For many women, attempts to become a parent end in heartbreak: 10% of known pregnancies end in miscarriage, according to the American College of Obstetricians and Gynecologists. Others experience similarly painful losses through failed surrogacy or adoptions, or unsuccessful infertility treatments.
U.S. Rep. Ayanna Pressley wants to talk about it. This week, the Massachusetts Democrat announced the introduction of the Support Through Loss Act, aimed at better supporting people impacted by pregnancy loss. Sen. Tammy Duckworth, D-Ill., has introduced a companion bill.
The legislation would direct the Department of Health and Human Services, through the Centers for Disease Control and Prevention and other agencies, to disseminate information on the prevalence of pregnancy loss, along with information on treatment options and mental health support. It additionally calls for an annual investment of $45 million for the National Institutes of Health to expand research into pregnancy loss, and would require employers to offer at least three days of paid leave for workers following an incident such as a pregnancy loss, failed adoption or unsuccessful assisted reproductive technology procedure.
U.S. News spoke with Pressley about her bill this week. The following interview has been edited for length and clarity.
This legislation was created in partnership with advocates and impacted families. How did that inform the bill?
I really believe in cooperative governing and when it comes to legislating, I want to ensure that the bills that I offer are responsive and intersectional. And in order to best understand the complexity and the nuance of any issue, but also to develop the best solution, I think we have to be proximate. You have to be in conversation in the community, with those who’ve been directly impacted.
Rep. Ayanna Pressley speaks in Iowa City, Iowa, on Feb. 1, 2020.(KEREM YUCEL/AFP/Getty Images)
Maya Angelou once said that “there is no greater agony than bearing an untold story,” and there are so many families, so many women, who have been suffering in silence, in agony, because of the cultural stigma and the isolation of pregnancy loss through miscarriage, failed surrogacy agreements or infertility. And they need and deserve to be met with compassion and care, holistic support. And that should also include paid leave. We need to be expanding that definition of bereavement, and be responsive to the many, many families who have been directly impacted. This is incredibly underreported. We know that at least 10% of known pregnancies end in miscarriage.
There’s a teacher who comes to mind, who left school for a doctor’s appointment, found out she had a miscarriage, then she went back to work the rest of the day. Imagine that. I have a friend who lost their first pregnancy in the midst of this pandemic. Consider what that must have been like to be navigating a complicated medical process and not being able to do that with a supportive partner or supportive person being allowed into the hospital because of COVID restrictions. Or a parent who was battling deep anxiety and depression following a pregnancy loss, and they were unable to be connected to support, and they were harboring deep guilt over what is a common experience and was completely outside of their control. And so, our bill is just responsive to those stories.
How does the bill address the intersections of childbearing and the loss of a child? In other words, how does it include parents adopting children or parents navigating infertility, for example?
They’re named [in the bill]. It is my hope that through the Support Through Loss Act, that these families will feel seen. That includes those in their journey to start a family, to expand the family – we are naming miscarriage, we’re naming surrogacy, fertility treatments. We want to be supportive of whatever your family model, in whatever way that your pregnancy journey, your journey to start or to expand your family, has been disrupted and you’ve suffered a traumatic loss – that you feel supported. You feel supported by your doctor, you feel supported by your family and community, and that you feel supported by your employer.
The bill calls for information on pregnancy loss to be disseminated by HHS and the CDC. Ideally, what should be included in this information and why is it important to have this information?
What it does is direct the CDC and HHS to develop and distribute information on pregnancy loss, or the incidence and prevalence of miscarriage, and then treatment options for miscarriage. When you’ve already experienced such a disruptive and painful life event, and you were feeling the impacts of that loss, you’re already feeling isolated. And then that can be compounded by the fact that, should you choose to navigate this on your own until you’re ready to talk about it, the information is not readily available or accessible. Many are unaware that there are doulas that can support you through pregnancy loss, so we need the data to show the prevalence of miscarriage.
That’s also why within the Support Through Loss Act, we are calling for a $45 million investment through NIH because we need the research into pregnancy loss, including miscarriage, and then recurrent miscarriage, which is also a story that I heard of over and over again. So it was not already traumatic enough to suffer one pregnancy loss, there were so many who I spoke with who had experienced recurrent miscarriage. So the research will allow us to see just how prevalent this is.
It’s hard to believe that there has not been a much bigger response to something that has destabilized and traumatized.
You mentioned that we know now how common miscarriage is. Why hasn’t more research into pregnancy loss been done before? Why put funding toward it now?
That’s why storytelling is so important. That’s why we have to shine a light, why we need the data.
If you look at something like the maternal morbidity crisis, which I’ve also done a fair amount of work on, as a Black woman, with my own family, those numbers were very high. But it wasn’t until enough impacted families began to amplify their voices and did that with vigilance. And now we are having a national conversation and there are multiple pieces of legislation, including my bill with Sen. Booker.
It’s taken that long because people have been suffering in silence. They have felt great cultural stigma. They’ve felt personal shame for something completely outside of their control. I want to bring some attention and dignity to their stories, and hopefully in our collective advocacy, support to keep them on a pathway to healing.
Part of the bill includes requiring employers to offer paid leave for workers processing a pregnancy loss of some sort. Why include that?
Federal and private employers in our Support Through Loss Act would be required to provide at least three days of paid leave, so that’s consistent with other bereavement policies.
We wanted to send a clear message here that we’re here to support these families and to help them to heal. Think of that teacher who went to a doctor’s appointment in the middle of the workday to learn she’s miscarried and returned to work without making any of the additional medical appointments that she needed to. These are unconscionable choices, and it doesn’t have to be this way. And we’re going to change it.