The Brink of Being: Talking About Miscarriage

by Julia Bueno

"Wise and compassionate . . . a profound game-changer of a book." --Caroline Leavitt, author of Pictures of You

Though approximately one in four pregnancies ends in miscarriage, it remains a rarely talked about, under-researched, and largely misunderstood area of women's health. This profoundly necessary book--the first comprehensive portrait of the psychological, emotional, medical, and cultural aspects of miscarriage--aims to help break that silence.

With candor, warmth, and empathy, psychotherapist Julia Bueno blends women's stories (including her own) with research and analysis, exploring the effect of pregnancy loss on women and highlighting the ways in which our society fails to effectively respond to it. The result is a galvanizing, urgent, and moving exploration of a too-often-hidden human experience, and a crucial resource for anyone struggling with--or seeking to better understand--miscarriage.

Genres: Nonfiction, Parenting, Memoir, Mental Health, Death

320 pages, Paperback

Published July 2, 2019

Reviews

[Rachel Miao · Rating 5 out of 5]

I appreciated the lovely blend of styles/lenses throughout this book: journalistic, scientific, autobiographical, anthropological. It's personal, professional, and interesting. It helped me process my miscarriage in a way that engaged both my head and my heart. I especially love that she explores perspectives on pregnancy loss from antiquity.

The Brink of Being is also wonderfully practical; Bueno deftly translates how such an intimately personal experience can be drastically shaped by hospital policies, various campaigns, federal laws, and the linguistic choices we make (or that have been made for us).

If I had to recommend a single resource on early pregnancy loss, this would be it. It's a fantastic resource ror women, partners, friends, and family alike.

[Annie McArthur · Rating 4 out of 5]

An insightful book into a topic so rarely talked about. Was helpful to be understand better what some close to me have sadly gone through and given more empathy into different ways people grieve and how to be of support. Would be wary about reading this if you are hoping to get pregnant soon and have not lost a little one. To those who pick this up, be gentle X

[Sandi · Rating 4 out of 5]

A issue that is often not talked about, but needs to be--with compassion. One of the few books I could find about the subject. Cases discussed are in the UK.

[Phoebe · Rating 4 out of 5]

Perhaps a bit UK-specific in parts, but overall a worthwhile (and very touching) read about something we don’t talk about anywhere near as much as we should

[Krista · Rating 4 out of 5]

A heartbreaking read, but an insight into a topic that many are reluctant to discuss. It was an uncomfortable read, but it helped me understand what other women have gone through. We need to be more open and have conversations, to help others understand and to heal.

[Janel Atlas · Rating 5 out of 5]

I've read a lot of books about babyloss, and this one is right up there with the best. It's compassionate, thoughtful, story-driven, and will be helpful to both babyloss families and those who know them.

[Laura Hennen · Rating 4 out of 5]

I found much of this book immensely helpful in grieving following my miscarriage.

[Susanna · Rating 5 out of 5]

"For a decade, the framed footprints sat beside me as I slept and were directly in the line of the sun that streamed through my window on spring and summer mornings. Very slowly, imperceptibly at first, the sunshine bleached the footprints away. I watched it happen. Year after year, my only link to my babies' soles and twenty teeny toes disappeared before my eyes, yet I was seemingly unable to move the frame. I was frozen--again--by pain, denial, and not-knowing, just as I had been at the time of their births." (Chapter 6: Efforts to Remember, Pressure to Forget).

This book is a tender exploration of miscarriage. Bueno seems to have chosen every word with great care. Each chapter she discusses one person's story and weaves in the history of miscarriage and medical explanations throughout.

I came away grateful for how my parents commemorated their miscarriage in the 90s, realizing now it was probably quite unusual. At the time, it seemed normal that my siblings and I would get to see my little brother's tiny body, that we would name him, help to bury him, and think of him when we saw the dogwood flowering over his grave.

I picked this book up at the library along with several others about miscarriage (I Had a Miscarriage and The Myth of the Perfect Pregnancy) out of curiosity.

[Josh · Rating 5 out of 5]

The Brink of Being is a book that should be required reading for all, acknowledging that the assignment will probably be an uncomfortable and eye-opening experience. The loss of a pregnancy, while common, is a gut-wrenching trauma that is remarkably misunderstood and even discounted, even in the 21st century, meaning it is also a uniquely solitary experience for those most directly affected. Pregnancy loss occurs in roughly 1 in 4 pregnancies; so you undoubtedly know someone who has suffered, whether you are aware of their loss or not. This book’s purpose is to make more people aware, and therefore, more informed and appropriate support available to those who need it.

If you or your partner has directly experienced miscarriage, stillbirth, or any loss of a yearned-for child, this book will certainly be a tough read, and its stories of other families’ experiences will likely bring back your own painful memories. If pregnancy loss is something you haven’t experienced directly, or you want to learn how to better understand and care for your loved ones who have lost, then please consider this book.

The Brink of Being is written by a therapist specializing in the care of mothers and families who have experienced pregnancy loss. It covers all stages of this not-well-understood trauma, from the earliest miscarriages in the first few weeks of pregnancy to late-stage loss and stillbirths. The author also admirably, empathetically, presents the cases of even lesser understood and respected feelings of loss, for example, those experienced by same-sex couples, fathers-to-be, and others not “directly” impacted by the pregnancy.

In a perfect world, The Brink of Being will illuminate this trauma to create a larger support network for those who have lost a pregnancy, and to normalize their feelings/experiences in order to shift priorities of care for affected families (family leave policies, funeral & memorial rites, medical provider empathy, and semantics issues, etc.).

Highly recommended.

[Andi · Rating 5 out of 5]

“Just as no miscarriage can ever be the same as another, neither can the experience of what comes in its wake. Every pregnancy, and each abrupt ending, is embedded in its own constellation of circumstance.”

This book was so beautifully written with consideration of how every story of loss is unique, but all stories are worth telling. It blended stories with facts and historical understanding of losses in such a compassionate way. I recommend this book to all who have experienced loss, and to those that want to understand more of what loss entails physically, medically, and emotionally.

“As so many couples discover in the wake of their heartache, miscarriage is common yet generally little understood, and this lack of knowledge compounds the grief of so many bereaved.”

Let this book deepen your knowledge and/or give space for your grief to unravel & gain some comfort in the connectedness of the experience of loss

[Sarah · Rating 5 out of 5]

An essential book on a topic that remains taboo and hardly spoken of publicly. This gives vital insights into many aspects of miscarriage. It is of course heartbreaking, but makes the case for the need for better care and communication so clearly. I imagine it would also be a solace to those who have experienced a miscarriage, and it also provides helpful information for those who are interacting with a friend or colleague who has had a miscarriage (or indeed multiple miscarriages).

This is also essential reading for any healthcare professionals involved in the care of women in pregnancy or where pregnancy ends, particularly those in A&E or O&G. We can and must do better as a profession in the care given to these mothers.

Content warnings: discussion of miscarriage (and associated medical procedures and similar) is sometimes graphic.

[Anna · Rating 4 out of 5]

Although I have read several books on pregnancy and parenting this is an aspect that I had not previously explored. Bueno covers the emotional ground in great detail and with great sensitivity. I almost feel I could even support a friend or loved one through this trial, if I was any good at being that kind of support. The most disappointing thing about this book is that it does not include an appendix of resources for further information or support. I found this particularly odd when she was bewailing that her clients were never given enough good information about the process, but she does not include that information in this book either.
Popsugar Reading Challenge 2020: A book you picked up because the title caught your attention

[Hoan · Rating 5 out of 5]

Surprisingly touching, compassionate and thorough are what come to mind as Bueno collectively shares stories of miscarriages experienced by her clients and of her own losses in addition to the variety of research on the subject matter. Very relatable, sad at moments from the raw details of these tragic occasions but eye opening and insightful. I felt like not only was this thought provoking but written with so much respect and compassion for those who have experienced loss that is often not acknowledged. I recommend this to anyone who is considering having a baby or has experienced a loss or know of someone who has. Well written and appreciated insights.

[Quinn · Rating 4 out of 5]

While this book is interesting and insightful, I didn’t find it as helpful for me. It’s very academic, with clearly a ton of research put into it. But because of the sheer amount of information presented, it felt more stilted I felt less of an emotional connection. It was also harder to connect as much with the stories since I knew they were combinations of various patients, so I knew they weren’t “real”. The stories were real, but not necessarily combined in the way they were.

[Amanda · Rating 4 out of 5]

I thought it was touching and delved into a lot of the aspects of miscarriage that people do not usually get to hear about. I myself have never been pregnant nor miscarried so obviously I don't know much about it but from a feminist perspective I think it's great as a book to give more information and personal stories on this often silenced topic

[yossi · Rating 5 out of 5]

a very insightful book about miscarriage. i didnt know much about miscarriage, so when i stumbled upon this book on a book fair, i immidiately picked this book up. this book helped me learn a lot of new things about miscarriage. took me so long to read because a lot of these terms are unfamiliar to me.

[Alex Hayes · Rating 5 out of 5]

I would highly recommend this book for anyone who has been through or wants to better support anyone going through a miscarriage. This book is the perfect balance of research and personal experiences.

[Alyssa Roberts · Rating 3 out of 5]

I can see how this could be helpful to some women but it wasn't for me. I didn't relate to how a lot of these women felt and I was hoping for more medical information about miscarriage but this was all about the mental and social impact of it.

[Brooke · Rating 5 out of 5]

A must read for anyone going through loss or supporting a couple experiancing loss. This book helps bring emotional support, as well as education on the subject. I'm glad I found this book, as many other books surrounding the topic have a religious focus - while this did not.

[Amy Engelhard · Rating 5 out of 5]

For anyone who has experienced a miscarriage, this book is extremely helpful in navigating your feelings.

[Aly Salustri · Rating 1 out of 5]

Did not find it helpful post miscarriage.

[Daniella Graham · Rating 4 out of 5]

Thought this was a really smart and compassionate book. Discusses the emotional as well as physical complexities of pregnancy loss in an intelligent yet empathetic way.

[Jemima Barnes · Rating 4 out of 5]

clear, compassionate and informative. kind of wished i read this before pregnancy and loss to feel less alone in my experience of the latter.

[Lori · Rating 5 out of 5]

I have read a lot of books & memoirs about pregnancy loss since my daughter was stillborn 21 years ago. I agree with Goodreads reviewer Janel C. that "The Brink of Being: Talking about Miscarriage" by Julia Bueno ranks among the very best. It deserves to be widely read, not only by those who have experienced loss, but those around them, including family members & friends as well as medical professionals, human resources experts and others.

Bueno uses the experience of her own miscarriages (including twin girls), as well as those of composite patients from her psychotherapy practice (specializing in infertility & loss issues), to explore various aspects of this often misunderstood loss. I normally tend to be slightly leery of the use of "composite" figures in books, but these were so well drawn with such compelling and believable stories that after a while I forgot they were composites.

"I then stepped back out into the world as a woman who had just had a miscarriage," Bueno writes in the introduction. "This was a world that would struggle to understand both the physical process that I had been through and the agonizing nature of my everlasting grief. A world that didn't want to know the details of what had happened, let alone remember them; a world that didn't know if I was a mother or David a father or whether my two babies had been born or whether they had actually died. This world was poorly equipped to support me -- and the countless other women and couples I soon discovered who were also reeling in their own versions of such pain."

The book explores "the potentially profound relationship that can come into being with a barely conceived or even unconceived baby, which lays the foundations for profound grief when a pregnancy ends." It examines the differences -- and similarities -- between early and later losses, and "the gruelling nature of repeated miscarriage." Bueno also addresses the impact miscarriage has on partners, family members and others around us, and how we choose to dispose of (cremate/bury/etc.), and remember, these tiny beings (in a chapter titled "Efforts to Remember, Pressure to Forget").

In addition to personal stories, there is a blend of research and statistics, as well as examples of how different cultures deal with the subject of miscarriage and other pregnancy losses, and advances in developing medical protocols and support structures to help those affected. (Bueno is British, and most of her information is U.K.-centric, but she also includes information from the U.S., Australia and other countries.) "Although I acknowledge how far we have come, I also want to show you how much further we can, and must, go," she writes in the introduction.

This was a lovely, warm, compassionate book about a rather un-lovely subject. Five stars on Goodreads.

[Pauline]

Interesting, but a text book

[Marina · Rating 5 out of 5]

This book was a much needed read for my soul. So calming, though such a complex subject and yet so comforting and compassionate.
Will come back to it (hopefully won‘t have to).