Analysis Maternity and Birthing

Overcoming Stigma: A Film Story of Stillbirth, Miscarriage

Jhene Erwin

My first miscarriage occurred at six weeks. My second was at almost eleven weeks. The grief was alarming but I did what many women do - my best to quietly “carry on.”

This article is published in partnership with the Bill & Melinda Gates Foundation.

In 2007, with one two and half-year-old child, my husband and I decided it was time to have another baby. My first miscarriage occurred at six weeks. My second was at almost eleven weeks. The grief was alarming but I did what many women do – my best to quietly “carry on.”

Simple tasks became challenging. I’d stand in the cereal aisle frozen by the choice between honey-nut and plain. The question, “Paper or plastic?” should not make a person cry. Maintaining this external “everything-is-ok” façade was agonizing.

It was the tension – between façade and grief – which inspired my short film about miscarriage, stillbirth and early infant loss. “The House I Keep” is a story of transformation during one woman’s struggle to come to terms with the loss of her child.

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My hope is that this film frees people to talk more openly about what remains stubbornly taboo. When people hear about my film total strangers let loose regardless of location: be it the gym or in a grocery store. Their stories are always deeply moving and I am honored by their candor.

What do they say?

They tell me there is no appropriate place to mourn this loss. While family and community are powerful sources of comfort, the silence on this subject prevents women from accessing that healing power. Consequently, the mental health of not only mothers but also their children suffers.

Consider this stigma magnified around the globe. In some developing countries, superstitious beliefs lead women to be blamed for a stillbirth or miscarriage. Some communities feel more people will die if the bereaved mother is in contact with other women and children. Subsequently, access to the healing power of family and community becomes greatly restricted. As we move forward with the important work of improving global maternal and newborn health, the long term effects of stigma on the mental health of women and their surviving children cannot be over looked or marginalized.

Talking heals. Women want to feel reassured that their child’s too-short life had a place in the world and that the world is different because of that child’s absence. You can help mark that life by just being willing to talk and listen. The landmark Lancet Stillbirth Series released in April is already impacting the worldwide perception of stillbirth.

In my own community of Seattle, Washington, in the United States, nonprofits that counsel women postpartum will be using my film as a starting place for open discussions. The ripple effect of community efforts, combined with the work of organizations including PATH, UNICEF, Save the Children, and the Bill & Melinda Gates Foundation, will undoubtedly lessen the stigma of a tragedy for which no woman should ever be held accountable.

By letting women talk openly, and by listening, our communities around the world can help women – including me – begin to heal.

Commentary Abortion

It’s Time for an Abortion Renaissance

Charlotte Taft

We’ve been under attack and hanging by a thread for so long, it’s been almost impossible to create and carry out our highest vision of abortion care.

My life’s work has been to transform the conversation about abortion, so I am overcome with joy at the Supreme Court ruling in Whole Woman’s Health v. Hellerstedt. Abortion providers have been living under a very dark cloud since the 2010 elections, and this ruling represents a new day.

Abortion providers can finally begin to turn our attention from the idiocy and frustration of dealing with legislation whose only intention is to prevent all legal abortion. We can apply our energy and creativity fully to the work we love and the people we serve.

My work has been with independent providers who have always proudly delivered most of the abortion care in our country. It is thrilling that the Court recognized their unique contribution. In his opinion, after taking note of the $26 million facility that Planned Parenthood built in Houston, Justice Stephen Breyer wrote:

More fundamentally, in the face of no threat to women’s health, Texas seeks to force women to travel long distances to get abortions in crammed-to-capacity superfacilities. Patients seeking these services are less likely to get the kind of individualized attention, serious conversation, and emotional support that doctors at less taxed facilities may have offered.

This is a critical time to build on the burgeoning recognition that independent clinics are essential and, at their best, create a sanctuary for women. And it’s also a critical time for independent providers as a field to share, learn from, and adopt each other’s best practices while inventing bold new strategies to meet these new times. New generations expect and demand a more open and just society. Access to all kinds of health care for all people, including excellent, affordable, and state-of-the-art abortion care is an essential part of this.

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We’ve been under attack and hanging by a thread for so long—with our financial, emotional, and psychic energies drained by relentless, unconstitutional anti-abortion legislation—it’s been almost impossible to create and carry out our highest vision of abortion care.

Now that the Supreme Court has made it clear that abortion regulations must be supported by medical proof that they improve health, and that even with proof, the burdens can’t outweigh the benefits, it is time to say goodbye to the many politically motivated regulations that have been passed. These include waiting periods, medically inaccurate state-mandated counseling, bans on telemedicine, and mandated ultrasounds, along with the admitting privileges and ambulatory surgical center requirements declared unconstitutional by the Court.

Clearly 20-week bans don’t pass the undue burden test, imposed by the Court under Planned Parenthood v. Casey, because they take place before viability and abortion at 20 weeks is safer than childbirth. The federal Hyde Amendment, a restriction on Medicaid coverage of abortion, obviously represents an undue burden because it places additional risk on poor women who can’t access care as early as women with resources. Whatever the benefit was to late Rep. Henry Hyde (R-IL) it can’t possibly outweigh that burden.

Some of these have already been rejected by the Court and, in Alabama’s case, an attorney general, in the wake of the Whole Woman’s Health ruling. Others will require the kind of bold action already planned by the Center for Reproductive Rights and other organizations. The Renaissance involves raising an even more powerful voice against these regulations, and being firm in our unwillingness to spend taxpayer dollars harming women.

I’d like to entertain the idea that we simply ignore regulations like these that impose burdens and do not improve health and safety. Of course I know that this wouldn’t be possible in many places because abortion providers don’t have much political leverage. This may just be the part of me that wants reproductive rights to warrant the many risks of civil disobedience. In my mind is the man who stood in front of moving tanks in Tiananmen Square. I am yearning for all the ways to stand in front of those tanks, both legal and extralegal.

Early abortion is a community public health service, and a Renaissance goal could be to have early abortion care accessible within one hour of every woman in the country. There are more than 3,000 fake clinics in this country, many of them supported by tax dollars. Surely we can find a way to make actual services as widely available to people who need them. Of course many areas couldn’t support a clinic, but we can find ways to create satellite or even mobile clinics using telemedicine to serve women in rural areas. We can use technology to check in with patients during medication abortions, and we can provide ways to simplify after-care and empower women to be partners with us in their care. Later abortion would be available in larger cities, just as more complex medical procedures are.

In this brave new world, we can invent new ways to involve the families and partners of our patients in abortion care when it is appropriate. This is likely to improve health outcomes and also general satisfaction. And it can increase the number of people who are grateful for and support independent abortion care providers and who are able to talk openly about abortion.

We can tailor our services to learn which women may benefit from additional time or counseling and give them what they need. And we can provide abortion services for women who own their choices. When a woman tells us that she doesn’t believe in abortion, or that it is “murder” but she has to have one, we can see that as a need for deeper counseling. If the conflict is not resolved, we may decide that it doesn’t benefit the patient, the clinic, or our society to perform an abortion on a woman who is asking the clinic to do something she doesn’t believe in.

I am aware that this last idea may be controversial. But I have spent 40 years counseling with representatives of the very small, but real, percentage of women who are in emotional turmoil after their abortions. My experience with these women and reading online “testimonies” from women who say they regret their abortions and see themselves as victimized, including the ones cited by Justice Kennedy in the Casey decision, have reinforced my belief that when a woman doesn’t own her abortion decision she will suffer and find someone to blame for it.

We can transform the conversation about abortion. As an abortion counselor I know that love is at the base of women’s choices—love for the children they already have; love for their partners; love for the potential child; and even sometimes love for themselves. It is this that the anti-abortion movement will never understand because they believe women are essentially irresponsible whores. These are the accusations protesters scream at women day after day outside abortion clinics.

Of course there are obstacles to our brave new world.

The most obvious obstacles are political. As long as more than 20 states are run by Republican supermajorities, legislatures will continue to find new ways to undermine access to abortion. The Republican Party has become an arm of the militant anti-choice movement. As with any fundamentalist sect, they constantly attack women’s rights and dignity starting with the most intimate aspects of their lives. A society’s view of abortion is closely linked to and mirrors its regard for women, so it is time to boldly assert the full humanity of women.

Anti-choice LifeNews.com contends that there have been approximately 58,586,256 abortions in this country since 1973. That means that 58,586,256 men have been personally involved in abortion, and the friends and family members of at least 58,586,256 people having abortions have been too. So more than 180 million Americans have had a personal experience with abortion. There is no way a small cadre of bitter men with gory signs could stand up to all of them. So they have, very successfully so far, imposed and reinforced shame and stigma to keep many of that 180 million silent. Yet in the time leading up to the Whole Woman’s Health case we have seen a new opening of conversation—with thousands of women telling their personal stories—and the recognition that safe abortion is an essential and normal part of health care. If we can build on that and continue to talk openly and honestly about the most uncomfortable aspects of pregnancy and abortion, we can heal the shame and stigma that have been the most successful weapons of anti-abortion zealots.

A second obstacle is money. There are many extraordinary organizations dedicated to raising funds to assist poor women who have been betrayed by the Hyde Amendment. They can never raise enough to make up for the abandonment of the government, and that has to be fixed. However most people don’t realize that many clinics are themselves in financial distress. Most abortion providers have kept their fees ridiculously and perilously low in order to be within reach of their patients.

Consider this: In 1975 when I had my first job as an abortion counselor, an abortion within the first 12 weeks cost $150. Today an average price for the same abortion is around $550. That is an increase of less than $10 a year! Even in the 15 states that provide funding for abortion, the reimbursement to clinics is so low that providers could go out of business serving those in most need of care.

Over the years a higher percent of the women seeking abortion care are poor women, women of color, and immigrant and undocumented women largely due to the gap in sexual health education and resources. That means that a clinic can’t subsidize care through larger fees for those with more resources. While Hyde must be repealed, perhaps it is also time to invent some new approaches to funding abortion so that the fees can be sustainable.

Women are often very much on their own to find the funds needed for an abortion, and as the time goes by both the costs and the risk to them increases. Since patients bear 100 percent of the medical risk and physical experience of pregnancy, and the lioness’ share of the emotional experience, it makes sense to me that the partner involved be responsible for 100 percent of the cost of an abortion. And why not codify this into law, just as paternal responsibilities have been? Perhaps such laws, coupled with new technology to make DNA testing as quick and inexpensive as pregnancy testing, would shift the balance of responsibility so that men would be responsible for paying abortion fees, and exercise care as to when and where they release their sperm!

In spite of the millions of women who have chosen abortion through the ages, many women still feel alone. I wonder if it could make a difference if women having abortions, including those who received assistance from abortion funds, were asked to “pay it forward”—to give something in the future if they can, to help another woman? What if they also wrote a letter—not a bread-and-butter “thank you” note—but a letter of love and support to a woman connected to them by the web of this individual, intimate, yet universal experience? This certainly wouldn’t solve the economic crisis, but it could help transform some women’s experience of isolation and shame.

One in three women will have an abortion, yet many are still afraid to talk about it. Now that there is safe medication for abortion, more and more women will be accessing abortion through the internet in some DIY fashion. What if we could teach everyone how to be excellent abortion counselors—give them accurate information; teach them to listen with nonjudgmental compassion, and to help women look deeper into their own feelings and beliefs so that they can come to a sense of confidence and resolution about their decision before they have an abortion?

There are so many brilliant, caring, and amazing people who provide abortion care—and room for many more to establish new clinics where they are needed. When we turn our sights to what can be, there is no limit to what we can create.

Being frustrated and helpless is exhausting and can burn us out. So here’s a glass of champagne to being able to dream again, and to dreaming big. From my own past clinic work:

At this clinic we do sacred work
That honors women
And the circle of life and death.

Culture & Conversation Media

A Q&A With ‘Never Too Real’ Author Carmen Rita Wong on Why #WeNeedDiverseBooks

Ilana Masad

Rewire had a chance to chat with Wong about her experience finding a place for the work she wanted to create, and what the media often gets wrong when portraying Latina women and other women of color.

Carmen Rita Wong says the characters in her new novel, Never Too Real, are largely invisible in media, which is why she chose to tell their stories. The fictional work is about Latina women who are both struggling and successful in their various fields. Wong says she’s treating this writing project as a mission, a way to tell the story of women like her: Latina women and other women of color who exist in ways other than the stereotypes so often portrayed on television and in films.

Wong herself is a master of media: She’s written for countless outlets, been the host of her own TV show, written books on finance, and now, she’s turned to fiction.

Rewire had a chance to chat with Wong about her experience finding a place for the work she wanted to create, and what the media often gets wrong when portraying Latina women and other women of color.

Rewire: How did this novel come about?

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Carmen Rita Wong: My a-ha! moment came with my daughter; we were walking together and passed a bus stop with [a poster for] a show and she said, “Mom, that poster, all those women look like you. But why are they maids?”

My daughter’s frame of reference is very different from mine: She’s growing up more privileged and with a Black president, surrounded by family where she happens to be a blonde Latina while her cousins are Black Latinas. I waited tables alongside my mom to put myself through college, so I have a deep respect for every form of work. But it was definitely one of those things where you only see yourself reflected in one way—and that’s how I grew up, seeing Latinas being shown in one way; but this is not how I live, and not how my daughter lives, now.

That same month I was having a party, celebrating my wonderful, successful girlfriends. We all came up together, we’ve all supported each other, and we’re all women of color, mostly Latina. I looked around and wondered, how come nobody knows we exist?

So I thought, all right, you know what? Now’s the time. This has just got to get done. I’m in a position to do this, I need to do it. It was very much a mission; I didn’t approach it as a side project.

Rewire: Kirkus Reviews, a book review site, called Never Too Real a “multicultural edition of Sex and the City.” How would you characterize the book? Would you call it that?

CRW: I think that superficially that’s a nice, easy elevator pitch because there are four of these women, they’re glamorous, and they’re in New York City. I think that’s where the similarities pretty much end. The book goes a lot deeper than that. If you had to categorize it TV-wise, it’s a “dramedy”: There’s some lightheartedness, there’s some playfulness, some glamor, but it is really about real issues in your life as you try to do well, if you try to be the first generation to do better than the previous. I think that’s one of the uniting factors of these four women—they’re all … first [in their families] to be born in the United States, and grow up and finish college. And that’s an important bonding issue that makes it very different [from] Sex in the City.

Rewire: Diversity in literature is a widely-discussed issue in the literary community these days, with hashtags like #WeNeedDiverseBooks. Was it hard for you to find a place for your book, to publish it?

CRW: I don’t know—hard for some people is not hard for others. Let’s just say—my agent’s probably going to kill me—but my favorite rejection from a major publisher, which actually confirmed to me that I was on the right track, was (and I have it memorized): “We are not looking for aspirational in this market at this time.”

Rewire: They called it aspirational?

CRW: Exactly. So it was mildly crushing, and then I realized—I’m on it, I am so on it. Because these publishers, who are they, and what have they published? Books by white men. Yes, those publishers are powerful, and yes, they’re rich, but they don’t get it. They don’t see it. They don’t know we exist. What is “this market,” and what is “aspirational?”

When I was coming up in media, in publishing and magazines, I would hear from people, “Carmen, we know you want to get ahead, but we just don’t know what to do with you.” And that’s code. What it really means is, “Carmen, you’re a brown girl, and we can promote this white guy or girl, but we can’t promote you. We just don’t know what to do with you.” But they would never say that to a white male. They would never say, “You know what, Bob? We just don’t know what to do with you.” So to me that rejection letter was just like that.

I remember back in the ’90s, there was a really great push of [books] like Waiting to Exhale or Joy Luck Club. There was just a lot more in fiction about successful, multigenerational, multicultural families. It just was normal and it was not considered crazy. I think there was a trend, and it just became a different trend. And then there was a push for powerful stories, but stories of only one note, for a long time in Latino fiction. I can’t read that stuff, because I lived it already. I want to read stories that make me escape or make me inspired or make me feel heard.

Rewire: In the book, you introduce women who come from all walks of life and economic backgrounds, but they’re all upper-middle-class at the time of the narrative. Going back to your daughter seeing the poster of Latina women portrayed as maids, do you find that economic diversity is what’s often missing in popular and literary culture?

CRW: My book wasn’t as calculated as that, because this is my life, and these are my friends and the people I surround myself with. I think what I saw missing in these cultures was that niche [of successful Latina women].

Latinos in popular culture … I’ve watched it be a very hard process. For example, when I was in magazines, they tried to push me to the Spanish-language property, and I’d say that I don’t primarily speak in Spanish. Why can’t I be used in the English-dominant space? Why? Give me a reason why! And they’d have to say, “Well, because you’re Latina.” So? Latinos speak English! We’re Americans! If you were Black or Latina you’d have to be in that particular space and you weren’t allowed to exist in the general market. And as we’ve seen, and as we see now, that has changed a lot.

Rewire: How so?

CRW: We have huge growth in numbers, but also too, if you look at, for example, ShondaLand, [the production company] on ABC—it’s an example of an openness to seeing and consuming media from all cultures, whether it’s music or TV. I definitely feel that things have changed, there’s a big shift and a huge push now toward inclusion.

I think with social media too, you see the pressure of people saying, for example, #OscarsSoWhite. I grew up in a time when media was controlled by a small group of people and I’ve watched it change, morph, and transform. Fifteen years ago, when I was co-chair of the Hispanic Affinity Group at Time Inc., I was saying we’re here, we consume stuff in English, and you need to pay attention to us. When the census came out [proving what I had been saying], I said, the census, look at the census!

And still the dollars didn’t come in; but when social media happened, that’s when the money started coming in. And finally people started saying, “Oh, they’re, they’re quite vocal, they exist.” [Laughs.] But our ethnicity or color shouldn’t be our only draw. We’re here and have been here. What they’re seeing shouldn’t come as such a shock.

This interview has been edited for length and clarity.