Motherhood lost: cultural dimensions of miscarriage and stillbirth in America.

Despite the frequency of incompleted pregnancies (an estimated 20-30% of all pregnancies), a veil of silence surrounds pregnancy loss in our culture. In the last fifteen years organizations have sprung up throughout the United States which protest the cultural denial of perinatal loss and seek to define a miscarriage or stillbirth as a legitimate source of grief. Participants in support groups are for the most part members of the white middle class and cannot be taken to represent 'American society' but because they are organized and vocal, members of such groups hold the potential for significantly changing the way miscarriage and stillbirth are treated in American society. This article explores a number of recurrent themes observed among participants of pregnancy loss support groups: the angst of an incompleted rite of passage; the struggle for defining the embryo, fetus, or neonate as a 'child' and of oneself as a 'parent'; the search for and attribution of meaning to a seemingly unexplainable event; and the link between changing attitudes towards birth, death, and personhood. The impact of new technologies on the experience of pregnancy and consequentially on the experience of pregnancy loss is also explored. Most prior studies of pregnancy loss have been quantitative and have focused on the individual. The anthropological approach, with its emphasis on the cultural construction of meanings and special understanding of ritual process adds an important dimension to this area of research.