One small step for Harry and Meghan, one giant leap backward for women

I am neither “Team Kate and William” nor “Team Meghan and Harry.” I used to be ambivalent about the media narrative surrounding Britain’s royal family. However, when I watched Harry and Meghan on Netflix, my fertility doctor brain could not help but revolt at the sixth episode. And when I learned that 28 million households had already viewed it (Netflix’s highest-viewed documentary ever), I was deeply saddened that the miscarriage-without-stigma movement had taken a huge step backward.[1,2]

Rewind to 2020, before the Netflix series, when Meghan wrote an opinion piece in the New York Times titled “The losses we share.”[3] She wrote about having a miscarriage after the first night in their new California home: “I felt a sharp cramp. . . . I knew, as I clutched my firstborn child, that I was losing my second.” The essay was widely praised as a brave and raw description of the pain and loneliness that women suffer when miscarriage occurs.[4] In the piece, she also wrote about the collective grief of a nation mourning the losses of George Floyd and Breonna Taylor. I loved her essay and shared it widely, grateful that someone of her public status was talking openly about loss and calling for unity and support.

In their recollection of that same miscarriage for the Netflix series, however, the narrative changed. Meghan and Harry’s description was that the pregnancy loss occurred after Meghan “wasn’t really sleeping,” having just moved into a new house and enduring stress caused by tabloid papers.[5,6] “I believe my wife suffered a miscarriage because of what the Mail did,” Harry said. “Now, do we absolutely know that the miscarriage was caused by that—’course we don’t. . . . But bearing in mind the stress that caused, the lack of sleep, and the timing of the pregnancy—how many weeks in she was—I can say from what I saw, that miscarriage was created by what they were trying to do to her.”

Attributing her miscarriage to the media troubles me. It implies that miscarriages can be avoided, and worse, that someone is to blame. In most cases, this could not be further from the truth. I am obviously not Meghan’s doctor, nor do I have any details about her medical history, but as a fertility specialist I can say that, statistically, her chances of a clinical miscarriage around age 39 would have been 30% to 40%, purely based on age.[7,8] The odds of any conception being chromosomally abnormal (aneuploid) at age 39 is even higher, at 50% to 60%, which is why many early miscarriages go unrecognized.[9]

I spend my days counseling patients, in the most compassionate way that I know how, about the negative effects of age on eggs. I am continually trying to comfort and reassure my patients that miscarriage is not their fault. People cannot be blamed for a pregnancy loss because they went to work, took a walk, ate spicy food, had intercourse, missed a prenatal vitamin, swam in a pool, or lifted their toddler. In most cases, miscarriage is not pathological. To be clear, just because miscarriage is common does not mean it’s not heartbreaking, devastating, painful, and traumatic. Miscarriage can be all those things and still be a normal part of reproduction. I think that miscarriage, like any loss, can affect people differently. I encourage my patients who have endured a pregnancy loss to take time to process and to grieve. I encourage self-care, not self-doubt.

The sooner we accept that miscarriage can be normal, the faster we will reduce the shame and stigma that people face when Mother Nature errs. My heart goes out to Meghan and Harry for their loss, and I hope they have since sought the healing and care that prospective parents deserve when faced with such a difficult part of life.
—Caitlin Dunne, MD, FRCSC

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References

1.    O’Kane C. “Harry and Meghan” is Netflix’s highest viewed documentary ever. CBS News. 14 December 2022. Accessed 20 March 2023. www.cbsnews.com/news/harry-and-meghan-documentary-netflix-highest-viewed-premiere.

2.    World Health Organization. The unacceptable stigma and shame women face after baby loss must end. Accessed 20 March 2023. www.who.int/news-room/spotlight/why-we-need-to-talk-about-losing-a-baby/unacceptable-stigma-and-shame.

3.    Meghan, the Duchess of Sussex. The losses we share. New York Times. 25 November 2020. Ac­cessed 20 March 2023. www.nytimes.com/2020/11/25/opinion/meghan-markle-miscarriage.html.

4.    Puente M. Duchess Meghan praised for sharing miscarriage; Chrissy Teigen in “grief depression hole.” USA Today. 25 November 2020. Accessed 20 March 2023. www.usatoday.com/story/entertainment/celebrities/2020/11/25/meghan-markle-praised-opening-up-miscarriage-raw-essay/6421173002.

5.    Gretener J. Harry blames media coverage for Meghan’s miscarriage. CNN Entertainment. 15 December 2022. Accessed 20 March 2023. www.cnn.com/2022/12/15/entertainment/harry-meghan-netflix-miscarriage-scli-intl/index.html.

6.    Kirkpatrick E. Prince Harry blames stress from the Daily Mail lawsuit for Meghan Markle’s miscarriage. 15 December 2022. Accessed 20 March 2023. www.vanityfair.com/style/2022/12/prince-harry-blames-daily-mail-lawsuit-stress-meghan-markle-miscarriage-harry-and-meghan-netflix-documentary-new-york-times-op-ed.

7.    Kausar S, Bewley S. Pregnancy after the age of 40. Women’s Health 2006;2:839-845.

8.    Nybo Andersen A-M, Wohlfahrt J, Christens P, et al. Maternal age and fetal loss: Population based register linkage study. BMJ 2000;320:1708-1712.

9.    Franasiak JM, Forman EJ, Hong KH, et al. The nature of aneuploidy with increasing age of the female partner: A review of 15,169 consecutive trophectoderm biopsies evaluated with comprehensive chromosomal screening. Fertil Steril 2014;101:656-663.