[VIDEO] Should We Reject the Code of Silence? Early Pregnancy Conversations and IVF
You're waiting. Counting the days until you can share your pregnancy news. We're taught that sharing pregnancy news is safe at 12 weeks or maybe 13 weeks but that telling anyone before that is an iffy idea, at best.
Where'd we learn this? What are the facts behind miscarriage, pregnancy loss, and silence?
Facts About Pregnancy, Miscarriage, and Loss
Laura Malcolm, CEO of Give InKind, an organization she built with her husband after facing the devastating loss of a 35 week old pregnancy, describes why she shared her earliest pregnancy findings, even after that loss. She also explains how Give InKind is devoted to supporting those in need, without putting undue pressure on those grieving.
Because the American Society for Reproductive Medicine is one of the most highly respected expert resources when looking at the innumerable articles that are out there about in vitro fertilization (IVF), we turned to them for the facts that you can count on, updated whenever there are new research and data.
Why Early Pregnancy Talk is Considered Taboo
A major reason that we don't talk about an early pregnancy is the risk of loss. That feels even more tender when fertility treatment and infertility have been part of the picture.
But what about “pregnancy loss” makes telling the news so off limits? Why is that so different than the other deeply significant and personal aspects of our lives that we discuss in the early stages? Our friends and family are precisely the people we go to discuss critical job interviews and career opportunities, possible homes we're trying to buy, a strategic move across the country, or the possibilities of a budding, romantic relationship, just to name a few. Why is early pregnancy so different?
Why don't we let our friends and family in at such a fundamental time of our lives?
Let's start with some pregnancy and miscarriage facts.
If fear is the overriding reason, here are some actual facts to consider.
4 Miscarriage and IVF Facts You Need to Know
- One in four pregnancies ends in miscarriage, making pregnancy loss a heartbreakingly frequent occurrence.
- Although miscarriages decrease dramatically after the second semester has begun, pregnancy losses still occur.
- Preimplantation Genetic Testing (PGT) dramatically decreases the chance of a miscarriage. PGT is a test that can determine chromosomal abnormalities or mutations within an embryo that is created through in vitro fertilization.
A report released in October 2019 at the American Society for Reproductive Medicine conference, "In the largest study to date examining the usefulness of preimplantation genetic testing for aneuploidy (PGT-A), for patients with recurrent pregnancy loss (RPL), Rutgers researchers report that PGT-A is associated with significant improvements in live birth, clinical pregnancy, and spontaneous abortion rates, especially in women over the age of 35."
- IVF does not increase the chances of a miscarriage. According to the American Society for Reproductive Medicine, "The rate of miscarriage after IVF is similar to the rate following natural conception, with the risk going up with the mother's age."
Dr. Joshua Hurwitz, MD, one of the reproductive endocrinologists at RMA of CT, had these encouraging words to share as well, "Up to one in four women will experience pregnancy losses but will then go on to have a healthy pregnancy without complications."
Starting the Conversation Around Miscarriage Despite Our Fears
It's slowly starting to change, but here are the top five reasons, in my opinion, why early pregnancy news is not shared with friends and family:
- First and foremost, we're worried about a pregnancy loss.
- We worry about “jinxing” it.
- It's private.
- We don't want to follow it up with bad news if we do have a loss.
- We're afraid our friends and family won't be supportive or helpful.
But what if we pushed beyond these fears? What if we allowed ourselves to open up to our loved ones and gave people a chance to be supportive of us, no matter the outcome?
Vogue writer, Dan Schwerin did just that.
He and his wife shared their pregnancy news early, saying, "we figured that if something went wrong, we'd want the support of our loved ones more than ever."
After having to disclose the indescribably sad news about a medically necessary termination of a much wanted pregnancy, Dan said this, in reference to their family and friends knowing from the very beginning of their pregnancy.
"I had wondered if it had been a mistake. Now, I felt enormously grateful."
For Dan, being open had the intended consequences, a lot of support when he and his wife needed it most. He is quick, however, to point out that this is not true for everyone.
One question. Is it true for you?
Is there a happy middle ground? Telling some trusted loved ones but not necessarily everyone.
Laura Malcolm, CEO, and Founder of Give InKind answered questions about why she and her husband, James, made the decision to share their pregnancy news early and why she advocates for being open when possible, acknowledging that this is a highly personal decision.
She reveals that by sharing the pain, by talking about it, by shedding light on such a painful topic, we are all better off.
Interview with Laura Malcolm: Pregnancy Sharing and Loss
LR- You have a very personal reason as to why you started Give InKind. Would you share that with us?
LM- My husband and I lost our first daughter when I was 35 weeks pregnant. It was completely unexplained and, of course, unexpected. Our friends and family from around the country wanted so badly to help us, but they didn't know how - emotionally or practically. We wanted to create an easier way for loved ones to show up for one another, one that was more suited to our on-demand and digital lives.
LR- Thank you for sharing that intimate look into the beginning of your company. I want to step backwards to an earlier time in pregnancy- the first trimester. Because the risk of miscarriage is so high, our society encourages NOT sharing the news until after that time. Can you tell us your thoughts on why sharing the news earlier could actually be helpful?
LM- Keeping early pregnancy quiet has conditioned us to grieve alone. Because there's often no medical support needed for early pregnancy, women are sent home with an 'I'm sorry' and Tylenol, told to watch for clots that are too big, etc. How terrifying is that without knowing how many of your friends or family members have been through that same experience and could offer their support? If we keep early pregnancy from even those closest to us, we feel 'relieved' when we didn't tell anyone, because we don't have to ‘untell.’ All this does is continue to have us unaware of how many women we know that have walked this path ahead of us.
LR- The pushback I've heard is that it's painful to have to talk about, so keep it more private. What are your thoughts about that?
LM- Of course it's painful to talk about - that doesn't mean we should keep it more private. Postpartum depression and anxiety are difficult to talk about. But the more we talk about it, the more we learn how common it is, and the less likely we are to feel shame around pregnancy loss, or infertility, or failed IVF, or any of the many journeys so many of us have taken to either having children or not.
Because we don't talk about it, we have people walking around in pain; we have moms-to-be and dads-to-be not getting support and empathy. Because we don't talk about it, it never becomes an accepted part of life to talk about. Because we don't talk about it, we're alone in our pain. Because we don't talk about it, we don't discover the right things to say that are helpful and avoid unhelpful or painful things to hear when you're the one suffering.
LR- What do you think about the "not pregnant enough or not very pregnant anyway" theory of things?
LM- The moment you find out you're pregnant (and I'd say even before that - the moment you decide to try), the hopes and dreams start. There may be a physical difference in the way those pregnancies end, but the emotion is no different. We have no idea how much families have riding on that pregnancy - the seemingly easy first one that was actually a year of treatments and transfers. The family facing secondary infertility, with friends and family assuming they don't want more kids. Or in our case, having one of the first girls in our family, due the exact same day as my sister-in-law with another baby girl. From the moment we both shared that we were early in our pregnancies, and then both found out we were having girls, our whole world revolved around those pregnancies. The loss would have been as significant had it happened at 8 or 18 weeks as it did at 35.
LR- Would you like to see women and men sharing pregnancy news earlier?
LM- I would like us to be more comfortable celebrating the ways that people want to share. We honor a mother that wants to post a pregnancy test, or that she's had a transfer, or that first ultrasound. I'd like to move towards a society that talks about things more so that actions can also be taken to support people throughout their journeys. We built Give InKind with the premise that we've moved away from community support. If we were better about creating a space where our loved ones could say ‘this is hard,’ we can so much more effectively mobilize when our loved ones need us, and that collectively moves us all forward.
LR- What would you offer those people who feel this kind of sharing is too private?
LM – I think how private it is, is a decision to be made by those experiencing the loss. If I have learned anything through my own experiences and then through Give InKind, it's that we all grieve so differently and that the most beautiful thing we can do for one another is just show up, listen, and offer support. For some people, that means staying private, and that's ok. For others, sharing those experiences and photos and getting the positive reinforcement of support truly helps us move through that time and know that our community will continue to be there for us as we continue on our journey.
LR- There should be a list of the wrong things to say. For me, anything to do about gratitude was unhelpful to me. Might be right for someone else, but not for me. Taking the lead from the person in pain is always the best thing. Offering to listen was the kindest thing I was offered. What do you think?
LM- Each of us grieves in our own time and way. Sticking to "I'm here for you" or "I care about you" and letting someone share their experience is an incredibly loving thing to do. Even I make mistakes sometimes; I know I've said the wrong thing before. We really have to just lead with empathy - you're almost never wrong if you lead with empathy (which, is not the same as sympathy, which many people lead with).
LR- Final words of wisdom for those suffering from the effects of a pregnancy, stillbirth or infant loss?
LM- You're not alone. Let others in. Let others help.
Share your story. It may be a light for someone else in the dark, hurting and in need of help. I agree with Laura: You're not alone. Let others in. Let others help.
Looking for more support? We’re here for you.
About Lisa Rosenthal
Lisa has over thirty years of experience in the fertility field. After her personal infertility journey, she felt dissatisfied with the lack of comprehensive services available to support her. She was determined to help others undergoing fertility treatment. Lisa has been with RMACT for eleven years and serves as Patient Advocate and the Strategic Content Lead.
Lisa is the teacher and founder of Fertile Yoga, a program designed to support men and women on their quest for their families through gentle movement and meditation.
Lisa’s true passion is supporting patients getting into treatment, being able to stay in treatment and staying whole and complete throughout the process. Lisa is also a Certified Grief Recovery Specialist, which is helpful in her work with fertility patients.
Her experience also includes working with RESOLVE: The National Infertility Association and The American Fertility Association (now Path2Parenthood), where she was Educational Coordinator, Conference Director and Assistant Executive Director.