Invisible labours: the reproductive politics of second trimester pregnancy loss in England

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The loss of a wanted pregnancy, through miscarriage or termination for foetal anomaly, has historically been marginalised in the UK, and it is only recently that such events have been more widely recognised as potentially significant medical and social experiences. Events of stillbirth, after 24 weeks' gestation, and early miscarriage, before 12 weeks' gestation, are increasingly socially acknowledged, and research about their social impacts has been carried out in the UK.By contrast, pregnancy loss in the second trimester of pregnancy, after 13 weeks but before legal foetal viability at 24 weeks, has not been specifically addressed in social science. Termination for foetal anomaly has also received limited attention and is sometimes excluded from the category of pregnancy 'loss'. My research addresses spontaneous or induced forms of second trimester loss, which are managed in the English NHS by labour and birth rather than surgically, and often involve encounters with the formed and recognisably human body of a foetal being. I argue that second trimester loss is a specific experience which is different to early losses because of the degree of formation of the foetal body, the potential intensity of the labour and birth, and the way many women have begun to consider the coming baby as a specific person. At the same time, second trimester loss is different from stillbirth because the threshold of legal viability usually means that civil registration is not permitted, and the recognition of personhood and kinship which this entails is withheld, along with associated support such as maternity leave.The consequences of this betwixt-and-between status are felt in the healthcare offered to women in the second trimester, who often undergo delivery without the support offered to women later in pregnancy, such as epidural pain relief or midwife assistance. They may not be entitled to the postnatal six week check, or psychological bereavement support. Even the number of women who go through this experience is not known because pre- viability spontaneous loss statistics are not collated, and only terminations are reported nationally.My research with women about their experiences of second trimester loss in England describes the distress many feel about the experience itself, the way it is managed in the English NHS, and the subsequent social marginalisation of the event. It also describes the ways in which some women resist the dominant definitions of what has happened to them and assert the personhood of their baby as a person who lived and died. For example, women use evidence of the foetal body such as ultrasound images, photos, and cremation ashes to memorialise the life and death of their baby. They also resist their exclusion from the person-making and kin-making features of civil registration when they assert their own motherhood and the existence of their baby within their family.In this ESRC fellowship I will produce an academic book and journal articles, and develop relationships with relevant third sector and parliamentary groups. All this work will address second trimester pregnancy loss in England, including foetal death, very premature labour, and termination for foetal anomaly, through the experiences of pregnant women. In this manner, I aim to increase the visibility of marginalised reproductive experiences, to prioritise the experiences of pregnant women, and to pay attention to the understudied period of gestation in human reproduction. My work also describes how social and medical categories such as the 'second trimester' and 'foetal viability' produce particular types of exclusion, and how these can be contested by the agency of pregnant women, and it therefore addresses questions of politics and reproductive justice.During the fellowship I will also build on this work to develop future research in the social science of reproduction and prepare grant applications to UKRI and Wellcome