“Mom, Dad, I’m pregnant,” my mother announced to my grandparents. She was seventeen years old, preparing to begin her senior year of high school, and completely unaware of the next twenty years ahead of her. My grandparents, though shocked, were ready to support her decision to raise her child. Soon after the initial shock, they came to find out that they would be supporting my mother with her children — twins to be exact. My brother and I made quite the entrance into this world. 

Two decades later, I am celebrating my twentieth birthday. I have the fierce freedom and independence of a college student — far from my mother’s experience at twenty with twin toddlers.

My place in this world was certain when two blue lines showed up on the at-home pregnancy test. My mother never questioned following through with her pregnancy, and she diligently prepared for her new life. But there is a 20% chance in modern medicine that her pregnancy would have resulted in a miscarriage. Our family has been blessed with “perfect” pregnancies — no severe genetic abnormalities, no fertility challenges — but many women are not so fortunate. 

Miscarriages are treated as normal conditions, as if the mother had caught the flu or sprained her ankle, until she is affected by multiple, which may indicate a genetic abnormality. But minimizing the heartbreak of a miscarriage in medicine juxtaposes society’s accusations toward the mother. Instead of blaming statistical probability for a lost child, society demonizes the miscarriage, holding the mother responsible. The more attentive she is to her own health, the better her baby’s outcomes will be. In reality, miscarriages feel anything but normal. It shatters women. It causes guilt and grievance. It is not soon forgotten. My mother, though not initially expecting a pregnancy, would have been destroyed by such a case. 

I often see these cases as a clinical records assistant at the Kliman Lab. Our lab helps diagnose genetic abnormalities resulting in pregnancy losses. Hundreds of women seek out the lab’s clinical diagnostics for answers, frequently relieved to receive confirmation that it’s not their fault. Most of the time, it’s not. 

One particular woman, desperate for answers, brought her placenta home after delivering her pregnancy loss. She quickly emailed our lab, looking for direction. We advised her to store it properly and bring it to our lab for analysis. That afternoon, I donned my lab coat, oversized goggles, and latex gloves to dissect the thick, muscular tissue of her placenta. As I sliced open the tissue, I looked for the characteristic “feathery” texture of endometrial tissue that we use to observe biomarkers of genetic abnormalities under a microscope. Taking thin slices of the tissue, held between two pieces of glass on a slide, we stained the tissue with pink and purple dyes that clung to certain parts of the tissue. In this way, we can identify deep purple rings that represent “trophoblast inclusions,” biomarkers of genetic abnormality. The bright shades that colored my childhood bedroom now seemed to symbolize the loss of another child’s opportunity. I was relieved to see only faint pink and lavender hues on this patient’s slide rather than the vibrance of a biomarker. It meant the loss was not from her intrinsic genetic code but a chance occurrence. 

Though my mom chose to carry out her pregnancy with my brother and me, it was nothing short of a miracle that no other uncontrollable factors took this choice away from her. To her, a positive pregnancy test meant a 100% chance of having a child. But that chance is closer to 80%, and it might only continue lowering as we design tests that detect pregnancy earlier and earlier. Nearly one in four pregnancies, clinically confirmed or not, end in miscarriage.

When I first joined my lab, my research mentor trained me to navigate our digital database. Without the background knowledge, many of the terms and dialogue boxes were coded jargon to me. She began by inputting a new patient into the database; this includes the patient’s name, basic medical history, and pregnancy complications. This patient had multiple unsuccessful pregnancies, and I immediately felt sympathetic that she may never have children, but to my surprise, my mentor reassured me that many women like her are able to have successful pregnancies in the future; genetic probability played a larger role in predicting a baby’s outcomes than their clinical history. One miscarriage doesn’t define a woman. 

My mother has always been grateful for my brother and I, and likewise I will be grateful for my children. But gratitude must be accompanied by understanding. To appreciate life is not to have blind faith, but to have an understanding of all the odds we work against. 

Loss is one of the greatest pains we can experience, but it is also natural. It is an opportunity to hold on tight to the life we do get.