Considering Miscarriage in a Pro-Choice Frame

An important source of inspiration for this column came from a conversation with the beautiful, strong, and wise Sara Colb, Associate, Day Pitney LLP.

I recently had occasion to think about an issue that seldom arises in everyday conversations about abortion and reproductive rights: how do pro-choice advocates think about the profound loss that many women suffer when they miscarry a pregnancy? In this column, I will consider some answers to this question, but I first want to situate the question in the context within which it arose, though the context will initially take us a bit afield of the question itself.

Last month, Cornell University for the first time hosted the Ivy League Vegan Conference, the fourth of its kind and the second in which I had the honor of speaking. Present company excluded, the conference included numerous illustrious, prestigious, and fascinating speakers on some of the many features of veganism, moral, intellectual, and biological, and the day was filled with useful and sometimes surprising information. My husband and fellow law professor Michael C. Dorf and I gave two presentations (one each), followed by a joint question-and-answer session, in which we discussed some of the material in our forthcoming book, Beating Hearts: Abortion and Animal Rights (Columbia University Press). My presentation asked whether it is morally consistent to be both pro-choice on the issue of abortion and an ethical vegan on the issue of animal rights. Michael’s presentation asked whether a painless killing harms the animal (or human) who is killed. The question that sparked my thinking about miscarriages and reproductive rights emerged during the joint Q & A session.

At the time the particular audience member offered his query, I failed to fully appreciate its importance for the issue of the uneasy relationship between miscarriage and abortion within the pro-choice framework. As I mentioned, my presentation was aimed at analyzing whether one could reconcile a pro-choice view of abortion with the choice to be an ethical vegan—that is, to avoid as much as one can, the consumption of the products of animal exploitation, including dairy, eggs, flesh, wool, and leather.

To learn more about my answer to this question, I recommend reading chapter 7 of my book, Mind If I Order the Cheeseburger? And Other Questions People Ask Vegans, and I also recommend reading the more extensive and thorough treatment of the links and lines between abortion and animal rights in Beating Hearts, as soon as it is published. One of our audience members at the Ivy League Vegan Conference, however, managed with his question to inspire in me an interest in a separate question: How does a pro-choice person think about and reconcile with her own values the grief in loss of an embryo or fetus that many women experience in a miscarriage?

The questioner did not pose precisely this inquiry. Instead, he asked a rather personal question. He addressed Michael and asked whether, if Michael suddenly learned that I was pregnant, he (Michael again) would feel like a father to the new life, regardless of its/his/her stage of development. I made a sardonic comment under my breath, while Michael answered with an unequivocal yes.

The man’s question was aimed primarily, I think, at the point that my own presentation had been emphasizing: the fact that the overwhelming majority of abortions take place prior to fetal sentience (i.e., prior to the fetus’s capacity to have pain or other feelings), whereas the exploitation of animals harms fully sentient beings. Yet the question has relevance that goes beyond this comparison between abortion and animal exploitation.

I interpret the question as relevant to miscarriage because it highlights the fact that pro-choice people share something quite profound with pro-life people: the sense of excitement, joy, and love that they experience upon hearing the news of a wanted pregnancy, a pregnancy that they plan to see through to birth. When people want to have a baby, they delight upon learning of a pregnancy, even if it is still only at an early stage and regardless of what the particular people’s political position might be on the proper legal and moral status of abortion.

Likewise, if this celebrated pregnancy were to end suddenly, through a miscarriage (also sometimes called a “spontaneous abortion”), the reaction of the woman (or the couple) who had eagerly anticipated the birth of her/their child could be expected to be grief and sadness, again despite the early stage in pregnancy and again regardless of one’s political view of abortion.

Why Reproductive Politics May Not Connect With Miscarriage Grief

Why is that? Why does one’s conception of abortion (as “murder” versus as “a woman’s legitimately autonomous reproductive choice”) play little to no role in mediating one’s reaction to the experience of having a miscarriage? One glib (and partially accurate) response would be to say that “it is all about choice.” If a woman wants to be pregnant (and if her partner shares that feeling), then a miscarriage robs her of her choice in some of the same ways as a prohibition against abortion robs the unhappily pregnant woman (and perhaps her unhappy partner as well) of their choice.

Though true enough, I think this answer is inadequate or, at least, incomplete. The reason is that part of what explains the pro-choice views of many people, male and female alike, is that at its early stages, an embryo or a pre-sentient fetus is not yet “someone” to be taken into account as a moral matter when deciding whether or not to proceed with a pregnancy. The vast majority of abortions occur before the fetus is capable of experiencing pain, comfort, or any sensation at all, and it therefore follows, for many pro-choice advocates, that approximately 99 percent of abortions do not raise serious moral questions.

To the extent that this thinking is what drives how many pro-choice folks think about abortion, it does seem to raise a question about the profound grief that so many women and their partners endure after a miscarriage. If the embryo or fetus is not yet “someone,” in other words—if it is little more than the sperm and egg that preceded it—then for whom or for what exactly is the pro-choice miscarriage patient grieving? For whom is that deep sorrow that so many women unquestionably experience? And most provocatively, does post-miscarriage grief offer a visceral rebuttal to the claims of pro-choice theorists that early and pre-sentient abortions raise no serious moral questions?

Perhaps, but I am inclined to think the answer is no. The grief that people (and especially the women directly) enduring a miscarriage suffer is complicated and potentially multi-layered. One feature of the grief likely resides in the fact that we invest a great deal of emotion in the rapidly growing embryo that we hope and anticipate will someday take on the form and qualities of a newborn baby. We grow attached to the “someone” our embryos will one day become long before they actually get there. Having done so already, when a pregnancy is lost, we lose not only the embryo or fetus that/who was actually there but we also lose the anticipated-baby we imagined, fantasized about, and looked forward to holding in our arms. We in essence lose what we never truly had. The speciesist expression “don’t count your chickens before they hatch” is an expression precisely because we are much inclined to do exactly that, not only with the chickens’ eggs we commodify as our property but with the embryos and fetuses we carry within ourselves as well.

Another feature of the grief accompanying miscarriage is the meaning that we might attribute to the loss, beyond its specificity. We might, for example, infer from a miscarriage that we will (a) either never have a child or have a very difficult time having one, and/or (b) necessarily relinquish a valued sense of safety and security, that feeling that “everything will turn out alright” that might have been part of the magic of a first, uncomplicated, wanted pregnancy, before it terminated in a miscarriage. A miscarriage—for someone, whether pro-life or pro-choice, who wants to be pregnant—may seem to represent the body’s betrayal of one’s self, a betrayal that can feel very momentous, whether because one has developed a narrative for the particular person that this embryo or fetus might have become or because the experience of self-betrayal is independently traumatic and anxiety-provoking, or for both reasons together.

In short, I do not think that the suffering of women (and their partners) who experience early miscarriage calls into question the foundations of the pro-choice position on abortion. Indeed, even a feeling of loss upon having a chosen abortion need not do that (as literature on the Japanese “mizuko-kuyo” mourning ritual for aborted and miscarried fetuses confirms), although this is surely a topic for another day. Loss often brings with it pain, disappointment, and anxiety, and none of these feelings necessarily correspond to the “objective” moral status of what or who or how much is lost.

I wonder sometimes whether our society’s failure to honor and support the women who experience tremendous grief after miscarrying reflects a worry about implicitly endorsing the view that an embryo or fetus has a “right to life” as against the wishes of the pregnant woman. If so, then I hope a candid discussion of the differences between a woman’s grief and an embryo’s or fetus’s rights can perhaps begin to help fill a need that so many women find unmet and ignored when they face the often-devastating experience of pregnancy loss.