The shadow of evil. The sins of a past life. Neglect. These are just some of the superstitions attributed to having a miscarriage in India. These myths are pervasive and not only haunt women’s homes but also trickle into the realms of healthcare, where they reasonably shouldn’t. “Before disclosing to me that we had lost the baby, my radiologist asked me a series of questions, like did you travel recently, did you lift something heavy, et cetera. My OB/GYN later assured me that none of these things can lead to a miscarriage, but I still felt immense guilt for a long time after,” Kavita Nehemiah told The Swaddle.

The societal horror of a miscarriage lies in what it seemingly represents: a primordial, unwholesome sign of a woman’s body rejecting motherhood itself.

“Elderly women will remind the woman who had had a miscarriage [or] abortion that she must have done something wrong in her previous birth and this is the way God has chosen to punish her,” says Usha Ram, a maternal and reproductive health researcher and professor at the International Institute of Population Sciences. The idea is based in the notion that a healthy birth depends entirely on how the person conducts themselves during their pregnancy – inadvertently paving yet another way to micromanage and control women’s bodies.

The science that has emerged around this is straightforward and has the potential to correct the cultural falsities around how much women can affect — or be blamed for — their pregnancies. In most cases, it is genetic abnormalities – which have nothing to do with how the pregnant person conducts themselves – that cause the body to automatically reject a fetus that is unviable.

A recent study – the largest of its kind – confirmed that randomly occurring chromosomal abnormalities cause most miscarriages. The finding could well usher in a paradigm shift in the way we think and talk about not only miscarriages but pregnancies themselves. Importantly, they highlight how women’s bodies aren’t merely incubators of new life that must be kept functioning like a machine. Instead, the research shows that bodies actively play a role in evaluating the health and viability of a fetus.

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“As the genetic makeup of the baby shapes up, there may be defective numbers of total chromosomes, which the body realises isn’t a normal genetic makeup of a human being. Then the growth of the pregnancy stops, turning into a miscarriage,” explained Dr. Vaishali Joshi, a senior obstetrician and gynaecologist from Mumbai. This happens more often than people assume, and it also shows how a miscarriage can actually be as “natural” as a pregnancy itself. It’s the body’s way of recognizing when something is wrong, but is mistakenly labelled an unnatural outcome to a pregnancy.

As The Swaddle noted earlier: “Sometimes, two partners’ genetic material combines in a way that doesn’t support a healthy human life; miscarriage is the the body’s natural termination of a pregnancy unlikely to result in a viable, healthy fetus.” That is, these are chance occurrences that have nothing to do with either parent. As a result, there’s almost no way to prevent miscarriages from occurring.

Despite this, the blame on women is implicit in the way that most cultures approach pregnancies, because of the valorization of motherhood. But there is more than just individual shame at play here. Many scholars studying the cultural norms around motherhood have noted how it constitutes “biopower” – or the capacity of the state to manage and control large groups of people. Constantly reiterated ideas about miscarriages essentially succeed in turning women’s bodies docile, accountable to external scrutiny, especially in the context of reproduction.

“Some [women] find themselves depressed or angry. Even guilt and self-blaming happens in several cases when the woman feels that it is she who is responsible for it. After a miscarriage, a woman’s brain turns extremely vulnerable due to grief, and she often finds all sorts of illogical reasons to blame herself. In one case, a woman I counselled believed she lost her baby during pregnancy because she had sexual relationships before marriage,” says Arti Sharma, a clinical and counseling psychologist, talking about how often she encounters the consequences of the cultural shaming around miscarriages.

Or consider the account of Bhavya: “My in-laws believed that I had killed the baby because it wasn’t my husband’s,” she told The News Minute.

The inescapable feeling of guilt and blatant shaming often involve parts of people’s lives that have nothing to do with the pregnancy itself – like allegations of infidelity and premarital sex – showing how the discourse around miscarriages is ultimately aimed at regulating women’s lives and choices.

“I was heartlessly blamed by social media trolls for the loss of one of my twins just because I flaunted my baby bump in a bikini,” Celina Jaitly Haag, an actor, told TOI. Once again, science has concluded that none of these are responsible for miscarriages – and yet they prevail, providing an easy narrative of blame that can police women’s everyday behavior in the name of motherhood.

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Mental Health Struggles Are Common After Miscarriage, but Women Get Little to No Support

The state has arguably the largest role in legitimizing these myths into forms of control. In Indian law, “deliberately” causing a miscarriage is a punishable offence. While the law was meant to criminalize sex-selective abortion practices by families and in-laws, because it applies to the people who are pregnant themselves, it inadvertently frames miscarriages as something that the woman can cause.

There are other factors that people believe to be responsible for miscarriages, including job stress, sex during pregnancy, lifting heavy objects, using contraception devices or birth control pills prior to the pregnancy. Some women are even advised to stop working during their pregnancies, and are later blamed for not doing so if they miscarry.

The idea goes back centuries. “Fright, blaspheming, strong emotions, sneezing, riding in a carriage, heavy lifting, and being conceived under bad planetary alignment were all thought to cause miscarriage,” as far back as the Middle Ages and beyond, notes one study. In the 20th century, miscarriages were linked to criminality and poverty, with working-class women being blamed for not wanting a pregnancy due to economic stress.

These ideas – all centered around controlling women’s bodies – are ones we’ve inherited and that persist even until today. What they all have in common is that they’re all lifestyle choices that are normally tinged with some form of stigma or shame in women, and that society in one way or another tries to control. And what better way to do so than to tie them with the sacrament of motherhood?

Contributing to the shame is the silence around just how common miscarriages are – and many reports suggest that people always tend to vastly underestimate this number. There are no officially recorded statistics for miscarriages, but estimates put the global number at approximately one in ten pregnancies. This number could be higher, given how many miscarriages happen before people even know that they’re pregnant. Previous research has noted that while most miscarriages remain undiagnosed and the causes are unknown, genetic factors may be at play in individuals who undergo recurrent miscarriages.

But it’s not all genetic either. Systemic causes make marginalized women more likely to experience miscarriages on account of receiving limited prenatal care. The lack of institutional support, moreover, puts the spotlight on the individual – furthering the notion of incompetence or a patronizing “lack of awareness” specifically among marginalized people. Further, the rate of recurrent miscarriages among Indian women is higher than the global average due to the added burden of infectious diseases and environmental factors – both systemic issues that have little to do with individual behavior and everything to do with how a state treats and cares for its population.

Climate change is another factor that has begun to influence who and how many people experience miscarriages; rising sea levels increase the salinity of drinking water, which is linked to miscarriage and preeclampsia. Malnutrition among people of reproductive age is another factor. In other words, when miscarriages aren’t simply a natural response to unviable pregnancies, they’re a public health issue that we need to take seriously. In neither instance does the individual have much to do with it, and yet they are overwhelmingly the ones who are blamed.

Some have begun to advocate for changing the terminology around miscarriage itself – calling it “pregnancy loss” instead, which would emphasize how an individual isn’t simply a “carrier” of fetuses but a complete, embodied human being undergoing a trauma. Further, by placing the onus of losing a fetus on the person who carries it, the term “miscarriage” inadvertently implies that there is a correct way of “carrying.” But combatting the myths around why pregnancies are lost is a trickier matter altogether: one that would require the emphasis on bodily autonomy, science, and a commitment to building institutional support for pregnant people from the ground-up.