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If our culture has a complicated relationship with the topics of pregnancy, illness, and death, we have a positively stunted relationship with their nexus: that nightmare situation in which a pregnant woman finds herself carrying a non-viable fetus. Mira Ptacin had to forge her own path through these dark woods when she found herself pregnant with such a child. Ptacin’s memoir about this experience, Poor Your Soul, out now from Soho Press, asks some complex questions. Should she terminate her pregnancy or carry it to term? How does she mourn, and how can she heal? As Ptacin writes, “Grief is unpredictable. Messy.”

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Despite technological advances, the medical profession is still sorting through how to help parents like Ptacin. As British Medical Journal (BMJ) notes: “Perinatal death poses two kinds of problems: firstly, how to manage the immediate painful reactions and, secondly, the serious long term dangers of unresolved parental mourning, which results in psychiatric problems and a vulnerability to future losses and crises.”


One group of bereaved parents formed an organization called Antenatal Results and Choices specifically to support “parents who are considering or have undergone a termination after a diagnosis of fetal abnormality.” According to an ARC newsletter, in this situation, “rather than commiserating with your loss, people tend to say how lucky you were the abnormality was detected…the baby has no identity as such, so it is difficult to mourn and grieve and come to terms with.” In other words, parents have no road map. No one knows how to mourn this kind of liminal, category-defying loss.

Ptacin writes about this difficulty as well: “You want your grief to be temporary, predictable. You want to see the stages of grief and identify with them, check them off, but grief never ends. Maybe you expect a time limit where you can put it behind you and go on with your life, but how can you? You just do. Because the grief narrative never ends; it has become woven in, part of the braid of your life.”

There is some hope that the medical profession will continue to improve its responses to these losses. In “The Silent Birth: A Feminist Perspective,” Joanne Cacciatore writes:

Improved standards of compassionate care in hospitals, supportive nurturance from family and friends, and support groups contribute to a lessening of posttraumatic stress responses and chronic, debilitating grief. These types of systemic changes and grassroots efforts are giving women words—the language—to speak about their losses, and when individuals can find words to capture an experience, society’s responses to these experiences slowly evolve in understanding.

With Poor Your Soul, Mira Ptacin has found those words.


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BMJ: British Medical Journal, Vol. 302, No. 6786 (May 18, 1991), pp. 1167-1168
Reproductive Health Matters, Vol. 16, No. 31, Supplement: Second Trimester Abortion: Women's Health and Public Policy (May, 2008), pp. 57-6
Reproductive Health Matters (RHM)
Social Work, Vol. 54, No. 1 (January 2009), pp. 91-95
Oxford University Press