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IIt is estimated that one in four pregnancies ends in miscarriage, yet it is an experience that remains largely ignored – a grief that the world apparently does not know how to talk about. In The edge of beingJulia Bueno, a psychotherapist, draws on her personal experience, her consulting firm's stories and her interactions with experts to examine miscarriage in her broader cultural, medical and historical context, encouraging us to think more otherwise to pregnancy loss.
The heartbreaking loss of twins Matilda and Florence, at 22 weeks, tore the world of Bueno, leaving it irreversibly changed – time now divided into "before" and "after". The acute feelings of hopelessness, sadness, guilt, shame, bitterness, anger (and all the other emotions between the two), which so often accompany miscarriage, were only felt during the day. exacerbated by the lack of understanding of his suffering.
I often say that the worst thing about my (unsuccessful) journey through several cycles of IVF and two losses was not just the sadness that plagued us never to have children, but the deep sense of isolation. It's not that I was ashamed to have had a miscarriage, but rather emotions that followed. The loss of a baby is so much part of the life of so many people, but we live it mostly in the shadows, weighed down by unbelievably heavy feelings and fears that may seem stifling.
It is in this context that Bueno explores different experiences of pregnancy loss: early, late and recurrent miscarriages; the impact of these losses on partners and relatives; and finally, how to commemorate the family member who has never visited the family tree.
Each chapter examines some of the more specific aspects of these different experiences – such as the development of a strong maternal attachment to newly designed children; visceral physics of having an early miscarriage at home and the agony of having to throw your baby to the sewer; give birth and capture the memories of a baby born dead in the second trimester; the psychological impact on long-term mental health in the event of recurrent miscarriage; social conditioning and gender expectations that shape the male partner's experience; and the creation of funerary rituals and memorials to commemorate these losses.
The choice of Bueno's language is thoughtful and thought out, solving difficult problems that are so often avoided for fear of causing distress. She writes with sensitivity and compbadion, filling a much needed void in the discussion on the subject and opening the door to more candid conversations.
At the intersection of these discrete experiences are universal themes and ideas that invite reflection on some of the fundamental badumptions and expectations that shape the experience of miscarriage. The narrative surrounding pregnancy loss is intrinsically defined by the deeply held belief that a bond with a child can only begin after the birth of a baby alive – establishing a hierarchy of grief, according to the longer the pregnancy, the more valuable the loss; the ease with which medical staff so easily qualify early miscarriages of "simply a ball of cells" – something that had never really existed; the unwritten rule that one should not externally recognize the existence of a pregnancy before the 12-week milestone and the conspiracy of silence surrounding a miscarriage before that time; the arbitrary boundary between a late miscarriage and a stillbirth, which officially recognizes a loss, erases another that occurs a few weeks ago.
This book offers a different, and more satisfying perspective, that the stage of gestation does not determine the meaning of a pregnancy, nor the impact of its loss – but that each pregnancy, each miscarriage is related to its own meaning. , "annotated with ardent dreams, hopes and fantasies of a future life – a remembrance memory difficult to quantify, held privately".
Attitudes towards miscarriage continue to evolve: women with recurrent miscarriage have been described as "habitual abortionists" until the 1980s, and more and more women are beginning to explain themselves their loss experience – but Bueno clearly has a long way to go before the anguish of a miscarriage "gains fixed coordinates on the mourning card".
Katy Lindemann is writing a book that tells real stories of women on the emotional experience of infertility and pregnancy loss.
• At the edge of being: talking about miscarriage by Julia Bueno is published by Little, Brown (£ 18.99). To order a copy, go to guardianbookshop.com or call 0330 333 6846. Free UK postage from £ 15 (online orders only). Phone orders min. p & p from £ 1.99
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