Miscarriage, Abortion and Reflections on Motherhood

Half the Sky: Miscarriage, Abortion and Reflections on Motherhood

As we mark the second anniversary of the seemingly endless global pandemic, let’s not allow it to eclipse International Women’s Day on March 8th, which doggedly rolls around year after year in the similarly seemingly endless march towards equality, justice and simple dignity. 

Some decades ago, when cigarette advertising was still legal in the US, the specially designed “women’s” smokes had the catchy ad slogan ”You’ve come a long way, Baby…” Well, maybe some, in the First World anyway, but we still have a long way to go. As ever, I wrestle with my skepticism that “Me Too” and other momentarily epoch-making advances will disappear in the quicksand of traumatic memory, as other interests compel the public mind or sell news.

In 1970 pro tennis when male players were paid seven times (!) more prize money than their female counterparts (if women were admitted to compete at all!) and Billie Jean King fought for parity, it appeared as if female athletes were winning ground. Recent events like Chinese tennis player Peng Shuai’s “disappearance” and “silence” after speaking out about sexual abuse; or mysterious events surrounding teen Russian figure skater Kamila Valieva make me wonder.

As ever, I wrestle with my skepticism that “Me Too” and other momentarily epoch-making advances will disappear in the quicksand of traumatic memory, as other interests compel the public mind or sell news.

Perhaps Valieva’s tumble is a fitting metaphor. Yes, we have a woman vice president and women are even driving now in Saudi Arabia, but as contemporary Peruvian author Sylvia Vasquez-Lavado recounts in her recent memoir, even in her short lifetime she learned early that making herself ugly was the only defense against the relentless sexual intrusions and obnoxious attention of any random man.

Because of my own interest in “mother-lessness” and motherhood, I chose to focus on that female issue because it can have such profound meaning and impact on development, trauma and neglect. I remember when I first started therapy in my 20’s, my mother railed “It is the blame your mother generation!” That is certainly not my intent. However, Vasquez-Lavado’s mother is a vivid illustration. 

In effect, “sold” into an arranged marriage at the age of 14; she had born three children while still a teen, until overwhelmed and overcome with tremendous shame and terror (and most likely dissociation), she fled. Vasquez-Lavado herself only learned her mother’s story years later, having always believed that the older relatives she thought were aunts and uncles, were her siblings. Of course, this all had a tremendous impact on her

Deception, a mother’s disrupted development: generations of mother-lessness begetting generations of mother-lessness. 

I have to wonder, with utmost compassion, what it was like for my mother growing up with my cold, upper-class intellectual grandmother. I believe there were a lot of nannies involved. And this, even before the explosion of the Nazi Holocaust.


I was stunned and horrified when I heard the story on February 5th that a Salvadoran woman identified only as “Etsy” was released after completing ten years of a 30-year prison sentence. The crime: abortion. 

Well, they called it “aggravated homicide.” In El Salvador, abortion for any reason, including rape, incest, or danger to the mother’s health is strictly illegal. Still, in Etsy’s case it was an obstetric emergency that prompted her high stakes decision. Her release after ten years was a triumph of the international reproductive rights movement. 

I don’t know if Etsy already had children before going to prison. If she did, they were motherless for ten years, and Etsy, besides being robbed of a decade of her life in conditions that I hate to envision, would have been torn away from them, Not to mention the grief of losing a wanted pregnancy. 

This is all present tense. And as we all know, Roe v. Wade, the famous case that made abortion legal in the US in 1973, teeters on the precarious brink of survival.


Etsy’s trauma hovered right at the interface between abortion and miscarriage. In El Salvador, the line is blurry between the two, and even women who suffer miscarriages and stillbirths can be prosecuted for murder. I could not find any other countries that criminalize miscarriage, but I did learn that in some other cultures, women who miscarry are viewed as “dangerous” or possessed of some sort of spell that would make them, at the very least a threat and thereby unwelcome at baby showers and the like.

How very sad! Their likely grief and loss is then compounded by social isolation and ostracization – rejection. All too often, women are blamed or stigmatized for miscarrying, and certainly, this trauma is poorly understood by most who have not experienced it.

I have seen numerous examples in my practice of women who lost wanted pregnancies grieving with profound and vacuous loneliness upon these traumatic losses, especially when their reproductive window may appear to be soon to close. Somehow our culture is clueless about miscarriage, not understanding it as the death of a beloved other. I guess perhaps we don’t know what to say. 

All too often, the grieving mother will hear something overly cheery like “you can try again…” or a quick jump to the joys of adoption, which may sound to the grieving “not-to-be-mother” like “this is no big deal,” or “there is nothing here to talk about,” or simply ”I don’t want to hear it.” The grieving one may then wonder if she is pathological or if her depression is exaggerated or self-indulgent. 

There may also be medical complications or hormonal shifts that make healing slow, difficult and again lonely. There are no sympathy cards. There is no funeral, in most cases no spiritual or religious marker, public or private—a lonely and poorly understood road. And when grief is complicated and traumatic, and there is a subsequent pregnancy, that child spends its early months of development in a womb still lost in grief, stress hormones and fears that it might happen again. We could certainly help those children and later, adults, by developing an understanding of how to support miscarrying mothers-to-be and also make it a safer and kinder world in which to talk about miscarriage openly.

I was troubled to learn that in Spanish, or certainly in El Salvador, there is no word for miscarriage. The same word is used to refer to miscarriage as to abortion: aborto. So the mother of miscarriage is categorically likely to feel like a “sinner.” My recommendation to those who learn that a loved one or friend has lost a pregnancy and who don’t know what to say, is to just say that! Just say, “I don’t know what to say, but my heart goes out to you.” That is what I always recommend when we don’t know what to say, as it is a way to communicate that my silence is not because I don’t want to talk about this. I simply don’t want to make it worse. And it may serve as an invitation to let you know what would perhaps help.


I knew when I was five that motherhood was not for me. I was such a profoundly sad and lonely child, I knew I did not want anyone to ever come into the world and feel like that, and I feared I could not do better. I did not speak of it, but I always knew. As I got older, and my mother would refer to couples we knew who chose not to have children as “too selfish.” So, I concluded that my undisclosed plan for myself was another indication of my badness or defectiveness, it was probably true about me too. I was all the more compelled to be “unselfish.”

As I got older and saw how excited others and later my friends were about having families, I grew to believe that there was perhaps something monstrous about me and unnatural in my preference. In my thirties, as my window of possibility was narrowing, I had the good fortune to have a consultant, Mardy Ireland, who had recently written a book on the subject. All these years later, I still highly recommend that book: Reconceiving Women: Separating Motherhood from Female Identity. 

Both Mardy and her book helped me tremendously to make my peace with my decision, which I have never regretted. I was also fortunate to partner with a man who was on the fence about children and therefore left it up to me. I am blessed with a wealth of nieces and nephews whom I adore, and the one thing that really endeared me to Tim Cook, the CEO of Apple, is when I read an essay he wrote on the joys of being an uncle. Being an aunt is one of the great pleasures of my life. I am good with that.

Admittedly I can slip into feeling that motherhood is an act of heroism and courage that I lacked. I must be mindful that when a client is grieving what she has not “accomplished” in other areas, that I do not miss the mark or intrude with my own formulation. And we all live or wrestle, like George Floyd in his final breaths, with a deep memory of the at least then, most important person in the world. In that spirit, I do say, thanks mom.

In the 1970’s Women’s Movement, we used to say Women Hold Up Half the Sky.

Happy Women’s Day to all.

Each time I write a blog, I always try to think of a song that I love that goes with what I’ve written. Today’s is Madre by Silvio Rodriguez.

My book “Working with the Developmental Trauma of Childhood Neglect: Using Psychotherapy and Attachment Theory Techniques in Clinical Practice” was published on August 31st. It provides psychotherapists with a multidimensional view of childhood neglect and a practical roadmap for facilitating survivors’ healing.

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