Mother’s Day after miscarriage: Celebrating and grieving a lost pregnancy.

After a Miscarriage, My Patient Asked: “Can I Celebrate Mother’s Day?”

After a Miscarriage, My Patient Asked: “Can I Celebrate Mother’s Day?”

Health and medicine explained.
May 8 2015 3:54 AM

“Can I Celebrate Mother’s Day?”

How my patients face the holiday after a miscarriage. 

Pink wrapped present with bunch of white tulips and mothers day
Not so happy for everyone.

Photo illustration by Slate. Photo by Thinkstock.

It wasn’t fair because it wasn’t a medical question.

The question came from someone I didn’t know until the middle of one of my nights on call as a high-risk obstetrician, when I took care of her. By then she had already been diagnosed with her stillborn pregnancy and preterm labor; we already knew that she had a very serious infection that either caused or followed her terrible pregnancy outcome. I took care of her for the night. She got better and was discharged from the hospital.

Now she is gravely sad and distracted and in my office for a follow-up appointment. She answers my questions about her pain, her fevers, her healing. She responds with short, impatient sentences, although all these issues seem to be heading in the right direction. Finally, after I feel her belly and tap on her kidneys, she turns to me and asks the question that really interests her: “Can I celebrate Mother’s Day?”

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There are probably as many reasons for a woman to not love Mother’s Day as there are women. There are women who never wanted to become mothers and find this day to be yet another public criticism of their choices. In the LGBTQ community, there are gestational parents who don’t identify as women or as mothers. Everywhere there are women who desperately want to parent but are not able to for reasons of biology, society, economics, a combination of those factors, or something entirely different. And of course, anyone whose mother has died feels the loss more acutely on Mother’s Day.

Less dramatically, my Facebook feed is full of women who, like me, are mothers and thrilled about that but who find that the vaguely 1950s retro mom generally being celebrated is not the person we can (or really ever wanted to) be. For us, the whole thing becomes slightly strange and guilt-ridden.

And then there are my patients. Because I’m a high-risk obstetrician, many of my patients have had pregnancies that were scary the whole way through; or like the one above, were low-risk until something terrible happened. 

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Many of these women spend Mother’s Day and the weeks of marketing that precede it hiding as far from reminders as they can get. Some of them have told me that this time of year is just ugly, that the roses and the chocolates are all reminders of something they couldn’t have. Even if—when—they have children, the day can be full of doubt and envy for “normal” women for whom pregnancy is not a minefield, and for whom healthy children are a given.

But people are complicated. And it turns out that some of my patients want the opposite. For them, Mother’s Day is an opportunity. Some of them so very much wanted to be mothers to those babies that would have, could have resulted from those terrible, doomed pregnancies. For the time of their gestation, however brief, they were mothers. And that time, that opportunity, was so fleeting that they feel cheated; they feel that nobody remembers that experience, that pregnancy, that baby-to-be. Mother’s Day is a chance to recognize—and ask for public recognition—for that time. It was real, my patients are saying, and I need you to know that.

I had a baby of my own recently. By now I know that what I see at work will haunt me during any pregnancy. So it wasn’t unexpected that I had a million terrifying thoughts during this ultimately uncomplicated pregnancy. But what was most interesting to me was my reaction every time I went in for an ultrasound during my first trimester. As the tech put the gel on my belly and prepared the machine, I was surprised that my first fear wasn’t that the baby would have no heartbeat, that it would be dead. That was my second fear. My first fear was that the ultrasound would show emptiness, that the pregnancy would be inexplicably gone, or would have never been there. That this beloved project I had been working on, suffering for, would just be … nothing.

The question Can I celebrate Mother’s Day? is complicated, as are all questions. We could wade into the terminology: whether the pregnancy was a gestation or an embryo or a fetus or a baby. It would be easy to get very tangled in the nearby weeds of bioethics and abortion and discuss whether being 20 weeks or 24 weeks or 28 weeks changes a woman’s title. But the truth is, that’s not the question my patient is asking, and none of that is the answer she needs. She’s asking: Does my pain matter? Does my grief matter? Does my love matter? Did this happen, even if there’s no baby at the end? And because she asks that question, you already know the answer.

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Of course I tell her she can celebrate Mother’s Day. But what I really mean is this: Yes, it happened. I was there. It is terribly cruel that there is no baby. It is terribly cruel that you delivered and bled and made milk for a newborn who won’t ever come home to you. But it did really happen, even if it feels like a nightmare. You shouldn’t need a witness; you should be the arbiter of whether you’re a mother—not your mother-in-law, not your casually cruel girlfriends, not the grocery store checkout clerk, not your husband, who, weeks later, cannot even bear to drive by the hospital, not me. But I can be your witness, and I will say: Yes, your grief matters; your pain matters; your love matters, even when the ending is so hard, even when there is no baby to show the world.

So I say that. I say: Yes. You give yourself permission to celebrate Mother’s Day, and that’s more than enough.

She smiles, a small crooked smile. We schedule another appointment for six weeks later. As she’s at the door to my office, I say, “Have a wonderful Mother’s Day, however you’d like that to be.”

“You too,” she says. And then she’s gone.

Chavi Eve Karkowsky is a specialist in high-risk pregnancy, also known as maternal-fetal medicine. Follow her on Twitter.