Monthly Archives: March 2014

Misunderstanding Miscarriage

Miscarriage rarely makes the news, except in tabloids. But last year, Virginia state Senator Mark Obenshain’s ill-advised attempt to require Virginia women to report all miscarriages to the police contributed to his failure to become Virginia’s state attorney general. The bill, introduced in 2009, haunted his race for the position.

Obenshain was trying to demonstrate his moral outrage over the case of a frightened teenager who had given birth to a premature stillborn baby, and disposed of it in a dumpster.  It was a tragic case, to all observers.  But instead of asking how his state could better provide sex education and contraception, or provide support to teens who get pregnant, he wrote a bill aimed at surveillance and punishment.  On penalty of up to a year in prison, women would be required to report all incidences of fetal demise occurring outside a physician’s supervision to the police.  They were to report the pregnant woman’s name and the location of the remains, and would not be allowed to dispose of them without police supervision.

This would be an alarming proposal even if miscarriage were a rare occurrence.  It smacks of Margaret Atwood’s The Handmaid’s Tale, or eighteenth century English laws, under which a woman was presumed to have committed infanticide if she had an unattended stillbirth.

But miscarriage is not rare.  About 20% of confirmed pregnancies miscarry.  And that is only the tip of the iceberg.  Only about a third of fertilized eggs actually become babies; the rest fail to implant in the uterus, or begin to develop but are not genetically compatible with life, or stop developing for reasons still mysterious to researchers.

Obenshein’s bill was promptly ridiculed.  Obenshein was forced to reach out to Planned Parenthood to try to fix his gaffe, and was rebuffed; in the end, he himself withdrew the bill.

What remains interesting to me, as the episode resurfaced in the news, is how exactly Obenshein was taken to task.  I see two major threads.  One, in a subtle way, reinforces Obenshein’s perspective.  The other is perhaps more counter-cultural.

Some of Obenshein’s critics emphasized the emotional burden the reporting requirement would place on women who are presumed to already be mourning a grave loss.  It is true that today in the United States, many women experience miscarriages, even very early ones, as akin to losing a child.  Even Obenshein’s supporters surely were aghast at the idea of emotionally torturing women who were devastated to lose their pregnancies.

The more counter-cultural perspective is that, as obstetrician Carrie Terrell has explained, miscarriage is “a completely normal and natural event. It would be sort of like having to report every time you had intercourse or your period. It’s a normal part of a woman’s reproductive life.”  If we wanted to be sure to report every single miscarriage, we’d need to report every single menstrual period as a possible miscarriage.  Many of those early losses look exactly like regular periods.  None of us who have been heterosexually active, fertile women in fact know how many early pregnancy losses we have had.

I would like to see both of these perspectives taken into account, not only in preventing ridiculous laws like that proposed by Obenshain, but in understanding miscarriage more generally.  Many women today need emotional support and understanding when they lose pregnancies, and they deserve that support.  At the same time, it could help us a great deal to learn to regard miscarriage as common, natural, and normal.  Miscarriages are a regular part of a healthy women’s reproductive life, just like intercourse, menstruation and pregnancies that go to term.

Innovations in Marketing to Pregnant Women: Sears “Baby Book,” 1907

In 1907, Sears came up with a fantastic new idea for marketing to pregnant women: it hired Mrs. Eliza Emerson Goff to organize all its maternity and baby goods, from maternity corsets to nursing blouses to layettes, rattles and doctors’ kits for home births, into a single catalog. Sears advertised its catalog in Women’s Home Companion and other women’s magazines, with a personal note from Mrs. Goff: “Let me send you a free copy of THE BABY BOOK. It will tell you many things that will interest you and will introduce you to the most exclusive and most beautiful baby clothes to be obtained anywhere. Address me personally. I want to handle your correspondence myself.” Printers’ Ink praised the approach as “introducing the human element in a way that seems sure to prove effective.”

The Baby Book was intended for “every mother, present or prospective.” It was the 1907 equivalent of the Right Start catalog. A woman could start shopping while she was pregnant, and keep the catalog around to order more as her baby grew. It covered every category of baby goods.

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What made this catalog so innovative was that it organized products according to the needs and shopping patterns of the consumer, rather than by categories that made sense to producers. The Sears “Big Book” of the era scattered baby goods across 700-some pages, with baby clothes next to adult clothes, diapers with tablecloths and towels, and baby spoons with silverware. To shop from the Big Book, a woman would have to know exactly what she needed, and searched for each item separately. The Baby Book educated women about all the items she might need or want, probably many more than she would have come up with on her own.

With this catalog, Sears began to think of pregnant women as a distinct category of consumer, and implicitly recognized the marketing incentive to reach women before they had their babies, while they still needed lots of stuff, and might be in the mood to buy extra. And thus we see the beginnings of shopping for the baby as one of the greatest potential pleasures of pregnancy.