Science  /  Comparison

Miscarriage Wasn’t Always a Tragedy or a Crime

Looking back on 150 years of history shows that American women grappled with miscarriages amid different legal, medical, and racial norms.

According to today’s social narratives, miscarriage is almost always a loss, an event to grieve, and usually a secret. But in a world where women had much less control over their fertility, things were different. When Annie Van Ness got married in 1873, her husband had just lost most of his wealth in the recent economic panic. She had no interest in starting her family amidst financial instability, but she also had no reliable means to prevent or terminate pregnancy (both were illegal in New York, where she lived). Within such restrictions it makes sense that she was cross when she suspected she was pregnant, and happy when she miscarried. My first miscarriage, and the disappointment I felt around it, took place under very different circumstances: I had the ability to prevent pregnancy until I felt I had the financial and social stability to start a family.

Van Ness, Cheney, and I—and American women everywhere, for the last 150 years—have also interpreted our miscarriages in ways that are contingent on race. Throughout the 1800s, white male physicians were trying to gain a foothold in the business of delivering babies. Previously, most American women had given birth at home, attended by female family members, friends, and midwives.

To argue that they were the better attendants for birthing women, male physicians perpetuated a narrative of racial and ethnic difference in childbirth. They claimed that groups that were “closer to nature” or “more animalistic” (namely, African Americans and Native Americans) did not need medical help in childbirth because they were naturally better at the job. But white, “civilized” women were removed from ancient natural knowledge and couldn’t possibly take care of matters on their own. (White physicians, angling to practice new skills or experiment with procedures, also sought to deliver the babies of enslaved Black women but in keeping with the narrative, rarely offered them pain relief or comfort.)

Doctors all over the country promoted and presented “proof” for the “civilized versus savage” narrative. St. Louis physician George Engelmann, writing in 1881 in the prestigious American Journal of Obstetrics, contended that most “primitive” women’s labor “may be characterized as short and easy, accompanied by few accidents and followed by little or no prostration.” He added, “the nearer the civilization is approached, the more trying does the ordeal of childbirth become.”