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I went for a 13-week appointment and experienced the deafening agony of the silent sonogram

When you are accustomed to a national fluency in the language of grief, miscarriage can be desperately lonely

Most people, even those boasting craven ideologies and in the throw of extreme political projects, place a value on pregnancy and the generative capacity of the uterus. So, it can be hard to understand the pitiless response – historical and modern – to pregnancy loss and infertility. Photograph: iStock
Most people, even those boasting craven ideologies and in the throw of extreme political projects, place a value on pregnancy and the generative capacity of the uterus. So, it can be hard to understand the pitiless response – historical and modern – to pregnancy loss and infertility. Photograph: iStock
Clare Moriarty
Sun Oct 20 2024 - 07:05

Last Tuesday was Pregnancy Loss Awareness Day and I have spent the week thinking about the history of the Irish uterus and its unusual political legacy.

I’m currently writing about early proponent of quantitative political economics and uterine prospector William Petty. Petty’s 1691 Political Anatomy of Ireland applied the data-driven instincts of his Political Arithmetick to the case of the Irish economy. Harvesting economically devastated Ireland for data “as Students in Medicine practise their inquiries upon cheap and common Animals”, he looked to remedy the national ills.

His work is an early example of the idea that biological reproduction and national productivity can be forced into some kind of useful harmony. He argued that Ireland was underpopulated, with 10 acres of good land for every person (compared to four in England and France). In private writings, he suggested dissolving marriages that did not result in children within six months and penalising women who did not produce a child every three years.

A post-conference dinner in Belfast last month placed me opposite a scholar writing about the reliance of women on informal online networks to find information about a now-banned female sterilisation device that had disastrous side-effects for patients. Discussion turned to the historical burden born by the women of west Belfast to help shift the confessional demography of Northern Ireland. Her granny had described visits from the parish priest when each newborn would hit three months, arriving with the message to get another one in the oven. Unrelenting pregnancy, she said, was a manifesto of priests and paramilitaries alike.

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Farther afield, even JD Vance’s craven “childless cat ladies” remarks imply a backhanded regard for the business of childbearing. Obviously, the position betrayed is one according to which women are to be valued for nothing but having children (and a specific biological version of it, since the key target of his remarks is reportedly very close to her stepchildren). Since the context was supposing that adults without children couldn’t claim any “direct stake” in the future, I think it speaks more about his limited capacity for social investment than anything else.

The conclusion I draw is that most people, even those boasting craven ideologies and in the thrall of extreme political projects, place a value on pregnancy and the generative capacity of the uterus. So, it can be hard to understand the pitiless response – historical and modern – to pregnancy loss and infertility.

Those miscarrying in Ireland usually do so alongside pregnancies that end in live births. You queue to register for D&C surgery alongside women checking in for inductions and sections. Misery and joy can be bad neighbours. Women with crying newborn babies may walk by your room as you recover. Though there are usually specialist midwives focused on bereavement, there are access issues and it can be hard to get through. You may have to ring around general numbers, articulating your loss and circumstances to numerous different people to get what you need. Bad infrastructure enhances the cruelty of misfortune.

Then, most miscarriage is followed by urgent, desperate attempts to reconceive. It’s great that some public support for IVF treatment has finally become available, though not, if, for example, you’re single, a woman over 40 (our mean maternal age is now 33.3), or if you have a BMI over 30 (important to incorporate a weight loss agenda into one’s fertility panic, on top of everything else).

There is no formal work leave for those who lose a pregnancy before 24 weeks. There has been a draft Bill in place since 2021 and it’s currently not tabled again until 2025. The Bill would provide 20 days’ paid leave following miscarriage, and 10 days’ leave to those seeking fertility treatment. It’s not perfect, but something beats nothing by a decent margin.

I lost a pregnancy two years ago. I went in for my booking appointment at 13 and a half weeks and experienced the deafening agony of the silent sonogram. I would have done anything to stay in the hospital and have the procedure immediately, but had to go home to wait a few days before it could be scheduled. In those intervening days, I felt like a human coffin, shuffling my sad burden around with me, and worrying my body would take matters into its own hands.

When I had the procedure, it was painless and civilised, and I was treated with great kindness by all I met. I wrote about it in the aftermath, and I can’t count the number of friends who then revealed they had also been through something similar. People whose grannies’ funerals I attended lost pregnancies I never knew about. Such is the cloak of quiet that surrounds much pregnancy loss. Of course, people are entitled to privacy, but it’s easy to suspect that the tradition of only telling people about pregnancy after week 12 (thought to mark a particular threshold of likelihood of foetal survival) was about more than sparing mothers.

I believe Ireland is a country that handles death well. The day I had a surgery to remove my ill-fated little foetus, my brother died suddenly the same night. The complex mechanisms of the Irish funereal orchestra set into motion, and I experienced the full suite of grief support – the wake, the lock-in, the best-pal trip to Kinsale, and the constant, enduring influx of love. I wonder if miscarriage often feels so lonely because we are accustomed to a national fluency in the language of grief, and it’s often completely absent when a pregnancy is lost.

Dr Clare Moriarty is an Irish Research Council postdoctoral fellow at Trinity College Dublin. Support is available from pregnancyandinfantloss.ie