Why Being South Asian Made My Miscarriage Even More Challenging

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The community expectation for most Sri Lankan women is largely the same: study hard, get a stable job, get married and have kids. However, for South Asian millennials living in the developed world, it can be a different trajectory. The decision to start a family is often deferred due to other priorities such as having a career or a desire to enjoy the last vestiges of childless freedom — or simply because they haven't met the right life partner.
So when I got married, and after almost 18 months of trying to get pregnant, I began to worry. At 35, should I have prioritised starting a family sooner? When I finally conceived, I was overjoyed. The news that my body was capable of creating life allayed my fears that I was infertile. I was so elated that I told my immediate family and close friends within the risky first trimester, despite advice from my mother and mother-in-law to the contrary.
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I was at work when the miscarriage happened. It started in the morning and then gradually escalated throughout the day, to the point where I had to leave right after a meeting and head to the Royal Women’s Hospital.
The process felt out of my control. My body was expelling my pregnancy and I couldn’t do anything except let it happen. The days after the miscarriage were hard as I felt mentally and physically exhausted.
Many Sri Lankan women feel isolated after a miscarriage as openness about sexual health is still taboo. But because I had told close friends and family earlier about the pregnancy, I had emotional support. 
As I had experienced the loss of a parent, I felt much more equipped to process my grief. The main sadness I felt was around the unrealised potential of who the baby could have been, but this only lasted a few days. My husband had to be brave as I went through the motions — supporting me while processing his emotional loss and helplessness alone through psychological support.

While my non-South Asian peers, in real life and on screen, were dating and openly having sex, being sexually active as a young South Asian woman meant that your reputation would be sullied by both your parents and your peers.

For a lot of Sri Lankan Tamil women, the conversations around our bodies and sexuality start from menstruation. Like most practising Hindus, starting my period eventuated in a religious ceremony in front of extended family and friends — not the best way to start your pubescent journey.
After I turned 18, the subtext of parental conversations included ‘don’t date until you’re married’ and ‘don’t have sex’, though sex was never overtly discussed. The conservatism at home and in my community were in stark contrast to the western context I was growing up in. While my non-South Asian peers, in real life and on screen, were dating and openly having sex, being sexually active as a young South Asian woman meant that your reputation would be sullied by both your parents and your peers. 
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When I did eventually fall pregnant, I was surprised when my mum opened up about her own pregnancy journey. Her advice felt outdated due to evolutions in health science and her cultural convictions.  She would provide useful advice about conception and diet, but would also chastise me for exercising. She constantly reiterated how easily she fell pregnant, which made me feel inadequate. When I did miscarry, though she showed more compassion than I expected, she would subtly blame me for exercising too much, which didn’t help as I was feeling vulnerable. 
I know that my mum cares about me, but in South Asian culture, having an emotionally supportive and openly communicative relationship with your parents isn’t the norm. Often what the community thinks is more important than how you feel. 
A comparison culture exists, where talking about the successes of your children, such as academic merit, marriage and having children elevates your status as a parent. This only reinforces the perception that sex, miscarriage and divorce are blemishes on a perfect track record.
Photo: Andrew Hardy and Jackie Dixon
Moving away from Sydney and the South Asian community I grew up with, and engaging with more socially progressive circles in Melbourne, enabled me to feel more comfortable talking about my miscarriage openly with my mum, sister, husband, and friends, without feeling inhibited.
It’s clear that a lot of women blame themselves for their miscarriages. From the triage nurses to the doctors, the staff at the Royal Women’s Hospital were incredibly empathetic, reassuring me that this wasn’t my fault, that miscarriages were a common occurrence (1 in 4 pregnancies statistically) and that ‘most women can carry to term after a miscarriage’. I felt safe in a health space run by women, for women.
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The pivotal turning point in my pregnancy journey was engaging gynaecologist Dr Vasi Sivagnanam. As a fellow Sri Lankan Tamil and family member, Dr Sivagnanam understood the cultural context I was coming from. Her health advice was key from pre-pregnancy to post-miscarriage.  
She shared that social acceptance on seeking sexual health advice within the Sri Lankan Tamil community is still confined to the sanctity of marriage or a long-term relationship.
“In our culture, fertility and sex goes hand in hand with marriage and is often only discussed with a health professional. Women don’t feel comfortable speaking about it with their parents or friends due to the stigma associated with sex, infertility and miscarriage. This can also isolate couples seeking emotional support during their journey,” says Dr Sivagnanam.
The lack of inter-generational conversations and acceptance of an extramarital sex life in the community inhibits women from fully understanding their bodies. 
“As pro-actively seeking sex education is not encouraged in the Sri Lankan community, women only see a gynaecologist when problems arise. Judgement from their family doctor, and fears they might tell their parents, means that sexual health advice is often sought anonymously through social media or from independent referrals,” continues Dr Sivagnanam.
According to Dr Sivagnanam, there’s more transparency around sex within Caucasian families. Children as young as 14 years old see gynaecologists for period management and contraception, speaking openly in their mother’s presence. It becomes a learning experience for both generations, and something I wish I'd been able to share with my mother.
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“There needs to be more acceptance of sex as a healthy part of life within communities. Ensuring sex education through the school system focuses on knowledge and empowerment for girls, will ensure these aren’t taboo subjects as generations get older”, says Dr Sivagnanam.  
“Ensuring doctor confidentiality and normalising regular sexual health checks with a gynaecologist will ensure women aren’t shackled by family and cultural expectations. It’s important for them to know they have options.” 
In South Asian culture, chastity is still upheld as the paradigm for women, and this prevents us from fully understanding ourselves. Since my pregnancy and miscarriage, I’ve been really open about my fertility, pregnancy and miscarriage journey with close friends and especially my younger sister, to create more intergenerational dialogue and reduce taboos about seeking health advice. It’s also enabled other women to open up about their experiences of abortion and miscarriage, including South Asian women in my immediate peer group. 
Perpetuating the expectation that you shouldn’t disclose your pregnancy within the first three months isolates women and reinforces the stigma against miscarriage. Telling close family and friends ensures you have emotional support throughout the journey. It’s time we make women’s health an open conversation and ensure that the next generation of South Asian women feel empowered to seek information and support as they need it.

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