'It was all ripped away': The cruel irony of the '12-week rule' (2024)

She isn’t alone. More couples are choosing to dismiss the tradition, saying it is forcing them into secrecy and lies during what is often the hardest trimester of pregnancy. And should the pregnancy be lost, as up to one in four identified pregnancies are, the isolation is exacerbated.

Monash University social researcher Dr Jade Bilardi says there is a cruel irony in the unwritten social rule, because while it’s intended to save couples from the difficulty of telling and then "untelling" people about a pregnancy, 80 per cent of miscarriages occur before the 12-week mark.

Loading

“It’s like saying to somebody, ‘well don’t tell everybody, what if you miscarry?’ Where does that leave a person? Alone in their grief and loss,” she said.

“It’s considered the safe point to tell people about your pregnancy. The problem with that though is that miscarriages are most common in the first trimester, so that means if we haven’t told people around us they aren’t there to support us when a miscarriage occurs.”

The rule means miscarriages are happening in the shadows, so the despair that touches so many goes untold, harming public awareness of pregnancy loss.

According to Dr Vijay Roach, president of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, the "12-week rule" is not coming from doctors. Instead, it has evolved out of the 12-week scan most expectant mothers undergo which confirms viability and can detect some abnormalities.

He says it’s wrong to see the 12-week mark as some magical point, describing the number as “arbitrary”. In most cases, he says, pregnancy can be deemed medically safe earlier.

Australian research shows that the risk of miscarriage falls dramatically after seven weeks gestation. In pregnancies deemed viable, the risk of miscarriage is 9.4 per cent at six weeks. It falls to 4.2 per cent at seven weeks, 1.5 per cent at eight weeks and from then the risk drops below 1 per cent.

“The science is misunderstood … [At 12 weeks] the chance the pregnancy will continue to full term and will result in a healthy baby is very high. But you can make that determination earlier.”

Dr Bilardi says society does not handle grief and loss well, meaning many couples have received unsympathetic reactions to the news of their miscarriage because many people fail to understand the magnitude of the loss.

In their heads their whole life was about to change, from the first moment they found out they were pregnant.

Jackie Mead, CEO of Sands

“We don’t know what to say or we don’t say anything at all, which makes it worse,” she says. It is all too common for the loss to be diminished, in the vein of ‘Oh well, you were only early along’ or ‘it was only a bunch of cells’.

“Research shows that grief and loss after miscarriage can be for many as significant as neonatal, perinatal death and later term death. It’s not contingent on how many weeks pregnant a woman was.”

Jackie Mead, chief executive of miscarriage and stillbirth organisation Sands, agrees that many people fail to grasp how difficult it can be for bereaved couples to cope with never having the chance to see or hold their baby.

“In their heads their whole life was about to change, from the first moment they found out they were pregnant,” Ms Mead says. “Whether a baby died at four weeks or 16 weeks, those feelings don’t change.”

Sydney woman Rachel Green, 38, is familiar with the fear of how insensitively people may react to early loss.

It’s why when she had her first pregnancy in 2014 via IVF after two years of fertility treatments, she followed the 12-week rule. When she lost the baby at seven weeks she was heartbroken and the isolation was unbearable. Having kept her fertility journey a secret, she says it seemed too hard to recount from the beginning what had happened so she was without support from others.

“It really compounded the devastation we felt. It was almost too late to catch people up. It’s such a long story to have to tell, so we held all that grief to ourselves,” says Ms Green, who is chair of Sands and now a mother of three.

The biggest thing we hear from women and partners is the importance of acknowledging the loss.

Dr Jade Bilardi, social researcher

Ms Rowe says given pregnancy “is something women are told we’re born to do”, when one is lost “there’s guilt”. But RANZCOG's Dr Roach hopes women stop blaming themselves because the vast majority of miscarriages are “beyond anybody's control”.

“At least 70 per cent are due to a chromosomal abnormality,” he says. Dr Roach offers couples data on the risks and suggests they consider their “comfort point” around announcing pregnancies, as each of us has a different one.

“We should encourage women to share a positive pregnancy and if the outcome isn’t desired then women should feel confident in sharing their experiences and seeking support.”

Dr Bilardi says it is nonsensical to have a blanket 12-week rule. “It has to be about what works best for each couple ... For many people we know that there is more support and understanding when miscarriage occurs if they’ve told others around them they were pregnant and it can make it easier for them to ask for help.”

But for some the thought of announcing a pregnancy and then telling people they miscarried can be “really, really difficult” so there is no right or wrong time. “It depends on the individual and I would hate to think there would be criticism of people for announcing early.”

A lot of needed change in attitudes to the rule will rest on expectant parents feeling confident that people will know how to behave if miscarriage occurs, she says. Hearing others simply say they are sorry and they are there for them is an important start.

“What we need is awareness around what sort of support people need,” she says. “The biggest thing we hear from women and partners is the importance of acknowledging the loss.”

While both sides in a couple are affected differently by early pregnancy loss, the 12-week rule can isolate a man as much as a woman. Paul Lyons, Ms Rowe’s husband, says he doesn’t think of his own pain when he witnesses the emotional and physical turmoil his wife goes through.

Having others know what they’re going through means while he is supporting his wife he also is able to get help from his community. “A pat on the back can change your day,” he says. “If we hadn’t announced and lost, no one would understand why we’re down.”

Having suffered through eight miscarriages and three stillbirths in five years, Ms Rowe has had a harder, longer road than most. She has since founded social enterprise Memories of an Angel, and says there is a “significant lack of understanding” of the impact of miscarriage and the painful medical ordeal often involved.

“You’re not magically not pregnant anymore,” she says. “Talking about it starts to normalise it ... It just breaks my heart knowing that just because of some stupid rule, people are suffering alone.”

“There’s no way we could have survived without support.”

Ms Rowe believes the most important message for women is to feel empowered to decide for themselves when to announce a pregnancy “at whatever point they are comfortable to do so ... and know that regardless of gestation or circ*mstance, they will be supported.”

October 15 is Pregnancy and Infant Loss Remembrance Day, with landmarks to be lit up pink and blue, memorial walks and a memorial service in Melbourne. For more information, visit sands.org.au.

Sands Australia's 24/7 national helpline is on 1300 072 637 or visit their website.