The Miscarriage Penalty

Why we need to talk more openly about pregnancy loss in academe

Pat Kinsella for The Chronicle Review

November 29, 2016

I spent a large part of my 30s suffering — largely in silence — because I couldn’t seem to get pregnant. And whenever I did, I had a miscarriage. Those were also my years on the tenure track, when I was working madly to publish, perfect my teaching, and do academic service in order to achieve a decent salary, job stability, and a successful career.

My body didn’t cooperate with the need to do well in my job, stay sane, and get pregnant. Mostly I didn’t talk about it, though. Because in academe, you don’t.

In recent years, we’ve had plenty of discussions about "Academia’s ‘Baby Penalty’" — i.e., that men with young children are 35 percent more likely to get tenure-track jobs and 20 percent more likely to earn tenure than women in the same boat. Even male professors have published op-eds about how "family-friendly" policies in higher education — such as paternal leave — could actually result in career advancement for men and career decline for women.

But in that public conversation, there is a glaring absence of discussion about the private reality of miscarriage. About 15 to 25 percent of all recognized pregnancies end in miscarriage. Yet in the United States, as anthropologist Linda L. Layne has shown, pregnancy loss is our "taboo." The culture of silence surrounding miscarriage adds a further strain to the ability of female faculty members to succeed in academe.

The culture of silence surrounding miscarriage adds a further strain to the ability of female faculty members to succeed in academe.
To have a pregnancy and then lose it puts women’s bodies through a hormonal roller coaster. It can take months to recover, and for hormones to reregulate. In that time, women can experience nausea, soreness, headaches, exhaustion, extremely painful cramps, heavy bleeding, irregular cycles, and even phantom kicks.

I did.

Like so many others, I had no idea how frequent miscarriage was until I had one. It can seem like everywhere you look you see another pregnant woman, and all your friends seem to be getting pregnant. You feel out of place and alone, because everyone knows what to say to a woman announcing her pregnancy, but it seems that no one knows what to say to a woman sharing its loss.

Unlike Japan and other societies, Americans have no cultural script for this encounter. We have the word — miscarriage — which seems to blame women for the loss. After my first miscarriage, a caring friend who surely didn’t mean to blame me asked, "What did you do?" As my Northwestern colleague, Ana Aparicio, wrote this past summer: Women who have gone through pregnancy loss need sensitive support, even if they themselves do not want to talk about their grieving process.

The effects of miscarriage can last for years. Numerous studies on what is called "reproductive trauma" have shown that women who have suffered pregnancy loss are at risk for depression and anxiety, as well as difficulty in subsequent parenting, for three or more years. Given that academe already has significant levels of mental illness, pregnancy loss can be a match that lights a well-prepared fire.

And it’s not just mental trauma. Women lose precious work and personal time to medical appointments. They often have to spend money on treatments, especially those not covered by health-care benefits. Such hidden costs increase exponentially should a woman with pregnancy loss seek fertility testing and assistance, which is often the case.

Pregnancy loss was very difficult for me, and I was in a tenure-track position at a relatively elite institution with good health insurance. Thousands of female academics are far less privileged, working for depressed salaries and meager-to-no benefits in a hypercompetitive faculty job market.

In short, there is significant room for improvement in the academic workplace on this front. We need to recognize that gender inequality starts when a woman tries to have children, not only after she has them.

We need to recognize that gender inequality starts when a woman tries to have children, not only after she has them.
Colleges and universities could do more to support the one in four women who suffer miscarriages while trying to have children. Just as tenure clocks are often extended for childbirth, they could also be extended to cover loss of work productivity resulting from documented pregnancy loss, and the resulting mental and physical problems. Department chairs, appointed mentors, deans, and tenure-and-promotion committees could receive formal guidance on this issue, perhaps as part of already existing human-resource or diversity training. Counseling centers could set up support groups for faculty members, administrators, and staff members in academe who have experienced miscarriages.

And everyone should recognize that female graduate students, and even undergraduates, also undergo such devastating loss, which may affect their financial status and their time time-to-degree. They need our support, too.

Now that I have a beautiful boy and the security of tenure, I know I am lucky. I look back on my 30s as one long exhausting blur. And I look around my campus at other women and wonder if they, too, are suffering in silence, trying to have a baby, get reappointed, or achieve tenure.

And I want them to know they are not alone.

Jessica Winegar is a professor of anthropology at Northwestern University.