Twenty-seven seconds. That’s how long it took for a doctor on the American comedy-drama The Bold Type to give lead character Sutton a scan and then tell her she was having a miscarriage.
The entire appointment, from the time the doctor walked in the door to the time she walked out, was depicted in one minute and 51 seconds.
Yes, it’s a TV show and of course there’s limited time. But perhaps if the writers had given it double the amount of time, a whopping four minutes, the audience would have been afforded a glimpse into the reality of miscarriage.
You could be forgiven for having high hopes for The Bold Type, with its history of portraying aspects of working life for young women with a healthier dose of reality than most. The story, which follows three American friends working in the publishing industry, has been praised for its diversity in both topic and representation.
But episode 13 of season four quickly devolved into the miscarriage equivalent of a Hollywood birthing scene.
After telling Sutton and her husband Richard there’s no heartbeat on the ultrasound, the doctor attempts to console Sutton by telling her that 10% of pregnancies end in miscarriage.
Given how rare it is that pregnancy loss is even part of popular culture narratives, it’s even more disappointing when it materialises into yet another missed opportunity. Or worse still, when it takes the easy way out with over-simplification or outright misinformation.
It’s incredibly difficult to collect data on miscarriage, given they can happen within or external to hospital settings, they can happen under the oversight of multiple kinds of doctors or with no medical oversight at all. And some women don’t even realise they’re pregnant when they have a miscarriage or don’t realise they’ve even had one. Put simply, there are many variables.
But the one in 10 figure is misleading at best. The definition of miscarriage is the loss of a pregnancy before 20 weeks. The one in 10 figure applies to women who miscarry before 12 weeks and whose pregnancy is clinically confirmed (meaning viewed on an ultrasound or the placental or foetal issue identified after the fact). Nevertheless, it is still at the very bottom of the data range for rates of miscarriage.
A much more realistic number is that one in five pregnancies end in miscarriage and in some countries, like Australia, the broadly accepted rate of miscarriage is one in four.
After the inclusion of such an undercooked statistic, it shouldn’t have come as any surprise that what was to follow in the scene was equally uninformed.
The doctor tells Sutton that “in up to 48 hours” she will start to bleed. Sutton has experienced a missed miscarriage, meaning at some point the baby’s heart has stopped beating, but the body hasn’t yet realised. In some cases the body can realise reasonably quickly, but sometimes it takes weeks for the process of bleeding to begin.
That’s why on diagnosis, women are given three options: waiting to bleed, medication to bring on the bleeding, or a medical procedure to complete the process. Each has specific challenges, but ultimately it should be a woman’s choice which is the least confronting of the three. No options were offered to Sutton.
Also worryingly, there was never the suggestion she might need a follow-up appointment to ensure the miscarriage is complete and avoid a dangerous infection. Likewise, the topic of counselling was never broached.
With the pervasive social silence around miscarriage, the importance of counselling has been repeatedly highlighted by medical and sociological research. While Sutton eventually realises she doesn’t want to have children, this revelation, sparked by her pregnancy loss and the subsequent dissolution of her marriage, may have been eased or better managed with counselling, or at least the knowledge that it was an option.
Several times during the remainder of the episode Sutton is told it’s “not her fault” despite her never articulating this fear. She is also “managed” by her friends and partner about what she should and shouldn’t do – going to work, for instance.
There are some positives in the episode, such as how her two close friends Kat and Jane are available for her in whatever way she needs and support her through the grief associated both with the loss and her realisation that she in fact does not want children.
But the episode begs the question: should women be grateful for miscarriage to simply exist in popular culture? Or should women expect that perhaps in 2020 such a potentially devastating event should be depicted with some semblance of accuracy?
Ask women gently in an appropriate setting and it’s astonishing how many will divulge that they have experienced pregnancy loss. The writers of The Bold Type wouldn’t have needed to look far to find first-hand experience. They could even have dipped into any one of the hundreds of online support groups for a dose of reality.
It’s not popular culture’s responsibility to educate the public, but we can and should aim to do better than homogenised, sanitised, and misleading depictions of the reality that millions of women worldwide experience, along with their partners, friends and families.
• Isabelle Oderberg is a journalist and communications professional working in the non-profit sector. She has two children. On her journey to having them, she lost seven pregnancies