Introduction: bearing the weight of loss in a crowded hospital
Three years have passed since my miscarriage, yet the shadow it cast still lingers in ordinary moments. My hospital memory is a blend of clinical routines, quiet loneliness, and small revelations about what care can be—and should be—during pregnancy loss. While the world contended with Covid-19, I faced a pregnancy that began with optimism and ended with a quiet, solitary surge of medical decisions. This is not a single story but a thread that runs through the experiences of many mothers who navigate miscarriage in the shadow of a strained health system.
Solo journeys through pregnancy and loss
For much of my first pregnancy, care arrived in fragments. I attended every appointment alone, while loved ones waited in public spaces near maternity units, anxious, distant, and uncertain. The isolation felt like a standard feature rather than an exception—a normalization I didn’t question at the time. When the pregnancy ended at just over 13 weeks, the instinct to have immediate procedures was strong, and I scheduled a D&C without considering whether my husband could be present. It wasn’t until later that I realized how deeply the pandemic had shaped my sense of agency in the hospital: the belief that certain experiences were solitary “me things” rather than shared moments of grief and support.
Trusting my body and listening to the data
As a philosopher who studies the history of science, I learned to balance reverence for medical expertise with healthy skepticism about definitive certainty. My own body provided a stubborn counter-narrative: a regular 29-day cycle, early scans that questioned the timing, and dates I trusted even when the medical theory suggested otherwise. There is a danger in clinging to optimism when it serves as a shield against recognizing signals your own body has repeatedly sent. In hindsight, trusting my knowledge of my cycle might have saved me a different kind of heartbreak, a reminder that patient insight remains essential in medical decision-making.
Infrastructure and compassion: the built environment of care
One vivid memory is the row of seats facing a hospital registration desk, where I sat between two heavily pregnant women heading toward birth. The juxtaposition of birth and loss in the same space underscored a design truth: infrastructure matters. Good design carries compassion—clear spaces, attentive staff, and spaces that respect both someone arriving for birth and someone facing miscarriage. But the reality I faced included the strain of ongoing construction, repurposed rooms, and the unsettling background of newborn cries from a recovery area where I was eating my first post-surgery toast. The emotional toll of such sensory contrasts should not be inevitable; it points to the urgent need for healthcare spaces that support dignity in all stages of reproductive experience.
Covid-era lessons: safety, support, and the fight for better care
The pandemic magnified the gaps in care, insisting that safety and compassion are not mutually exclusive. It highlighted the need for paid miscarriage and fertility leave and prompted calls for legislative progress. Yet policy changes are not enough without buildings and systems that acknowledge the lived realities of those who miscarry. We deserve environments where partners can stand beside us, where privacy and comfort are prioritized, and where the emotional weight of loss is met with practical, humane support rather than clinical distance.
A call to action: how we move forward
Healthcare should reflect both scientific rigor and human vulnerability. As we rebuild hospitals and revise public health planning, we must ensure spaces are fit for purpose and mindful of the long shadow miscarriages cast. Balance safety with ongoing care that honors patient experience, supports families, and recognizes the legitimacy of grief in all its forms. The conversation should continue—through policy, design, and everyday practice—until no one has to navigate miscarriage in a building that feels more like a block than a sanctuary.
In Ireland and beyond, the path forward lies in listening to patients, learning from our shared histories, and building healthcare that stands with us—not against us—when we need it most.
