cord which is what caused him to die, just one day before his due date. This could not have been prevented or detected. Just terrible luck, and a tragic loss. Our life with Winter was lived in those 9+ months I carried him, it was filled with love, laughter and dreams for his bright future. We will always wonder about what Winter's life would have been like here with us, and we will carry that wonder and curiosity with us in our hearts the rest of our lives. We move forward with HOPE and love."

Shared by Jessica Costanzo @hitch160

"Our son was 2 and we were ready to add to our family. We became pregnant with our second son and were very excited. At our 16 week ultrasound, the doctor came in and said, “I have serious concerns for this pregnancy.” The diagnosis was bilateral multicystic dysplastic kidneys - neither kidney had formed correctly — they were just balls of cysts. I waited for the doctor to tell us the solution. There was none. One cystic kidney can be managed, but two is very rare (1 in 10,000) and fatal. Because there were no kidneys, he could not form amniotic fluid and would not develop lungs. The doctor also did not see a bladder or stomach and the deformed kidneys were so large that his heart was displaced. If the pregnancy went full-term, our son would not live, and if he somehow did, it would be a short life in pain. Our options were to end the pregnancy then, wait to see if the pregnancy ended itself, or wait to see if the pregnancy went to term at risk to my health. If we waited to term, he could be stillborn or live for only a short time on dialysis awaiting a kidney transplant that would almost certainly not be successful. My husband and I decided to end the pregnancy. Waiting over a week for the next available hospital slot for my abortion procedure was the most emotionally draining experience of my life. At 18 weeks, we terminated the pregnancy and said goodbye to our son. After a year of grieving, we decide to try again. We have since miscarried our third pregnancy. While the grief that comes with termination and miscarriage is different, they do share one thing - the heartbreaking loss of what may have been."

Dr. Jessica Zucker supports The MISS Foundation, a community of compassion and hope for grieving families. This volunteer based organization provides C.A.R.E.: Counseling, Advocacy, Research, and Education services to families experiencing the death of a child.

She also supports Pregnancy After Loss Support and Sands.

Please consider donating to one of these organizations, to help families coping with loss of an infant.

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