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S2 E14: The Trifecta of Silence: Breaking Shame and Stigma in Pregnancy Loss
91 Plays8 days ago
In the final episode of Season 2 of the podcast , our host Sam is joined by the phenomenal Dr. Jessica Zucker a Los Angeles-based psychologist specialising in women's reproductive and maternal mental health, and the author of I Had a Miscarriage and Normalize It.
Dr. Jessica shares her personal and professional worlds colliding after her own devastating loss, including the traumatic experience of an unmedicated D&C. As a seasoned professional, she was shocked to realise she did not have the necessary tools to navigate her own profound grief and isolation.
This conversation delves into the heart of the movement Dr. Jessica started to dismantle the pervasive silence, stigma, and shame surrounding pregnancy loss. It is a critical discussion for anyone who has experienced loss, those supporting them, and anyone interested in improving women's health outcomes.
Together they discuss:
- The Power of Professional Vulnerability.
- The Trifecta of Shame
- The Antidote is Storytelling
- Toxic Platitudes
- Systemic Change
- Therapy's Crucial Role
Connect with Dr. Jessica
- @Ihadamiscarriage
- Jessica Zucker, Ph.D.
- I Had a Miscarriage: A Memoir, a Movement: Excellent for those who have recently experienced a loss.
- Normalize It: Upending the Silent Stigma and Shame that Shape Women's Lives: Broadens the lens to discuss the power of storytelling across many aspects of women's lives.
EARLY PREGNANCY LOSS SUPPORT
If you or someone you know has experienced miscarriage or early pregnancy loss, please know you are not alone.
- For crisis support, please call Lifeline - 13 11 14.
- Access all our support
- Connect through Live Chat with Peer Support
- Join Online Communities
- Call out Pregnancy Loss helpline delivered by PANDA
- Join the Circle of support
- Follow @pinkelephantssupport on instagram.
Recommended
Transcript
Introduction to Miscarriage Rebellion Podcast
00:00:04
Speaker
Welcome to the miscarriage rebellion. I am Stacey June Lewis, lead of the Pink Elephant Support Network group counseling program, Grief and Grace. And along with Pink Elephant's co-founder and CEO, Sam Payne, through this podcast, we will share the stories of many Australians who have lost their babies to early pregnancy loss.
00:00:21
Speaker
With evidence and empathy, we unpack the shame, blame and stigma and lack of support that they may face. This is a loss that has been silenced for far too long and we deserve better. We are here to normalise the conversation and to make lasting change.
Breaking Silence: Dr. Jessica's Story
00:00:37
Speaker
On today's episode of the Miscarriage Rebellion, we have the phenomenal, incredible Dr. Jessica. um I have followed Jessica's work for so many years and she has made such a personal impact on me, as well as an impact on our community and the way that we see early pregnancy loss, miscarriage. And she has taken many issues within this and she has tried her hardest and has, I would argue, in a great way, managed to break a lot of the shame, stigma and silence that surrounds the heartbreak and the devastation that we face when we go through this experience. um So without further ado, I'd really like Jessica just to tell you a little bit more about herself and what her role is and what she does for our community.
00:01:23
Speaker
Thank you so much. I'm so honored to be with you. And this has been a long time coming. We've been back and forth trying to get this together. So thank you for having me and thank you for the important work that you do.
00:01:36
Speaker
So I am a Los Angeles-based psychologist and I specialize in women's reproductive and maternal mental health and have done so for over 15 years at this point.
00:01:47
Speaker
And I actually come to the field with a background in public health. So I worked in international women's health and women's rights prior to pursuing my PhD. And at the time, i was just interested in all things women's health.
00:02:00
Speaker
I had not lived through an experience firsthand that sort of informed this trajectory until I did. So when I was 16 weeks into my second pregnancy, I had a miscarriage while I was home by myself.
00:02:17
Speaker
And I was coached by phone by my OBGYN how to cut the umbilical cord and promptly began to hemorrhage. And my husband, of course, he he had been at work, so he you know zoomed home, darted through LA traffic as quickly as possible to get home to me.
00:02:38
Speaker
And my doctor advised me to bring the fetus with me in a bag to her office for testing. And you know we we all knew that I would continue to hemorrhage until the placenta was out.
00:02:51
Speaker
and Unfortunately, basically I was given this, I guess you could call it a choice. It didn't feel like one at the time, but and to either sort of wait for anesthesiology to arrive, which would mean more blood loss and then a blood transfusion or undergo an unmedicated DNC.
00:03:13
Speaker
And so I opted for the latter, which, you know, ah to this day, i i can feel in the cells in my body, ah the sound of that machine and the feeling of the experience of the placenta being tugged out and and really sort of, you know, the end of this relationship as I knew it.
Campaigns and Books: 'I Had a Miscarriage'
00:03:40
Speaker
And i had been, you know, specializing in this long before undergoing this firsthand. and so my worlds collided, you know, my personal and professional life sort of like hit each other, um, full stop. And I really had to ask myself, like what do i want to do with this? Like, what, how do I navigate this pain that I've heard so much about that I thought I understood, but now that I'm the one in it,
00:04:15
Speaker
where are my tools? Like, where where where do I turn? How do I process the enormity and the profundity of the grief of the heartbreak and of the feelings of isolation I was experiencing?
00:04:30
Speaker
So I ended up starting this campaign, it was sort of unbeknownst to me. I mean, I wasn't planning to start like a whole thing, but I was feeling that writing was really the sort of most profound conduit for healing for me.
00:04:50
Speaker
And so in 2014, I launched the I had a miscarriage campaign with my first New York Times piece. And Honestly, it was the messages that i received and the comments and the emails and the DMs that sort of shored me up in a newfound way.
00:05:15
Speaker
And also gave me hope because this piece was really about, can we once and for all bid farewell to the silence, the stigma, and the shame that surround this all too common experience.
00:05:31
Speaker
And so to hear from women around the globe that they've been holding onto feelings of shame, for years and years or have not even told somebody that they went through this made me realize that this is a topic that we not only need to kind of bring out of the shadows, but we need to normalize it through talking about it continuously.
00:06:05
Speaker
And so that's what I did. And that's what eventually led to my first book, which is called I Had a Miscarriage, a Memoir Movement. There it is. That was back in 2021. then more recently,
00:06:19
Speaker
and then more recently I came out with my second book called Normalize It. and the title the subtitle of that book is Upending the Silent Stigma and Shame that Shape Women's Lives.
00:06:33
Speaker
Because what I quickly realized soon after my first book came out, and this mental health publisher came to me and asked me if I would write a book, I realized that this strident trifecta, the silence that begets the stigma, that begets the shame, actually surrounds so many experiences in women's lives. This is not just specific to reproduction, of course.
00:06:59
Speaker
And so this second book sort of expands my lens a bit. And I look at everything from menstruation through menopause and then some.
00:07:11
Speaker
I think you're an absolute force of nature. And I'm, again, incredibly in awe today. I really do. i'm like I've also read your story. But to hear you say in your own words, to hear that experience, you can't help but not like deeply empathise and just feel that pain and that silence, the isolation that you felt when you went home. And like you said, you were already a practising person. psychologists, you had experience in this area, yet you did not have the tools to equip you to navigate this. And if you're one of the best placed in society, then how are others who are maybe living rurally, regionally, with less access, or let's we've just done a report on that, how are they meant to get through this if those of us that are at the forefront of women's health can't even find, and we know we've had other doctors on Speak about this before,
00:08:05
Speaker
I guess I want to delve a bit more now into the first book and that I had a miscarriage. um It really is honest, vulnerable, really important work that just will make such huge difference. And I can't implore people to jump online and try and read this for themselves. But what did you learn through the process of writing that book?
The Therapeutic Power of Writing
00:08:26
Speaker
I feel emotional. i Thank you so much for um the empathy. i feel like a it's interesting because my loss was so long ago now and I've talked about it so much.
00:08:40
Speaker
that it's like a story sometimes that's not disembodied because of course, you know, I, I feel it and I've lived it deeply and it's incredibly vulnerable, but I find that I don't always sort of get the connection back about it. And so I really appreciate the fact that even though you already know my story, hearing it is landing differently for you. So I appreciate you saying that. um
00:09:12
Speaker
Your question was what led me to write the book or the process of writing the book? What did you learn through the process of writing the book? I think that would be really interesting. We know kind of like the back story as to how you got there. And I just, what else came to light during that process?
00:09:26
Speaker
How hard it is to write a book. my job Yeah. And mean for me, I had written so many pieces, short pieces for a variety of outlets on various aspects of loss and life after loss and pregnancy after loss and parenting after loss, all of it.
00:09:46
Speaker
But actually committing to long form writing was very different for me. And so the way that I sort of got through it was I sort of broke it down. Well, I mean, as any book is broken down by chapters, but each chapter takes on a different aspect of loss and life after loss. And so that made it, I think, less intimidating for me because it's intense to kind of sit down You look at a blank screen, you know what's expected, you know how many words this is going to be. And and i I was confident I had it in me, but I wasn't necessarily as comfortable with that sort of moment to moment.
00:10:29
Speaker
How am I going to you know actually produce this whole thing? But what i learned ah through the process was that you know And I said this already, writing has really been, and not that we have to choose what's what's been the most kind of helpful in our journeys, but therapy and writing has really gotten me to a new place. And I want to say the writing has been so important because it's connected me with other people.
00:11:07
Speaker
Therapy, of course, you know it's me and my therapist, and we're talking about the pain and the complexity and and family relationships and relationships with my children and you know all of that.
00:11:18
Speaker
But writing allows me to hear from other women and connect with people who would have been strangers otherwise. And it does something, right? It makes us feel like you know, okay, we know the numbers. We know that approximately one in four pregnancies results in miscarriage. I don't know the same stats apply to your country, but, um,
00:11:44
Speaker
you know but So knowing that is one thing, but feeling that through actually typing with somebody and connecting about you know the heartache and the grief and how circuitous it can be, that is really what made me feel like Like, yeah, this is a this is a community that people, of course, don't want to be part of but it sure is hearty community that, if you lean into it, provides so much strength and
Healing through Journaling
00:12:20
Speaker
so much hope. 100%. And when you see that. every day in Pink Elephants that we talk a lot about when I think Brené Brown's the one that framed it but connection being the antidote to isolation and that when we connect through these experiences we feel less alone we feel less judged we feel seen we feel heard and we feel like
00:12:39
Speaker
If we get it right, particularly at Pink Elephants, we create a safe space for that magic to happen and for those stories to be shared. And we know that that for so many is so helpful. um I want to touch a little bit on the writing because we know that kind of like journaling is a tool that's often recommended.
00:12:57
Speaker
But say you're listening to this podcast today and you've literally just experienced your first loss and that's why you're here. like When you say write, what advice would you give to someone? I know there's other things as well, but particularly around the journaling, what where would they start?
00:13:10
Speaker
So I'm so glad you brought up journaling because my second book is actually um is really focused around storytelling and how storytelling connects us to not only others, but primarily to ourselves.
00:13:28
Speaker
And so I do believe that this kind of storytelling can be the antidote to the silence and it can be the antidote to the shame because the more we stuff our pain in our bodies and keep quiet about it,
00:13:45
Speaker
the stormier things can become within our psyches and within our even, you know, behaviors in our relationships. So i provide in this book, various examples of ways people can move their stories through them.
00:14:00
Speaker
One of them is journaling. So you don't have to be a quote unquote writer. you know You don't have to be somebody who thinks of themselves as an author or plans you know to to write a book or to even publish a short piece.
00:14:16
Speaker
Not at all. Journaling is literally a piece of paper or even your phone and a pen or your thumbs. you know i mean So you can write it in the notes section of your phone. like You don't need anything in order to speak your truth.
00:14:35
Speaker
Yeah, 100%. Yeah. And so, you know, I just think journaling can be so validating because you are saying what is true for you.
00:14:46
Speaker
you are exploring what happened to you. There is no judgment. There is no, um you know, there are no platitudes being thrown at you. ah And there's nobody trying to quote unquote fix anything. No silver linings, nothing.
00:15:04
Speaker
gosh the silver linings, the platitudes. Can we go there? Oh, goodness. That just drives me crazy. Enough is enough. Yeah. What are some of the ones that you've heard that do the most damage? I think, you know, at least, you know, you can get pregnant is just outrageous. It needs to be, you know, tossed out. And the truth is, i look back and I feel like I didn't realize how painful and disruptive something like that could be for somebody.
00:15:36
Speaker
um And i tend to, and you know I know this is very you know personal to everybody, but I really tend to bristle at God doesn't give you more than you can handle. God has a plan and especially everything happens for a reason. Now, I know a lot of people believe in that. And if if that works for you, then, you know, so be it. And that's that's important. But.
Challenging Harmful Platitudes
00:16:05
Speaker
To say to somebody who's lost, let's say, you know, a baby at 38 weeks to stillbirth or an infant to c SIDS that God doesn't give you more than you can handle or God has a plan. i think that is incredibly potentially alienating. I think it will probably break that relationship in half for good. And i do think that unfortunately it is a form of distancing. you know So even if that person truly believes that from a religious or spiritual perspective,
00:16:46
Speaker
it it doesn't meet the person. Where are you? What do you need from me? I want to listen to what you've been through rather than kind of putting one's own feelings or philosophies onto somebody else.
00:17:01
Speaker
It's that silver lining to try and make themselves feel a bit better in a situation that's difficult and they're so scared and they don't know what to say because it's such a lack of conversation, which we'll move to next. But there's no conversation around this experience generally. So without the conversation, people don't know what to say. So then they quickly try to find a silver lining. and they quickly try and move through it because they're so uncomfortable and we need to get better at being in hard, uncomfortable conversations, leaning in, like you said, listening to the person and what they need, not, oh, at least you could have another one. Like, I can't tell you how crazy- How do they even know that anyway? They're not doctors, they're not psychics, and even if they are the doctors don't know. So it's like, yeah, I just, if we could huddle together
00:17:49
Speaker
and commune around grief, I do think that it will not evaporate sooner, but it will morph sooner than it will if we are trying to stave it off, push it away, pretend like it doesn't exist.
00:18:07
Speaker
And so I think that's what platitudes and silver linings do. you know, it just kind of, ooh I just don't want to feel this. So I'm going to pretend like I know the future or that I can make it better by saying something that temporarily makes me feel better. Yeah, 100%. I think that brings us really nicely now to that trifecta that you described earlier, the trifecta of shame, silence and stigma.
Silence, Stigma, and Shame in Women's Health
00:18:32
Speaker
And that how when we are in that, what we're doing is we're not normalising conversations around women's health issues. And then like I've joined that dot, you're then leading to people not knowing what to say and therefore either shying away and saying nothing. or leaning in and saying the wrong thing. So I guess, talk us a little bit kind of through that broader context of what that trifecta is. Yeah, you know, it's, I feel like it's an obvious one, but I'm like stuck on it, because it doesn't seem like it it doesn't seem like society thinks it's very obvious. um
00:19:02
Speaker
But I mean, or maybe somebody is really benefiting from it. But it seems like The cultural silence, and again, this kind of does apply to so many things in women's lives, not just pregnancy loss, but the silence surrounding miscarriage and pregnancy loss, then leads us into this stigma, because if we're not talking about it, then when we do, we're getting these like stilted, stunted looks or, you know, people not knowing what to say. And so then the the person's like, wait, maybe I shouldn't have shared it at all. Maybe I should actually go back to that silence.
00:19:41
Speaker
But what happens then is that it lodges them sometimes into feelings of shame. And as a psychologist, I think that's, I'm most concerned about that place, you know, the way that shame can overtake us, the things that it can make us do or not do, you know, in terms of um addiction or other behaviors that that leave us in a place that we're not feeling good and we're not actually living the lives that we want to.
00:20:14
Speaker
Absolutely. And we can observe a lot of those behaviors in people and they can lead to a really dangerous place. I mean, we've seen a huge increase sadly in things like suicidal ideation on our live chat and online communities. And I'd argue that a lot of these women are landing in these places because they're leaving a healthcare system with little to no support, no follow-up,
00:20:36
Speaker
They're then going out into the world and they're having conversations like we discussed earlier and then being met with, at least it happened early, least you know get pregnant. So then they're internalizing, I'm going crazy because I don't feel right, I feel awful and everyone's telling me I shouldn't feel okay, that I should be okay, so what's wrong with me? And it's this big spiral until you get to this place of a poor mental health outcome.
00:20:58
Speaker
We don't need to land there, right? can.
Cultural Gaslighting and Mental Health
00:21:01
Speaker
No. And I mean, the way you were describing it, it's it's very much a form of gaslighting, right? Because it's like, you start to feel crazy, even though you know your experience is your own.
00:21:16
Speaker
And because of the people around us, or because of a cultural sort of phenomenon, we end up questioning what we know to be true. And so that sort of you know, chasm, I think is what is making people feel as you say, quote unquote, crazy, or am I losing my mind? Or why can't I quote unquote, get over it? Like people want me to. And you're right, it it is dangerous, and it can lead to intractable depression or anxiety. um And then as you say, even suicidal ideation, it's really, really difficult to
00:21:55
Speaker
think that people can be feeling this way in the aftermath of loss. So what do we do? i know you've kind of talked a little bit about in your book, but what what do you need listeners to hear today? How do we change this? What can we do so that in 10 years, perhaps our daughters, our children that we do get to carry to turn that live or our family members, how do we make this better?
00:22:15
Speaker
Yeah, well, I mean, I think a lot needs to happen in terms of, you know, what is offered in our healthcare care system for mental health.
Normalizing Miscarriage: Advocacy and Change
00:22:25
Speaker
but That's sort of its own book, probably. But in terms of, you know, what I do, and what i think we can all do on a moment to moment basis is speaking up about our pain.
00:22:40
Speaker
Talking about miscarriage as if we're talking about what we're having for dinner tonight. We don't need to be quiet about it. We don't need to whisper. We don't need to. And if we have any shame or we feel our bodies failed us or we have a sense of self-blame for some reason, investigate it.
00:23:00
Speaker
Why do you feel that way? Do you really feel that way? Or is it because culture doesn't talk enough about this that you actually ended up feeling this way? You know, because a majority of miscarriages are due to chromosomal abnormalities, we know that women are not doing something to deserve this or doing something wrong. And so the fact that people are blaming themselves is incredibly problematic.
00:23:28
Speaker
But I do think The end to that is voice, is language, is sharing openly about what we've experienced so that nobody feels alone. So that by the time our kids have kids, they know that this is a possibility. I mean, I could go on and on also about how I think that in sex education, there should at least be a mention of you know, the potential for fertility struggles, one, and that not every pregnancy results in a live birth
00:24:03
Speaker
I understand all the reasons why people are afraid to include that. I get it. But that would be normalizing it. because I don't agree with them. I'm on your side 110%. in it now with my daughter. I'm going, hang on, your sex ed is still how to put a condom on a banana. Please, can we do better? Please. I know. I mean, because the only focus is, oh, you can get pregnant if you have sex and you're going to probably get a disease. So those are that that seems to be you know the the central focus.
00:24:33
Speaker
and i And I do understand, but I think because of the frequency of miscarriage, it would shape, it would really shift the zeitgeist in a profound way if we infuse this information early and young so that people didn't feel surprised.
00:24:56
Speaker
And also it can mitigate that. What I hear a lot from women is, I worked really hard. I got my degree. I went to college. I found my partner. We got married. i had a great career. I just kept working hard and I could tick each box as I went.
00:25:12
Speaker
And then this happened to me. and it was outside of my control. Yet I was led to believe to go on the pill at 16 so that you don't fall pregnant and you don't make that mistake throughout that period when you're meant to be achieving all these other milestones. And what we're actually doing women is a complete disservice.
00:25:29
Speaker
I didn't even know what an ovulation window was when I was going through this. had no idea about my own reproductive organs and what the purpose of all these hormones were. I haven't been given that education. That's not okay. And I feel like I'm really with my children now I talk a lot about them. And I'm like, you need to know these things. Because if this happens to you, you need to know that it is something that happens. And it's not your fault. And if it doesn't happen to them, but it happens to their friends, like it's, we just need them to know because it's part of being human, you know, and because it's going on around us. So it's like, We, yes, we want them to know it could happen to them, but also we want them to know that this is a normative outcome of
Storytelling and Education as Catalysts
00:26:15
Speaker
pregnancy. And so, you know, this is just something we should comfortably be talking about.
00:26:21
Speaker
And so, you know, your question of like, how do we actually change it? I do think it's through storytelling. I do think it's through sharing what we're living through. I think it's about education.
00:26:34
Speaker
And I think it is speaking up about the fact that, you know, women are getting missed and they're therefore their mental health is taking a real hit.
00:26:47
Speaker
This can't on any longer. no wholeheartedly agree. And that's why I absolutely adore and love your work. And you are using your voice in this way. and You are driving much needed change. And we will put full links to all of your work in the show
Therapy as Support for Grief
00:27:01
Speaker
notes. um Is there anything else that you'd like to add for our listeners to hear to at this stage?
00:27:06
Speaker
I mean, i you know i already did mention therapy. And of course, I'll just give a little plug for therapy because I am a therapist and believe so much in the process. you know Writing about your pain and sharing with others is key.
00:27:22
Speaker
If though you're feeling like you'd like to process this with somebody else, a trained professional, if you know of people who specialize in this specifically, it can also be a very helpful way to navigate ah the aftermath of pregnancy and infant loss. Yeah, I wholeheartedly agree. a woman that's been through four pregnancy after losses,
00:27:46
Speaker
some that have ended in babies, one of the best things I did in my last final pregnancy was seek therapy. um Like Pink Elephants' is Early Intervention Peer Support and some counselling group therapy. it's not one-on-one therapy. And For me, I needed that additional support. And the difference that made and when Rose did finally land in my arms, I was in a better position mentally to parent than say another pregnancy after loss where I hadn't had that support.
00:28:10
Speaker
I hadn't processed and dealt, I buried and buried and buried. And then I landed in a really awful position. So I'm a huge advocate for therapy for those that can access it. It is a beautiful way to be validated, acknowledged, and then to have some tools to move through this. And and again, we talk about it again, but normalize it. Right? yeah Not alone. yeah percent Awesome.
Reflections on Advocacy and Future Change
00:28:32
Speaker
I absolutely love the chat. I could, as always, carry on for hours, but I won't. I know. I have to spend hours with you I think we should. um
00:28:42
Speaker
You're incredible. We're really grateful. Thank you so, so much for coming on and just giving your wisdom in this way. It's really generous. Thank you so much for all that you do. And thank you so much for having me.
00:28:54
Speaker
I have that feeling that I've just met. a long time hero of mine. And I feel just in awe of the work that women do in this space to make this a better experience for others. It's not about us and our experiences anymore. It's not about changing it for us. It's about making a difference for those that will go next. And I think that Dr. Jessica is such a brilliant example of that.
00:29:20
Speaker
I feel there's so much power in a health professional, a psychologist speaking up and saying, before my experience, I didn't think of it this way. And these are the tools that I needed and I didn't have them. Because when they go first, that's how we then build long and lasting change, roadmaps, frameworks, advocate for the different support that we need for different communities that need support to go through this.
00:29:47
Speaker
No one should have to go through the death of their baby alone, isolated, without the tools to manage their grief. And I just think that Dr. Jessica is such an incredible example of that. I am a huge fan of all of her books. I think that if you've just had a loss, I think that I had a miscarriage is a brilliant book for you to have a look at now.
00:30:07
Speaker
I think when you're a little bit maybe further out and maybe even just a few months past the loss and you're starting to work out how I communicate this, then maybe the normalize it one is also an excellent one for you because this really does delve into the storytelling and As we talked about in that episode, the power of sharing our experiences. And what I always say at Pink Elephants is within a safe audience and a safe space, which is what Pink Elephants is. But when we tell these stories, we invoke more empathy and understanding for those that go after us. We change the narrative from at least it happened early. At least, you know, you can get pregnant too. I'm sorry for your loss.
00:30:49
Speaker
What can I do for you? or I'm here for you. And so it's by continually sharing these stories because sharing one story alone won't make ah everyone else feel seen. There are so many different experiences. So I implore you that if you really enjoyed today's podcast episode, please take the time to check out Dr. Jessica's work. She's got an incredible Instagram. She's also, like I said, a really strong advocate and a beautiful writer in this space. I am um i'm basically in awe, and that takes a lot for me in this space because I'm often challenging what's not okay. But I i can't thank Dr. Jessica Winnell for giving us her wisdom and her time on today's episode.
00:31:26
Speaker
Today's episode may have brought up some feelings that you need some extra support around. And that's totally okay. Head to pinkhelephants.org.au to access our circle of support. Your space where you can be met with empathy and support through all of your experiences of early pregnancy loss.
00:31:42
Speaker
We're here for you. You're not alone.