I knew we weren’t going to get good news, so I turned away. Technically, we hadn’t received any news at all—the ultrasound technician had said perhaps ten words the whole time—but that was its own evidence.
When previous scans had been normal, it had been apparent fairly quickly. Because of liability issues, technicians aren’t supposed to say much, but body language and demeanor say enough. When the technician cheerily points out the baby’s head, its chin, its heartbeat, fears are quickly alleviated.
Our technician didn’t speak and hardly looked at us. She stared straight ahead at the monitor. One hand operated the machine’s controls, and with her other arm, she somehow manipulated the ultrasound’s transducer without looking, almost as if she were an extension of the machine.
Other than the whirring of the equipment, the only sound in the room was a repetitive series of beeps—still frames for the radiologist to review. As this was our second pregnancy and something like our sixth ultrasound, we knew what we were seeing: Right ovary. Left ovary. The fetus, but no heartbeat.
A picture of a baby.
That was the first thing my wife and I saw after learning that we had suffered our second miscarriage. We were in the ultrasound examination room, and I’d just turned away from the black-and-white screen, and there it was, a picture of a baby—probably six or seven months old—staring straight at me. It was on a poster advertising for Philips or GE ultrasound machines, I can’t remember which, and it showed the week-by-week development of the fetus in utero.
Like all sudden loss, our grief was seismic: there was the great initial shock, then a myriad of lesser tremors: Diapers commercials. A friend who wasn’t supposed to be able to bear any more children announcing a pregnancy. The entire stage full of teen moms on Maury Povich. These things are always happening, but after a miscarriage, you take every successful pregnancy personally.
In our first pregnancy, we made the mistake of getting excited. We bought baby clothes, started designing a space-themed nursery. As we were more familiar with the mechanics of conceiving a child than the intricacies of embryonic and fetal development, we read What’s to Expect.
Early in the pregnancy, we referred to the fetus so much that it almost became a character in our everyday lives. At first, we called it “the B” as in “the baby,” but that wasn’t catchy enough; I’d read about the blastocyst stage in What’s to Expect, so I suggested we come up with an alliterative name for it. Even though we were technically past this stage of development, I suggested “Bill the Blastocyst” (B the B, for short). The wife agreed.
The eventual plan was to vary the name during different stages of development: Eduardo the Embryo, Frank the Fetus, but for whatever reason, the name Bill stuck.
Bill became a regular feature of our daily life. Before I left for work in the mornings, I’d address Bill by putting my head next to my wife’s belly and yelling, “Good morning, Bill! Have a wiggly day!”
On my lunch break at work, I’d use my phone’s rudimentary drawing program to create family pictures of sorts. They’d feature stick-figure versions of my wife, me, our dogs, our cats, and Bill, a wiggling—and always smiling—cluster of cells.
As the pregnancy progressed, I’d change the images to reflect Bill’s development. If you follow along in What to Expect, a lot of attention is given to the size of the fetus as it develops and most of the comparisons in the book refer to fruits or vegetables. In week five, your baby’s the size of an orange seed. By week eight, it’s a raspberry. By the ninth week, an olive. (To this day, every time I’m in the produce section, I think of babies.)
My drawings reflected the produce item of the week. For instance, when Bill was the size of an olive, my drawing showed our happy family and Bill, a smiling anthropomorphic olive floating in a martini.
In ancient Rome, when armies underperformed or were deemed mutinous or cowardly, the incensed generals sometimes resorted to decimation.
The practice is simple. Soldiers were divided into groups of ten. They drew lots, and one solider out of the ten would be beaten or clubbed to death by his comrades. A barbaric practice, today the word “decimate” is rightfully synonymous with outright destruction.
But decimation is outright merciful compared to miscarriage. According to most estimates, one in four pregnancies ends in miscarriage.
You already probably know a woman who has had at least one miscarriage, but you may not realize it. Miscarriage is one of the most common types of loss, but one of the least discussed.
In some ways, this makes sense. After we experienced our first one, my wife and I didn’t want to talk about it to each other, let alone to anyone else. There was simply nothing new to talk about: the pregnancy had failed, the lifeless fetus was still inside her, and our primary concern was removing the remnants before they could turn toxic.
It was something we simply had to endure.
This didn’t stop the questions from well-intentioned friends and coworkers. Right after it happened, my wife and I bristled about any questions pertaining to the miscarriage. Even seemingly innocuous ones such as “How are you doing?” were aggravating because it was pretty clear that the questioner didn’t want a truthful response.
In private, my wife and I would commiserate about these endless inquiries and share our imagined responses. Mine would usually go like this: How the hell do you think I’m doing? Let’s see, our future child is dead, its decaying remnants are still in my wife; if the pharmaceuticals don’t remove the remnants of the fetus, my wife will have to be anesthetized and undergo a potentially dangerous surgery, one that might make it even more difficult for us to have children, as if we needed any help there.
That sounds bitter and angry—and I was—but the anger was directed at the situation, not the friend or family member. It’s impossible not to be angry after a miscarriage, and in retrospect, this may be one reason that miscarriage isn’t discussed: friends and family are often rebuffed right away, so they don’t bring up the issue later, when the mother and father are more capable of reflecting on it.
My advice is simple: When someone you know undergoes a miscarriage, treat it like any other sort of loss. Be there, buy them a drink—or five—and let the would-be parents talk when they are ready, but don’t force the issue.
As much as I came to dread visiting the ultrasound exam room, the images themselves were beautiful. The strange shapes warp from one to the next, something like a living Rorschach test.
As an expectant father, you quickly get used to being a bystander. You stand by when you announce the pregnancy to her family, and even when you announce it to yours. You stand by when friends and family rub her stomach and when strangers at the supermarket strike up conversations about—and sometimes with—your wife’s belly. If all goes well, you stand by in the hospital room encouraging her to keep going, to push harder.
All of this attention is well deserved. After all, you’re not the one wracked by hormones, nausea, and back pain, and who wakes up one morning to discover your nipples are suddenly the size of a small nation.
But you’re never more of a bystander than when you don’t see a heartbeat on the ultrasound monitor. That was the worst part for me, the utter helplessness, knowing that there was no way to stop my wife’s suffering, or my own.
My wife and I were vehemently pro-choice before the miscarriages. You might think that experiencing a miscarriage changed our views, but it didn’t. On the contrary, it galvanized them because it laid bare a basic truth: mourning what might have been is not the same as mourning what actually was.
I unfortunately had the opportunity to compare these types of losses. My grandfather, whom I was close to, died just before we went through one of the miscarriages. I didn’t mourn our miscarried child in the same way as I mourned my grandfather. I couldn’t. I wasn’t mourning the same type of loss.
Even my first faith, Catholicism, seems to implicitly concede that a fetus is metaphysically different than a living, breathing child. Original sin doesn’t affect a child until it has entered the world. Until then, a fetus is something else—a category unto its own. An unbaptized fetus is not subject to perdition; an unbaptized newborn is.
Our first miscarriage was a “missed-miscarriage”; the pregnancy failed in the fifth or sixth week; we found out in the twelfth. For half the pregnancy, the fetus was alive. For half, we just thought it was.
During our second pregnancy, we saw the fetus at seven weeks; its heartbeat was fine, but the gestational sac was small. We went back at nine weeks, and the heartbeat was slower than it should have been. At week ten, there was no heartbeat.
After your second miscarriage, you’re essentially treated as high risk. This entails additional doctor’s visits, early ultrasounds and no small amount of stress: the threat of another miscarriage might as well be sitting in the exam room with you.
During our third pregnancy, everything was hypothetical. My wife and I both conditioned ourselves to expect another miscarriage and we only spoke of our future plans in general terms. I remember saying, If we get out of the first trimester, we can start designing the nursery again. That might seem fatalistic, but it was the only way for us to operate.
As I’m writing this, my six-month-old is right next to me. It can get better.
 During the second pregnancy, we attempted to avoid getting our hopes up—but we did stick to the B the B format. The codename for the second pregnancy was Bertha. In our third pregnancy, the codename was Bernard.