As she underwent in-vitro fertilisation (IVF) in early 2022, Ashley Spivey took her nearly 86,000 Instagram followers along for the journey, sharing updates under the highlight “Lil ‘Bryo.” The process resulted in a pregnancy, which she immediately revealed on her platform. And when she miscarried just days later, Spivey gave her followers the heartbreaking news in real-time.
Sharing news of a miscarriage on social media is nothing new in 2022 — society has, undoubtedly, come a long way in recent years. Pregnancy losses were often suffered in silence and secret; now, they’re something people are encouraged to talk about, at least in many circles. But Spivey, 37, revealed her loss to her thousands of followers in a way that’s not often seen on social media…or, really, anywhere. She issued a trigger warning before explaining that she had been at dinner with friends when she felt “a gush.” She looked down, saw blood on her seat, and knew what was happening. Then, Spivey did something many people don’t dare to do: She posted an arguably graphic photo of her blood-soaked jeans on her platform.
Ashley Spivey wants to change the way society talks about miscarriage
While people are finally having conversations about miscarriage, there’s still an incredibly vague cultural understanding of what they actually look like or entail. That’s why Spivey, who appeared on season 15 of The Bachelor, shared her news in the way she did. “This is my reality. Miscarriage is graphic and painful and too many people hide it to make everyone feel comfortable,” she wrote in an Instagram story following with the picture of her bloody pants.
“I think people think [miscarriage is] something that happens and then just magically everything goes away. That there’s not a physical aspect,” Spivey tells Shape. A 2013 study confirms that, when it comes to miscarriages, misunderstanding abounds. That’s why, if you’ve ever experienced one, you’ve probably been asked something along the lines of “so…how does it happen?” — or worse, had your trauma invalidated with a comment such as “maybe your pregnancy test was a false alarm.”
There isn’t a singular experience when it comes to pregnancy loss. In some cases, such as in Spivey’s most recent loss, bleeding or cramping will be the first sign. “The embryo detaches from the lining of the uterus where it had implanted and the detachment combined with the breakdown of the uterine lining (from the withdrawal of pregnancy hormones progesterone and HCG) leads to cramping and bleeding,” says reproductive endocrinologist Lucky Sekhon, MD. “There can be passage of clots and tissue and the actual fetus, depending on how far along into a pregnancy someone is when they experience the miscarriage. It is normal to have a heavy amount of bleeding in the initial phase of a miscarriage. In some cases, the bleeding can be excessive and requires medical attention.”
In other instances, a person may go in for a routine ultrasound and learn the pregnancy is not viable. If this happens, they may choose to undergo a surgical process called a D&C to remove tissue from the uterus. And then in other cases, a person will have an incomplete miscarriage, which means they’ll experience the bleeding and cramping, but still need a D&C to completely clear out their uterus.
Regardless of how a person experiences them, miscarriages aren’t just emotionally devastating, they’re also serious physical health events. Sadly, they’re still not treated as such: There’s the cultural misunderstanding, of course, but it’s also bigger than that. While bereavement leave is something many employees can access after weathering a significant loss (such as the death of a family member), paid leave after miscarriage is not the norm. Spivey frequently uses her platform to advocate for this to be changed.
“I wanted to show people what a miscarriage looks like because this is actually the first one I’ve had that’s not a missed miscarriage, which is where I see on an ultrasound that I’m having a miscarriage. [That type of loss] doesn’t seem like such a violent occurrence in your body,” says Spivey. “But this miscarriage happened to me in a popular restaurant and there were people all around. It was so surprising and so heartbreaking. When I think about all these discussions about paid leave around pregnancy loss, I think one reason why people haven’t offered it in the past is because they don’t have any experience with it. They don’t know everything [that comes along with miscarriage]…I need to show other people who haven’t experienced this and are having difficulty understanding why people need this time off of work after a miscarriage. I want to make this real for them.”
“A miscarriage can take days; it can take weeks,” she continues. “[With] one of my last miscarriages, I had a D&C procedure and one month later, there was still tissue [in my uterus], so I had to have a second D&C. People don’t realise what a miscarriage looks like, how long it can take, how much time you do need off to take care of everything that goes into having a miscarriage.”
In the days and weeks after a miscarriage, “continued spotting and on and off cramping is normal,” says Dr Sekhon. “You may feel physically weak and given the emotional and mental toll, you may feel unmotivated, lethargic, depressed. It can be hard to function normally in the first few weeks and months after a miscarriage…It is a very distressing event in a person’s life and there should be paid time off to accommodate those who have experienced a miscarriage.”
Speaking up about the common nature of miscarriage has been normalised, but it isn’t enough. It often feels as if sharing statistics about miscarriages is the go-to response when someone experiences one. People say things such as “It’s so common. Up to 20 percent of pregnancies end in miscarriage,” presumably with the intention of making others feel less isolated. But often those statements can feel terribly minimising — and an awful lot like toxic positivity.
“There’s something in our brains that must just shut down when we hear the word miscarriage or even stillbirth,” says Spivey, who also lost her son CJ to stillbirth (meaning after 20 weeks of pregnancy) in 2020. “It’s something people feel very uncomfortable talking about. When you have a friend talking about your miscarriage, they want to offer something to make you feel better. A lot of times they say something that makes you feel worse. I wish people would just listen to miscarriage stories and talk about how awful it is, or talk about how unfair it all is instead of trying to make someone feel better. I wish more people could sit in the uncomfortable-ness.”
It’s time to think beyond the statistics and start talking about the ugly realities of miscarriage — because if one thing is clear, it’s that societal awareness of pregnancy loss is poor. This shouldn’t come as a real surprise: People are still working to shed remnants of the long-held idea that miscarriages should never be revealed (think: that “don’t announce your pregnancy until after the second-trimester” rule). Even now, social media users are still talking about pregnancy loss in a way that feels heavily filtered in order to keep others comfortable, with cutesy terms, such as “rainbow baby” (which refers to a child born to parents after a loss), “baby dust” (a statement to express good luck to a couple trying to conceive), and “sticky bean” (to reflect the hope that a pregnancy will “stick” in the uterus instead of being lost to miscarriage), dominating conversations about fertility challenges online.
It’s understandable that people are squeamish when talking about pregnancy loss, but if more people push through that discomfort, maybe that can lead to change, both culturally and institutionally. And maybe then, miscarriage sufferers won’t have to jump right back to work with broken hearts and bodies that are still in the midst of healing.
Many of Spivey’s followers who don’t want children or are still a long way off from family planning are initiating conversations about paid leave after miscarriage with their companies’ HR departments. That speaks to the power of being so open about what miscarriages really look like and the toll they take on the body. As a society, we need people who are not directly affected to speak up — in part because, if Spivey’s observations are any indication, many pregnant employees are afraid to bring up this topic for fear of losing their jobs. Aside from that, it’s unfair to demand miscarriage sufferers take on all the emotional labour of leading these discussions.
At the same time, the voices and stories of miscarriage sufferers carry enormous weight. If the world can’t see the gory, grim realities of miscarriages, things won’t change and what those affected by miscarriage are working with now just isn’t working. Need proof? See Spivey’s Instagram highlight “Paid Leave Misc” for real, heartbreaking stories of people who have to work immediately after — or in some cases, during — their miscarriages, make excuses when leaving work for medical appointments, and use precious chunks of paid time off in order to recover at home.
Still, it’s important to note that strides are being made. Months ago, Senator Tammy Duckworth and Congresswoman Ayanna Pressley introduced a bill called the Support Through Loss Act. The bill has been introduced, which means it must undergo several additional steps before it’s written into law. If passed, this would guarantee a minimum of three days paid leave after a miscarriage to many employees. But right now, it’s up to companies.
Want to help? Look into your employer’s bereavement policy to see if miscarriages are covered under them. Bring this topic to your HR department’s attention. Find and contact your local representative to express your support for paid leave after pregnancy loss. By working together to change the conversation and the policies around miscarriage, you can help alleviate one logistical nightmare from what is already an unbearably difficult situation.
This story first appeared on www.shape.com
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