'How one doctor’s dismissal inspired me to campaign for better miscarriage care.'

This is an edited extract from Hard to Bear by Isabelle Oderberg. Out now with Ultimo Press. 

‘If women were educated about miscarriage in school, then this wouldn’t happen,’ the doctor said, gesturing towards me. All of me. ‘You’d know miscarriage was just a normal, natural thing that’s supposed to happen and you wouldn’t be crying about it.’

It was June 2018. I was in the middle of my sixth miscarriage, sitting in a chair, bleeding, cramping and sobbing into a tissue. I was in the office of one of Melbourne’s most pre-eminent obstetricians. A Cervical Celebrity.

As I walked out of his office, paid my bill and dragged myself towards my car, keeping my head down because my eyes were as puffy as campfire marshmallows, I had a moment of clarity, through the grief and the hormones.

This obstetrician spoke as a clinician who views a miscarriage solely through a scientific lens; a loss like mine was simply a chromosomally challenged cluster of cells, not compatible with life and requiring expulsion or removal. This man had delivered hundreds, possibly thousands, of babies and he was one of the best in the state, possibly the country.

But I also knew he’d never felt a baby move inside him; he’d never felt that magical connection, then lost it. A miscarriage is a full stop, when you want to keep reading.

Watch: Mia talks about feeling lost after miscarriage. Story continues after video.

There would be no happy ending with a perfect cherub in my arms, keeping me awake at night, giggling at me as I blow raspberries on her tummy, and peppering my life with the hilarity of projectile vomiting and explosive poonamis.

This was a feeling that the obstetrician would never understand and, despite decades working in obstetrics, it wasn’t something he was trying very hard to understand. A doctor doesn’t have to be female or have experienced pregnancy to show compassion or empathy and provide high-quality care, but all doctors have to listen. And there wasn’t a lot of listening going on in that room.

Even though I have come to understand what he was trying to tell me, his gruff dismissal of my grief is only one example of how I felt unsupported in the midst of this loss. And it’s a common experience. I think many people, especially doctors, would be horrified if they truly understood some of the trauma they’re causing their patients with their words, actions or inaction.

Patients and those close to them are routinely failed in myriad ways before, during and after miscarriage. They may be failed by medical specialists, a lack of medical knowledge or a lack of answers to better explain their situation. Or maybe it’s a lack of understanding from partners, friends and family. The loss associated with miscarriage can be debilitating and affect all areas of a person’s health: physical, psycho-logical, emotional, spiritual and social.

In Australia, a conservative estimate is that each and every year at least 103,000 families experience miscarriage; the definition of miscarriage being the loss of a pregnancy before twenty weeks of gestation. A vicious catch-22 applies to miscarriage and pregnancy loss. It is the most common ‘complication’ of pregnancy, and yet due to it prevalence there is a level of complacency and dismissiveness towards it, despite the trauma it can cause, both physically and mentally.

I found it absolutely fascinating when I read the autobiography of one of Australia’s most renowned obstetricians, Professor Caroline De Costa. The book traversed her entire career across multiple continents and all the different cases she treated. Stillbirth? Yes. Fistulas? Yes. C-section versus vaginal birth? Yes. She opined extensively on her activism around abortion rights. But nothing about miscarriage.

In 2020, non-profit health service provider Jean Hailes for Women’s Health added some questions about miscarriage to its national survey. It found that among almost 4500 respondents from around Australia who had been pregnant, more than a third had experienced miscarriage, with that number rising to over 40 per cent among those with a disability. Almost 60 per cent of respondents overall said they had not been given enough information about miscarriage (or stillbirth) to manage their loss.

We are failing people who experience pregnancy loss, whether they have that experience directly, or as a partner, a family member or as a part of an extended support network. We are failing them in almost every aspect of their care.

Listen to No Filter with Mia Freedman, This episode covers the difficult and emotional topic of miscarriage. Story continues below.

Early pregnancy loss can lead to severe depression, PTSD, anxiety or even suicide. A lack of cohesive and effective public health policy, and the related deficiencies in care, can compound the trauma and related fallout. It can even affect the way we parent subsequent children, if we are able to conceive successfully. It can be a potential marker for other adverse pregnancy outcomes such as preterm birth and increase a patient’s likelihood of heart attack, thrombosis or stroke later in life.

But the good news is: we can fix this. There is a way forward. And that’s why I decided to write Hard to Bear: Investigating the science and silence of miscarriage. 

My book is – as all investigation or analysis should be – under-pinned by a broad and diverse range of lived experience. Not just mine, but the hundreds of people I have engaged with over the past eight years. Whether a person has experienced one loss or seven, there are commonalities in that experience that weave their way through almost all the stories I hear, in the grief, the loss and, far too often, the disappointment from failures in care.

I have also made a concerted effort to include as broad a range of experiences as possible; miscarriage affects all people, no matter their gender, sexual orientation, ethnicity, colour of their skin, class, religion, disability or anything other aspect of their identity or reality.

While the Cervical Celebrity wounded me with his dismissal of my grief and my experience of loss, he also gave me a great gift: the desire to write this book and find a way to improve care in every way for all people affected by early pregnancy loss.

Feature image by TJ Garvie. 

After growing up in Hong Kong, Isabelle Oderberg went to university in Melbourne. She has worked as a journalist for two decades in newswires across Europe, Asia and Australia, where she was the country's first social media editor for Melbourne's Herald Sun. Her work has appeared in The Age/SMH, Guardian, ABC, Meanjin and elsewhere. She has also worked as a media and communications strategist across the not-for-profit sector. Hard to Bear is her first book.