How to language your grief when loss feels unspeakable

When my first pregnancy ended, I was uncertain what was happening inside my body. I was bleeding, but the ER doctor couldn’t tell me if I was miscarrying or still pregnant. The doctor couldn’t say whether the pregnancy hormones were increasing or decreasing in my body. She couldn’t see a gestational sac in the ultrasound—nothing there. My uterus was a tree hollow. Yet, there was a possibility that the pregnancy was too early to be detected in the scan. The doctor sent me home with the diagnosis of a threatened miscarriage. Her advice was to keep taking prenatal vitamins.

At home, it became apparent that I was losing the pregnancy. The bleeding escalated and went on for a week. There was no aftercare. Just the discharge notes from the ER and a number to call if I had questions. I floated in a state of liminality, a strange in-between space, where I moved from the threshold of motherhood to a body that was no longer pregnant. I felt numb and disconnected. I buried myself under blankets. In the face of overwhelming emotional pain, the body shuts down when you can’t fight or flight—it’s playing dead. I struggled to put the sense of ambiguity I felt into words.

Think of a sudden branch drop. Tree branches may break off even if the tree is healthy. The falling branches do not always result from wind or storms but happen randomly on a calm day. The embryo that had implanted in my uterus had disappeared. Early miscarriages are often attributed sporadic errors in the embryonic development when chromosomes divide and duplicate. Sometimes there is not enough hormones like progesterone, or the structure of the uterus makes the endometrium less favorable for the embryo to take hold. Sometimes the mother’s immune system interferes and sweeps the embryo away. Four years ago, scientists witnessed a star, 2.5 million times brighter than the sun, vanish without a trace. Sometimes things just end.

The body, too, is a site of nature. We tend to think of our bodies as something separate. Still, our bodies are deeply connected to the natural world and its processes. Our bodies grow and change over time, just as plants and animals do. We are born, we age, and eventually die, just like all living things. Our bodies are in synch with the same cycles and rhythms as the natural world, such as the circadian rhythms that govern our sleep and wake cycles. We are affected by weather, natural disasters, and the same forces of destruction and beauty as the earth. It moved me deeply to explore the meaning of embryo loss through the natural world. Perhaps I was not unlike a tree that loses a limb or a river that dries up before reaching the sea. Images that conclude something in nature flooded my mind, gradually pulling me out of the shutdown as I reoriented to the world around me.

Relating my experience to what happens in nature, I began to language my emotions. We understand metaphors intuitively—when one concept, experience, or object describes something else. We are familiar with the description of grief as a heavy weight. While there is no literal weight, we understand how such a burden can crush a person. Someone may compare grief to a storm that comes and goes, with moments of calm followed by intense periods of emotion. According to poet Jane Hirsfield, “metaphors get under your skin by ghosting right past the logical mind.” Linking something abstract, complicated, and enormous, like grief, into something more concrete, tangible, and familiar helps to convey some of the complexity of that experience.

Yet, miscarriage is often ambiguous. Early first-trimester losses can be confusing when the only signs are decreasing hormone levels and bleeding that resembles a heavy period. Tissue from the fertilized egg or placenta can make the loss of what existed in the body feel more concrete. With stillbirth, there is usually a strong emotional attachment to the baby as a complete person. The parents often want to hold their baby’s body after birth. In some countries, cooling cots help to preserve the body until the funeral, while the parents spend time holding their baby skin-to-skin, processing the death on their own terms.

In all pregnancy losses, the presence of the baby can live on. Pauline Boss, renowned for her work in the field of ambiguous loss, talks about losses with a physical absence but a psychological presence—a person is both here and gone. Pregnancy loss can shatter the future expected, and there is no closure to the despair of a lost relationship with the baby. The way forward, Pauline Boss suggests, is to lean into the sense of paradox—my baby is with me, and my baby is gone—the truth about the convoluted situation. Lorraine Hedtke’s narrative approach to grief is based on the premise that the relationship doesn’t end when a pregnancy terminates, or a child dies. Parents may have started forming identities as mom and dad. The baby has been alive in hopes, dreams, and plans, sometimes through a long fertility journey well before the pregnancy happens. Through storying and other rituals the baby is made part of the family, connected with the living.

Although miscarriages are prevalent, they often persist as unspoken losses within the society. There is an increased risk of miscarriage within the first 12 weeks, which is why many people wait to share their pregnancy news. There is tension between accepting miscarriage as a natural event in the physical body while simultaneously experiencing it as a taboo not openly discussed. Upholding silence around miscarriage creates more uncertainty about how to respond to those who experience it, and the cycle of silence continues. Kenneth Doka, expert in grief and bereavement, coined the term disenfranchised grief to describe losses that are not publicly recognized and for which there is no ritual—death of a pet, loss of a job, or a miscarriage, to name a few. These are real losses yet often nobody brings a casserole. The sense of isolation is compounded when these losses are grived in private. We are left with so many questions and might not have anyone to turn to for answers.

I remember how the doctor didn’t measure certain blood levels, so we couldn’t determine if progesterone would have helped to save the pregnancy. Progesterone is crucial for supporting the uterine lining for the implantation of a fertilized egg. Once the egg implants, progesterone maintains the uterine lining and prevents it from shedding, which could result in a miscarriage. I brought this up because I knew progesterone is sometimes given to women who have had multiple miscarriages. I now understand that doctors who specialize in fertility are more likely to test for progesterone compared to an ER doctor, who must deal with a wide range of patients, from a ruptured appendix to a drug overdose. I did not feel heard by the doctor. I felt confused and angry. After some months had passed, the metaphor of baking a meringue came to me—how a baker knows to add a pinch of cream of tartar to the egg whites to stabilize the meringue. Perhaps I needed a shot of progesterone, and the doctor failed to follow a proper care plan. Perhaps my uterine lining collapsed because the embryo was incompatible with life; perhaps progesterone would have delayed the inevitable.

Metaphors can offer a new perspective, engaging our senses and imagination. They can make the unknown feel more familiar or make the ordinary seem unfamiliar—such illumination feels oddly comforting. When I couldn’t find the words to talk about my miscarriage or describe the sense of liminality, I could capture a tree shedding fruit that is unable to survive as I grappled with what happens in the body when a pregnancy just ends. I began turning the imagery into poems. Thinking about the baby I could have had enabled my relationship with the embryo to unfold. Carving meaning out of the pain meant rekindling the relationship with my body and reaching into the origins of my own daughterhood. I was emerging out of my bedroom as a new kind of writer. The poems became like small rituals, breathing life into the embryo that, for some weeks, had burrowed into me. Eventually I collated them together, birthed a chapbook, and named it Feed It to the River. The poems in the book have carried me like water—floating, sinking, resurfacing through loss. In the cover of the book, a picture of me as a five-year-old girl, in the flowerbed of my childhood garden—carrying all the egg cells I would ever have, set aside like pearls in my own embryonic development.

The miscarriage hurtled me toward a space between destruction and creation—liminality, where my life had altered but was yet to transform. Sometimes a violent earthquake ruptures the earth and moves fluids underground until the waters resurface as natural springs. Sometimes we get initiated into parenthood through loss. The embryo that disappeared from my womb is now weaved into the story of my daughter who was born near the anniversary of my miscarriage, in a hospital Downtown Los Angeles. I have no metaphor big enough to convey my love for her. She’s almost two. I hold both grief and joy simultaneously as I lean into the paradox of life and death as inseparable. As Lorraine Hedtke notes, the relationship between the living and the dead is fluid and continuous—there is no closure or letting go. In my search for meaning in loss, no matter how ambiguous or unexplainable, I can carry my babies close. I can include the one I lost into the evolving story of who I am.