The Brink of Being

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

Praise for The Brink of Being:

"[M]oving . . . a comprehensive picture of shame, grief, and other emotions that accompany such a specific trauma. The Brink of Being is also a call of action to doctors, families, and our broader society: How can we better support people who miscarry?" —Bitch Media

"This book should be required reading for anyone who has had a miscarriage or been close to a woman who has." —*The Mercury 

• "Those who have been touched by miscarriage will surely find [The Brink of Being to be] a great resource outlining the emotional landscape after pregnancy loss or as a guide to better understand what a woman might be enduring." —Associated Press

"Bueno’s choice of language is considered and thoughtful, unpacking difficult issues that are so often avoided for fear of causing distress. She writes with sensitivity and compassion, filling a much-needed void in discussion around the subject, and opening the door to more candid conversations." —Observer

"A much-needed book on this difficult and often unspoken loss." —Julia Samuel, author of *Grief Works

• "Intelligent, sensitive, and utterly candid . . . The sort of book women have long been searching for." —Meaghan O'Connell, author of And Now We Have Everything

"A book of profound insight, rare courage, and calm, searching compassion." —Zoe Williams, author of The Madness of Modern Parenting

"A thoughtful work that identifies and honors an important passage of life for a great many women." —Julia Leigh, author of Avalanche

"[A] profound game-changer of a book that can not only support women, but can help reshape a society that often ignores or sweeps women's issues under that proverbial rug." —Caroline Leavitt, New York Times bestselling author of Pictures of You 

"Beautifully written and thoroughly researched, The Brink of Being *is vital reading, both for those who have experienced miscarriage and for the people who want to support them. I think a lot of people are going to be stronger for reading this." —Keith Stuart, author of *The Boy Made of Blocks

"Julia is one of the most intuitive, compassionate, and curious psychotherapists around, and in her approach to miscarriage all of these qualities are shown." —Sathnam Sanghera

Auteur

Julia Bueno is a psychotherapist who specializes in working with women who have experienced pregnancy loss or struggled to conceive. Her writing has been published in The Times (UK), Express, Therapy Today, and welldoing.org, among others. She lives in London with her husband and two sons.

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One

A Child in Mind

The Unconceived, Barely Conceived, Unusually Conceived

When you think you're pregnant, and you're not, what happens to the child that has already formed in your mind? You keep it filed in a drawer of your consciousness, like a short story that wouldn't work after the opening lines.

-Hilary Mantel, Giving Up the Ghost

Miscarriage often involves the loss of a unique relationship with a baby--a relationship that may have begun long before the baby was conceived, especially for those who have yearned for a baby for years and may have struggled to get pregnant. But the notion of a relationship existing with our unborn--however developed in the womb he or she may be--took a pitifully long while to grab the attention of medical and psychological research and can still be a fragile one for many. And if this bond isn't fully understood, the grief flowing from its dissipation when a pregnancy ends has little chance of a healthy expression.

From the beginnings of my desire to get pregnant, nearly a year before I conceived my twins, I played out a number of stories in my head that also stirred my heart. Sometimes my baby was a girl, sometimes it was a boy, sometimes it had grown into a child. I would drift into reveries of how I would guide a teenage son to be a feminist or encourage a daughter to embrace physical adventures in a way that I never had. It didn't stop there-I even imagined becoming a doting grandmother to my grown child's children.

In early 2002, I took my first pregnancy test. I had, at last, a reason to suspect that my dreams had come true as, tantalizingly, my bleeding had failed to arrive. I knew exactly how the test worked, but I still read and reread the instructions in the packet, worried that if I interpreted them wrongly, I would sabotage any chance of becoming a mother. I prayed to a God I no longer believed in for a second pink line to emerge in the teeny white plastic window of the wand. My fantasy baby, wedged tentatively but tenaciously in my mind for the many months I had been hoping and hoping, was about to become real-or not. And when the second line did appear, the bond with my baby in my mind instantly changed dimension.

These heartfelt imaginings I both enjoyed and worried about are often beyond our control. If our thoughts have an emotional charge-such as "I desperately want a baby" or "Maybe this month I'll be pregnant"-they can easily become tenacious. Trying to stop thinking about something that concerns-or threatens-us rarely works: the ruminative power of our mind is too forceful. I have yet to encounter anyone who wants to be pregnant and can successfully switch off their hopes, dreams, and fears about it, even if they try.

This mental labor in itself contributes to the sparks of a relationship with our unborn: the more we think, plan, daydream, or dream dream about our longed-for baby, the deeper the grooves in our mind become. In neuroscience, this concept has been summed up by the phrase "Neurons that fire together, wire together," coined by a Canadian behavioral psychologist, Donald Hebb, who proposed that the more we repeat a thought, feeling, or behavior, the stronger the neural connections in our brain become. And as these neural connections strengthen, the more we are prone to these thoughts, feelings, and behaviors.

Imagine learning that you have a very good chance of winning the lottery over the next few months. I challenge anyone not to think about-or find themselves thinking about-what they would do with their winnings. A real possibility, or probability, of something life changing can worm itself deep into our minds and hearts. And when a pregnancy is confirmed, this probability-and corollary relationship with an unborn-that had prevailed in mind then literally prevails in body, and in the world too.

Claire came to see me in the wake of her first miscarriage at nine weeks, and she left me in no doubt about the strength of her feelings for the baby she was still yearning for. Many other people she had turned to couldn't seem to understand that, for Claire, it didn't matter how tiny it was or that she was unable to describe what it looked …