Linda Layne

A devastating personal experience inspired Rensselaer Polytechnic Institute Professor Linda Layne to devote two decades to studying issues surrounding pregnancy loss. She is not alone in her loss. Nearly 20 percent of all pregnancies in the United States end in miscarriage or stillbirth each year, affecting some one million mothers.

Today, Layne, cultural anthropologist and Alma and H. Erwin Hale ’30 Professor of Humanities and Social Sciences at Rensselaer Polytechnic Institute, is a leading international advocate for reform. She has completed production on Motherhood Lost: Conversations, an educational television series developed in collaboration with Heather Bailey, producer, director, and lead graphic designer at George Mason University. The 11-episode program offers an innovative women’s health approach to child-bearing loss.

“Women’s health activists have worked to empower American women during pregnancy and childbirth by educating them about those natural processes and preparing them so they know what to expect and what choices they may have,” Layne said. “Comparable initiatives have not occurred for women whose pregnancies end without a live birth. Many times the possibility of pregnancy loss is not even discussed. I want to see equally good information provided, before losses occur, by health care providers and in pregnancy books. Women have a right to know the pros and cons of a range of care options and to receive the same quality of care during a loss that they would during a live birth.”

Throughout the series—in conversation with artists, midwives, novelists, doctors, nurses, lawyers, religious leaders, environmental activists and product designers—Layne calls for prevention, improved care during a loss, a better public understanding of loss, and the creation of feminist rituals.

“Most losses are inevitable, but some are not and we should do all we can to prevent preventable losses,” Layne explained. Some of the preventable causes for pregnancy loss that are addressed in the series include exposure to environmental toxins and intimate partner violence. Men’s contribution to loss is also addressed. Layne noted that although most people know that pregnant women should avoid tobacco, alcohol, and drugs, few realize that these substances, a man’s age, and his exposure to environmental toxins can also affect reproductive outcomes.

In the program, one of Layne’s guests, Lynn Paltrow, director of National Advocates for Pregnant Women, explains why arresting women who use drugs during their pregnancies actually increases the likelihood of pregnancy loss, since it discourages women who would most benefit from prenatal care from seeking it. Another guest, Dr. Ruth Fretts of Harvard Medical School, explains how the simple technique of kick counting could prevent some of the 26,000 stillbirths that occur in the Unites States each year.

A Reason to Act
When Layne became pregnant with her first child at age 30, she wasn’t even aware that it was possible for her to miscarry. After her first loss in 1986, which she called “the worst and most confusing experience of my life,” Layne dedicated herself to ending the silence that shrouds pregnancy loss.

“Miscarriage never came up during any of my prenatal visits,” Layne said. “And I devoured pregnancy books, eager to learn about the minute details of my baby’s development—but they, too, failed to mention the topic of pregnancy loss.”

When she began to show signs of a possible miscarriage at 13 weeks, Layne was told by her midwives to go to the emergency room. They did not go with her, although they would have if she was in labor and something went awry. Afraid, she hoped the doctors in the hospital could explain what was happening. What she got, however, was a gruff physician who announced that the loss was imminent and then left the room. Nurses prepped her for a medical procedure and wheeled her away. Before she knew it, the pregnancy she treasured was over.

After suffering the first of seven heartbreaking miscarriages, Layne vowed to bring the subject of pregnancy loss to light. In addition to the emergency room, Layne had miscarriages in her doctor’s office, an abortion clinic, and “naturally,” on her own, at home. In each setting she felt “unprepared, which made the experiences worse than they needed to be.” One episode in her television series is devoted to how to prepare to have a pregnancy loss at home.

“Women aren’t usually told about pregnancy loss until a demise has been discovered, often inadvertently during a routine ultrasound. Then, when a loss is imminent, caregivers begin to discuss a woman’s options with her. A crisis is not the best time to give people information.”  

Layne started to ask questions. Why had unnecessary cesarean sections received such critical attention from women’s health activists when use of a dilation and curettage (D&C) surgical procedure for miscarriage received no such scrutiny? Why is the comfort and quality of women’s birth experience considered so important, but comparable concern not given to the experience of pregnancy loss?

Layne realized that anthropology could help answer these and other questions. She joined a local support group and began investigating the experience of loss among the group’s members using an anthropological research method known as participant observation. Using the technique, researchers immerse themselves in the subject being studied to gain deeper understanding. Dealing with her own losses, Layne studied the topic as both an observer and a participant.

Shattering the Silence and Offering a Solution
In 2003, after 20 years of research, Layne published Motherhood Lost: A Feminist Account of Pregnancy Loss in America (Routledge). The book called to light the lack of information and physical and emotional support available to women whose pregnancies end without a live  birth. In it, she challenged society and women’s movements in particular to publicly discuss the topic and to offer more support.

“Grief for a longed-for child may be both inevitable and necessary, but the additional hurt that bereaved parents feel when their losses are dismissed and diminished by others is needless and cruel,” Layne said. “It is high time we recognize pregnancy loss and offer our support.”

The book was immediately endorsed by UNITE and SHARE, two prominent pregnancy loss support groups in the United States. Finally giving voice to a subject shrouded in silence for so long, Layne became an expert in the emerging field of research and was asked to discuss her findings with The New York Times, Boston Globe, Newsday, Chicago Tribune, and other major media outlets.

Since then, Layne has been speaking out on the need for pregnancy loss healthcare policy reform and lecturing at universities, hospitals, and conferences across the country and in the U.K. on society’s shortcomings when it comes to educating, caring for, and supporting women who have suffered losses.

Layne noted that the Motherhood Lost: Conversations television series provides the ideal opportunity to create more public awareness and support for pregnancy loss. The first episode, which premiered in 2006, received acclaim from the television and film community, garnering Layne a prestigious Gracie Award for “outstanding talk show,” a Silver Davey award, and a 2006 Bronze Telly Award. The program has gone on to win 12 national and international awards including two additional Gracie Awards, a Silver Telly, a Videographer Award, and a Communicator Award.

Layne has high hopes for the programs. “I’d like to see the shows become educational resources on television and available in public libraries, as well as medical school and nursing school libraries,” she said.

Layne noted that each 30-minute episode has a companion curriculum that is appropriate for continuing education and college classroom use. The shows are available for streaming over the Web, and the curriculum—which is free of charge—is also available for downloading.

Layne also sees indicators of positive change in several places, from the formation of coalitions like Pregnancy Loss and Infant Death Alliance and the International Stillbirth Alliance, to new services such as Planned Parenthood’s Miscarriage Management programs. She has also witnessed policy changes like the allocation of funding by the National Institutes of Health (NIH) for stillbirth research, the Stillbirth and SUID Research, Education and Awareness Act of 2009, and the designation of October as Pregnancy Loss Awareness Month, among other initiatives.

“There’s a national pregnancy loss support movement that has been growing since the mid-1970s,” Layne said. “We’re moving into a new stage now of not just offering support after losses occur, but becoming more proactive, and that is wonderful news to me.”

Once a lone voice speaking out on what she found was a cultural taboo surrounding pregnancy loss, Layne today is finding more allies and greater hope for her efforts to bring about understanding and policy reform. “Now there are lots of people out there advocating, and I hope more will join in this endeavor. Together, we can—and will—make things better.”

To view the program Motherhood Lost: Conversations, and to download the curriculum materials, visit: http://www.gmutv.gmu.edu/shows/motherhood_lost.asp.

Contact: Jessica Otitigbe
Phone: (518) 276-6050
E-mail: otitij@rpi.edu