I'm Sorry for My Loss: An Urgent Examination of Reproductive Care in America

by Rebecca Little, Colleen Long

A must-read investigation of reproductive health under fire in Post-Roe America.

More than a million people lose a pregnancy each year, whether through miscarriage, stillbirth, or termination for medical reasons. For most, the experience often casts a shadow of isolation, shame, and blame. In the aftermath of the 2022 decision to overturn Roe v Wade, 25 million people of childbearing age live in states with laws that restrict access to abortion, including for those who never wanted to end their pregnancies. How did we get here?

Rebecca Little and Colleen Long, childhood friends who grew up to be journalists, both experienced late-term loss, and together they take an incisive, deeply reported look at the issue, working to shatter taboos that have made so many pregnant people feel ashamed and alone. They trace the experience of pregnancy loss and reproductive care from America's founding to the present day, exposing the deep impact made by a dangerous tangle of laws, politics, medicine, racism, and misogyny. Combining powerful personal narratives with exhaustive research, I'm Sorry for My Loss is a comprehensive examination on how pregnancy loss came to be so stigmatized and politicized, and why a system of more compassionate care is critical for everyone.

Genres: Nonfiction, Feminism, Politics, Health, Memoir, Audiobook, Womens

488 pages, Kindle Edition

First published January 23, 2024

Reviews

[Sharon Orlopp · Rating 4 out of 5]

Rebecca Little and Colleen Long have written a powerful, memorable, must-read book about pregnancy loss in I'm Sorry for My Loss: An Urgent Examination of Reproductive Care in America. One-third to one-half of women experience a pregnancy loss due to miscarriage, stillbirths, or terminations for medical reasons. Yet it's something that is rarely talked about and in our post-Roe era, the impact and unintended consequences are tragic.

Hospitals and doctors, particularly in states with restrictive abortion legislation, are afraid to treat women who are experiencing serious pregnancy complications or situations where there are fetal anomalies. The result is that some women who decide to terminate a wanted pregnancy due to fetal anomalies or because the baby has died in their womb are sent to abortion clinics and must walk the gantlet of protestors in order to receive care.

Very few doctors provide information when a woman is pregnant about the possibilities or symptoms that something could go wrong. Annually, one million women experience a pregnancy loss. There are incredibly horrible stories in the book, particularly for Black women, about doctors who don't listen to their patients' concerns about their pregnancies....unfortunately the outcome can be very dangerous or deadly.

The statistics that are provided in this book include:
* One in four women have gotten an abortion

* A research study in 1953 showed that 24% of married women had an illegal abortion and 9 out of 10 teen pregnancies resulted in an abortion

* The current infant mortality rate in the US is 33rd out of 38 developed countries

* The current US maternal deaths is 32.9 per 100,000. The next closest country is the UK at 10.7 deaths per 100,000. Black women in the US who experience maternal deaths is 69.9 per 100,000. Maternal death rates are an indication on how we view women's health.

* 69% of Americans believe abortion should be legal for the first trimester

* Pregnancies are more fatal than abortions when abortions are legal

* Maternal mortality rates are the highest in states with the most restrictive abortion laws. Idah0 has stopped tracking maternal mortality rates; it is one of the most restrictive states for abortion.

* 60% of the women in The Turnaway Study were already mothers. It is a myth that abortion is used as a form of birth control. Many mothers want to limit the number of children due to financial concerns.

* Stillborn rates are still the same as 15 years ago.

One of the scariest parts of the book was that doctors who are worried about stringent abortion laws and "bounties" for those who turn in doctors and patients for having an abortion have started performing hysterectomies on women who come to them for an abortion. YIKES. WTH!

Troubling, insightful, and memorable book that should be read by women and men.

Thanks to NetGalley for a free ARC in exchange for my honest review.

[Jillian B · Rating 5 out of 5]

This is a deeply important book that sheds light on an aspect of reproductive justice that has received relatively little attention: the loss of wanted pregnancies. With humour and sensitivity, the authors explore how Americans have historically viewed miscarriages and the wrong footed ways in which society responds to them. It also sheds light on the very thin line between miscarriage and abortion (for instance, the deliberate early induction of a terminally ill fetus is not easily categorized) and the harmful impact that rigid abortion laws have on miscarriage care. I loved that the authors included the experiences of women of colour and nonbinary and trans pregnant people, and explored the unique ways pregnancy loss impacts these groups. This book gave me, someone who has never been pregnant, some much-needed understanding of these issues and why they are important. This is such a crucial read.

[Dee · Rating 4 out of 5]

4 solid stars for this very timely & insightful book. There is a real need for examining how our society treats pregnancy loss along with reproductive rights & this book is a good start on those conversations.

[Kerry Mullaney · Rating 5 out of 5]

I feel like women should be screaming all the time

[Cari · Rating 5 out of 5]

You may wonder what would motivate a person to pick up a book like this. For me, it was because I have friends who have been affected by loss, and I wanted to know how to show up for them. It's incredibly sad, true, but it's also filled with hope. It's about helping people heal while also naming the roadblocks that stand in their way. It's about unraveling complicated grief and searching for ways to fix our undeniably broken system. Both authors have experienced loss, and their stories bring vulnerability and authenticity to the narrative. They also explain complex issues--I can't even expand too much without worrying I'd misrepresent them. For instance, a person who has lost a wanted pregnancy might refer to a baby while someone who had an abortion might refer to tissue. It gets much deeper than that, so I highly recommend this book even for those who have not experienced this grief or loss. We are at a tipping point with reproductive care in this country, and the authors' keen observations are so important to our activism and support of grieving parents.

[laurel [the suspected bibliophile] · Rating 5 out of 5]

As someone who is childless by choice, a book about miscarriage in the US is perhaps not the first thing I'd pick up. But as someone with the potential to get pregnant, reproductive care and rights is something I deeply care about (and even people without the potential to get pregnant should care about reproductive rights and access to equitable, affordable healthcare).

This is a very thoughtful book about reproductive care—focusing intensely on how miscarriages are handled both presently and historically, and how people experiencing pregnancy loss deal manage their grief and how society expects miscarriage grief to be handled.

I learned a lot, I thought about a lot, and I really recommend people pick up this book.

[Rocio · Rating 4 out of 5]

Such a validating book on how so many pregnant related loss is experienced, I love the different perspectives of people’s stories mixed in with actual history backed by facts.

I hate the direction where reproductive health has gone in this country. Having the right to choose in my state legitimately saved my life.

I feel so angry at the system, so helpless. My heart aches for future generations and where we are headed.
Being educated and hearing stories of others and realizing that your feelings are valid are the only ways I know to feel slightly better.

[Ro U · Rating 5 out of 5]

As someone who has had an abortion of wanted pregnancy, and volunteers in reproductive rights, this book is absolutely critical reading in the Post-Roe landscape. It felt so nice to be SEEN as other publications completely dismiss circumstances such as my own. It was also really gratifying to see so many concerns that I have around the categorization of medical treatments and how they impact individuals brought to a larger stage. I loved the bits of humor (as a later abortion loss mom that uses some myself!) and the pacing of the book. I highly recommend this and will be buying copies to give to others.

[Maddie · Rating 5 out of 5]

This should be required reading for all Americans.

[Kara S · Rating 5 out of 5]

Extremely relevant and important book. Difficult subject matter but easy to read writing-wise. Clears up a lot of misconceptions about pregnancy/miscarriage/abortion and does an excellent job of weaving in personal stories with facts and statistics. I also thought the discussion on the history of abortions and miscarriages was fascinating. My only critique is that I would’ve loved to see a table or something outlining all of the current abortion laws in each state— they mention a lot of individual states’ laws and emphasize how the dobbs ruling eliminated federal protections, so I think it would’ve been relevant. Either way, I highly recommend and think everyone should read this.

[Morgan · Rating 5 out of 5]

I cannot emphasize enough just how important this book is.

[Jessi Hines · Rating 4 out of 5]

4.5, omg this made me so angry. such an excellent book!

[Erika Horton · Rating 5 out of 5]

Such an amazing but mentally exhausting book to get through.

[Kara · Rating 4 out of 5]

I found this book to be incredibly interesting. Having experienced my own loss, many parts of it really resonated with me.

However, I almost stopped reading this book in chapter 7 when the authors write that Dr. Steve Calvin "said he's had some patients bullied by their providers into terminating, especially genetic counselors." I feel the authors could have left out this man's personal opinion (and clear vendetta) against GCs. I am obviously biased as a genetic counselor myself and won't claim that all of us are perfect all the time. I believe that women who are in shock after hearing a fetal diagnosis may hear someone discuss the option of termination and feel that they are being told to terminate. But "bullying" a patient into termination goes completely against our training to be non-directive.

Looking at Dr. Calvin's Minnesota Birth Center page, where it talks about their new model of care that "embraces normal pregnancy and birth", I'm not sure why this man was included in a section about perinatal hospice, which is not normal pregnancy.

I wish the authors would have thought twice about throwing a whole profession under the bus based on one man's opinion. A profession that often helps women understand their baby's condition and their options...

[molly kerstetter ferris · Rating 5 out of 5]

Truly heartfelt, authentic, and factual . The authors combine historical facts, cultural influences, with the many real stories of people who have experienced one of the worst types of loss a human being can endure. And somehow as one reads , they find themselves crying AND laughing , and a fire lit from within to make a move for change so that people who lose babies do not continue to have their grief worsened by the chaos of the current medical system and a culture that has no framework for how to acknowledge and help those experiencing this type of grief.

[Jamie · Rating 5 out of 5]

I know a book is going to be good when it starts off with the way language limits or distorts our understanding of a subject. Recommended to absolutely anyone, with or without a uterus, with or without the intention to procreate. It’s ostensibly about pregnancy loss and miscarriage/stillbirth awareness, but that overlaps with many things—abortion, grief, medical misogyny, racial injustice, human rights. The authors treat a sensitive topic with care and respect, and fury when called for.

U.S. laws around women’s bodies, pregnancy, miscarriage, or abortions are rooted in a lack of understanding of how it all works, and it’s no coincidence that the women I know who are anti-abortion were raised with abstinence-only education. As the authors bluntly put it: “if you don’t even really understand how the fetus gets in there, you don’t sweat the details of how it gets out. Birth, miscarriage, abortion—it’s all a mystery.” Books like this go a long way toward rectifying that lack of understanding, and if we’re gonna stop the spiraling reproductive care crisis, it’s not a moment too soon.

ARC kindly provided by the publisher via NetGalley in exchange for an honest review.

[Nora · Rating 5 out of 5]

I am not American but i’ve always been fascinated by what makes this weird nation tick and you know what
it’s the capitalism-led patriarchy. anyway this was an arc on netgalley and it piqued my interest and thought i would check it out , was pleasantly surprised .
the topics discussed wether it’s abortion or just plain female patient care that’s regarded as a nuisance
it’s universal, the problems are universal and for this book to show all of this , specially currently with the ongoing genocide in gaza where women are dying wether it’s by american-funded israeli bombs , lack of period products , no hospitals to give birth in
i think this book does highlight how women’s bodies are never truly ours and how the big man (namely america here) fucks us all over all around the world
anyway this was a good read!

[Becca · Rating 5 out of 5]

I initially wanted to read this book because I was interviewed for it. I was curious to see if/how my story was written about. After I started reading though, I couldn't put it down. This was such a phenomenal read. Rebecca and Colleen wrote an amazing book. I plan on recommending this to EVERYONE, no matter their views on loss, abortions, politics, etc.

I loved all the bits of humor and asides by the authors. I cried and grieved for those who have lost.

I found the history on loss (miscarriage and abortions) to be fascinating. The profound change we as a society have gone through even in the last 100 years and how we view pregnancy and loss is eye-opening. Do not hesitate to read this book.

Thank you Netgalley for the ARC.

[Lisa · Rating 5 out of 5]

This book brought me to tears when I saw myself and what could have been my story outlined on the pages. I have never used the terminology, but yes, I had an abortion. My pregnancy could have never resulted in a viable baby, and it was aborted by a medical professional. I learned that my medical diagnosis is rare; so rare that I wouldn't trust that lawmakers would ever think to include it in whatever legislation they feel must be passed. So had my 2004 pregnancy happened in 2024, I shudder to think what I would have had to do to take care of myself.

I'm so grateful to Rebecca Little and Colleen Long. They gave voice to my thoughts, feelings, and fears far more elegantly and succinctly than I could hope to accomplish.

[Laura · Rating 5 out of 5]

Very sad first-hand accounts of women losing their babies, but very informative.
I think it did a good job of giving an overview of everything related to miscarriage, stillbirth, and abortion, especially for someone who hasn’t gone through it & probably doesn’t realize how all-encompassing that experience and loss is. It allowed me to realize more ways to be more empathetic to those in my life who have experienced that loss & how to better show love and support to them. ❤️

[Heidi · Rating 5 out of 5]

Essential reading for this present moment. It simultaneously affirmed every single desire I have ever had not to have biological children and to fight for the right of everyone else to have the freedom to make that choice for themselves. So much of the modern "debate" about reproductive care relies on false dichotomies and black-and-white thinking, and this book proves how damaging those arguments can be.

[Nicola Roux · Rating 4 out of 5]

This book took me ages to read not because it wasn’t good but because the topic was best absorbed in bite sized pieces. It managed to be serious and heavy without being dull or leaving me despairing. I appreciated the breadth of experiences represented in this book and the care taken to not categorize different types of pregnancy losses into a hierarchy. We are collectively so bad at addressing grief and loss in the Western world, and even more so when it comes to pregnancy loss, but this book tackles the subject head-on with unflinching (but not uncaring) frankness. Overall a thoughtful and thought-provoking read.

[LJ · Rating 4 out of 5]

I wish I could give this 4.5 stars. Who am I to say what is important, but I feel that this book is important. I think we need to be reading more books like this. I thought this was very well done, matter of fact, matter of heart, and incredibly insightful into the experience of pregnancy/child loss and how culture and significance has changed over time. I can 100% say I am a more empathetic person after reading this book. This was a long read for me. I think this offers great thought fodder for how our language / rhetoric is so influential.

To every person who has lost a baby or fetus or however you characterize it, my heart hurts for you. I dearly hope not to join your club but I am so grateful that I read this book so that in case I do, I’ll know a little bit more on what to do and will be a little bit braver to be honest with myself and the world.

To all birthing people - this sh*t is crazy - sending love.

[Adrianna · Rating 5 out of 5]

I don’t have the right words to say how important this book was to me. Obviously I’m biased but this book is a must-read for everyone. It’s intelligent and human, accessible and informative. I really took my time with this one and I’m glad I did. This will be one I revisit frequently. Highest praise to Little and Long for navigating the minefield that is the topic of reproductive care in this country. Absolutely 10/10.

[Jill Steffen · Rating 5 out of 5]

This book was incredibly educational about the history of pregnancy and evolution through centuries. It was very eye opening about systemic miscare of marginalized people. I would highly recommend, it offers all of this timely, well-researched information through a lens of humor.

[ella · Rating 5 out of 5]

I cried my way through this, in a good way. It’s the kind of book that I feel grateful fell into my hands. I think it should be required for every person who knows someone who might get pregnant. Incredible.

[Esther Swift · Rating 3 out of 5]

Not a lot about how to grieve w others but a full blown history of abortion rights in America since the founding of this country. & all of that did peak my interest.

[Brynna Morgan · Rating 4 out of 5]

4.5 stars. Really powerful book about the realities of pregnancy and how our current barbaric laws are going to kill women. It was more about still births and miscarriages than i expected which was extremely informative and helped me connect the dots between all of these different types of losses. Hugely helpful in how we can support those suffering not only from pregnancy loss but any loss or life challenge.

[Rosalie · Rating 4 out of 5]

I'm sad and I'm angry and more people should read this book.

[Julie B · Rating 5 out of 5]

Anyone who is interested in reproducing, or cares about someone who is interested in reproducing — both those groups should make up nearly everyone?? — needs to read this book. Historical background, a pointed recap of preliminary and current legislation, and how culture influences our loss and grief. Wow. Incredible read.