Lessons From the M膩ori and Japanese Peoples on Grieving Pregnancy Loss

Abortion in a world where reproductive justice is realized means allowing each person full autonomy over their pregnancy decision.

In 1994, after 18 years of providing care for hundreds of women in Tennessee, the Chattanooga Abortion Clinic was shut down. In its place, was born. This site features a 50-foot granite wall adorned with plaques for 鈥渦nborn children鈥� who were aborted. The National Memorial deems itself a place of healing, tribute, and closure redeemed from 鈥渢he business of death,鈥� and yet it stigmatizes abortions and the people who have them.

Replacing an abortion clinic with a site that mourns the pregnancies lost in abortion is emblematic of the abortion debates in the United States. For decades, these debates have set up a false dichotomy: You either focus entirely on the pregnant person and avoid discussing the concept of loss and death or you emphasize the loss of a baby while ignoring the needs of the pregnant person. In other words, we exist in a 鈥渃lump of cells vs. baby鈥� dichotomy.

What would it look like to marry these two ideas?

In 2018, this time in the state鈥檚 capital of Nashville, Tennesseans once again pushed the idea of eclipsing abortion access and rights through the grieving of aborted fetuses. After heated debate, the state鈥檚 House voted to use private funds to erect a 鈥溾€� on state capitol grounds. (Of note, this vote turned out to be primarily political theater. Years later, the monument has .)

Through this vote, the state鈥檚 legislators succeeded in communicating its values loud and clear. Even before the Dobbs decision overturned Roe v. Wade, Tennessee has long been one of the most hostile states for abortion rights with a pre-existing trigger law that made abortion illegal from conception onward. After much controversy, a subsequent lawsuit, and a demand for a recount, to change the state鈥檚 constitution to specifically declare that the right to abortion is not protected.

So why did lawmakers once more deem it necessary to put forth the idea of memorializing aborted fetuses? As an abortion researcher, I view these political moves as one piece of a larger issue in our abortion conversations. We discuss abortion in the U.S. in black-and-white binaries, ceding nuance to national political messaging. Much like pregnancies, abortion exists on a spectrum and shades of gray.

While the majority of abortions occur early on in pregnancy, they are not all 鈥渃lumps of cells,鈥� and pro-life groups routinely utilize fully grown鈥攁nd already birthed鈥攂abies in anti-abortion messaging. For instance, ProLife Across America has placed more than 12,000 anti-abortion billboards across 46 states that . Anti-choice protestors have often held ground in front of abortion clinics and used gruesome images to shame, scare, or dissuade patients from seeking care. While pro-choice circles shy away, the anti-abortion movement holds a monopoly on the imagery of abortion.聽

One very rare exception is a 2022 article published in that featured a series of photos of petri dishes holding early pregnancies鈥攖hough clearly after being and transformed into fluffy white blobs. While the cleaning process allowed the tissues to be more visible, it also created a sanitized image of abortion.

This false binary has also been weaponized in anti-abortion legislation. Across the country, namely Wisconsin, Kentucky, Louisiana, and Texas, legislators codified mandatory ultrasound viewing into their state鈥檚 abortion policy. explicitly mandated that medical providers place the ultrasound image in the patient鈥檚 line of sight, even if the patient did not wish to view the ultrasound.

Legislators presumed that pregnant people seeking abortions would cancel the procedure if they simply saw the contents of their uteruses. Research disproved this assumption: The vast majority of continued on with their abortion decision after viewing the ultrasound, with only 2% of people changing their minds. In other words, thousands of people saw an embryo or fetus and still felt confident in their decision to terminate a pregnancy they did not desire or feel ready for.

In a practice public health researcher Lena Hann calls 鈥溾€� some people even want to see the fetus, embryo, or pregnancy tissues after the abortion. In the research Hann and I conducted, we found that abortion providers habitually have to navigate this patient鈥檚 desire. Oftentimes, providers are wary of this practice because they do not want the patient to be upset or surprised by what they will see, but it can grant patients a sense of closure, agency, and knowledge about their bodies and pregnancies.

Despite the benefits for patients, this practice is quite taboo; many clinics lack written policy around it or prohibit it all together. Some of this taboo stems from a fear of departing from the clump of cells vs. baby binary. Allowing abortion patients to see and feel complicated feelings about their abortion is also contradictory to national abortion messaging.聽

But other countries offer cultural practices that acknowledge the fetus (and its death) without stigmatizing abortion, particularly if we don鈥檛 treat abortion loss as fundamentally distinct from miscarriage and stillbirth. In Japan, temples, graveyards, and roadsides are dotted with stone babies dressed in tiny red bibs. This practice, which is called , represents and honors unborn children who died from stillbirth, miscarriage, or abortion. Mizuko Kuyo is meant to provide solace to would-be parents and grant a space to grieve.

In New Zealand, Maori abortion patients are often allowed to take their fetal remains home and have a cultural burial. Rather than memorializing only aborted babies while vilifying the people who terminated them, these practices allow us to imagine a reality in which people in the U.S. can also respectfully acknowledge and have all sorts of complicated feelings about abortions.

If the U.S. were to depart from this 鈥渃lump of cells鈥� messaging, it could provide the nuance needed to acknowledge and normalize the fetus and聽defang anti-choice messaging. Pregnancy is a spectrum, and pregnant people often like to visualize their pregnancies as they develop, including using apps that use a fruit or other common object to indicate the size of the pregnancy based on weeks of gestation. What if we were able to likewise acknowledge the facts of the fetus within abortion care?

鈥淭here is something infantilizing about denying the fact that embryos die when we scrape them out of the bodies of which they are a part,鈥� writes Sophie Lewis in . 鈥淚t sentimentalizes pregnant or potentially pregnant humans as fundamentally nonviolent creatures to imply that we can鈥檛 handle the truth about what we are up to when we opt out.鈥�

Indeed, the notion that all women are inherently nurturing and feel an innate connection to their pregnancies is . To choose an abortion, amid abortion stigma, symbolically denotes rejecting these alleged truths about what it means to be a woman. By denying the loss involved in abortion, are we inadvertently perpetuating abortion stigma?

Abortion in a world where reproductive justice is realized means allowing each person full autonomy over their pregnancy decision. This means freedom to choose the type of abortion, full ability to access abortion without barriers or shame, and, critically, freedom to feel complicated feelings about one鈥檚 abortion. For some, an abortion is a clerical, non-emotional health decision that will . For others, an abortion is a loss. Freedom to choose means freedom to feel a full range of emotions鈥攅ven if these feelings contradict the political messaging we have long clinged to.

Andr茅a Becker is a medical sociologist researching abortion and contraception. Her writing has been published in The New York Times, Slate, and The Nation.