Monica N. Starkman M.D.

On Call

Miscarriage: Memoirs and Novels that Tell It Like It Is

Michelle Obama joins authors describing miscarriage as psychological trauma.

Posted Nov 16, 2018

Pixabay, Public Domain
Source: Pixabay, Public Domain

Miscarriage occurs in about 20% of recognized pregnancies. It is a serious psychological stressor that often results in painful personal shame. Yet it is only rarely discussed in the media, thus increasing its social stigma. Women themselves (and sometimes men) are reluctant to speak of it with others, in order to avoid feelings of humiliation. In fact, many women wait three months –after which the risk of miscarriage drops sharply – to even announce a pregnancy to their closest friends and family.

The Psychological Impact of Miscarriage

The psychological impact is profound because miscarriage is so deeply connected to an individual's sense of identity and self-esteem.

When a miscarriage occurs, women feel shame at being damaged, at not being able to carry out the basic female function of growing and birthing a baby.

They sense a loss of control over their lives, both present and future. It’s not only the pregnancy that is lost but also one's hopes and dreams for that child into the future. That often leads to feelings of guilt, since no one wants to inflict this loss on the partner they love.

As a profound loss, a miscarried baby must be mourned. And like all grieving, it's a process whose course varies from day to day over many weeks and many months. For many, grief continues for years, if not for a lifetime.

The Consequences of Silence

Silence about miscarriage in the media increases the social stigma associated with it and reinforces a person’s sense that this is indeed something to be ashamed of and should not be shared with others.

And that is truly unfortunate because social support from others is one thing we know to be a key factor in helping people deal with stressors of all sorts.  Personal silence prevents a woman who has suffered a miscarriage from hearing that so many others she knows personally may have had the same experience. It keeps her from re-framing her experience to realize that she is not a singular example of failed womanhood, but, instead, that she has had a not-uncommon outcome of pregnancy.

Books that can help change stigma and personal shame

It is not only print and social media that can shape the cultural climate about miscarriage. Books, both non-fiction and fiction, can help increase awareness and stimulate conversations about it.  They can increase understanding of the psychological reality lived by those who have suffered a miscarriage/stillbirth

Here are some books that do just that.


  • Becoming, by Michelle Obama, is a wide-ranging book about her personal development, her relationship with Barack Obama, their years in the White House, and her views on politics and social problems.  In one of the most powerful sections of the book, she frankly describes her emotional distress after a miscarriage, an experience she describes as “lonely, painful, and demoralizing almost on a cellular level."
  • An Exact Replica of a Figment of My Imagination, by Elizabeth McCracken, is devoted to showing how she experienced and struggled to move forward after her child died in utero during her ninth month of pregnancy. Her grief, her embarrassment, her feelings of failure, her attempts to shift the blame onto others, are vividly described. A stirring section of the book details her struggle with the many emotional streams that entered into the decision to try for another baby very soon after the stillbirth.


Through the power of fiction, novels can give the reader an immediate, intense understanding of the psychological underpinnings of the longing for a child, the trauma of miscarriage/stillbirth, and the repercussions on marriage and the future.  

  • The Light Between Oceans, by M.L. Stedman,  is about a woman who is deeply depressed after two miscarriages.  When a rowboat with a dead man and a live baby appears at their isolated home, she begs her husband to let them keep the child and raise it as their own. A heartbreaking struggle between ethics and psychological pain is at the heart of the story.
  • The End of Miracles, by Monica Starkman, is described by the American Library Association’s Booklist as a novel ”which powerfully reveals the complexity and strength of the human mind.”  It portrays a woman whose deep need to bear a child is sabotaged by infertility and miscarriage.  A false imagined pregnancy is only one way Margo tries to cope with her grief. She is also propelled into a psychiatric hospitalization and an impulsive startling act with harrowing consequences for herself and others. The novel is a suspenseful journey across the boundaries of grief, depression, and healing.

  • What Alice Forgot,  by Liane Moriarty,  includes a major character with miscarriages.  Alice's sister Elizabeth has suffered from multiple miscarriages. She has had a severe depression with each,  and as the book progresses, her depression deepens.  Alice is finally able to provide Elizabeth with necessary social support, and help with Elizabeth's last chance to become pregnant.

Talking about such books with friends or in book groups helps create the increased awareness and empathy needed to reduce the social stigma of miscarriage.

This increases the likelihood that miscarriage sufferers will gather courage to reveal their situation to others, and so receive the comfort and understanding so necessary for psychological recovery from trauma.