Anatomy of a Miscarriage| Leslie Cooles

It begins with flakes of blood. Tiny black dots, an infestation of fear. A sojourn to the hospital, though I’m only six weeks.  

They put us in a separate room, away from the smug women with their normal pregnancies. Close-up prints of grasshoppers and bees cover the walls. Details of thoraxes and antennae distract us from the reason we’re here.

“It’s too early to tell,” the doctor says. “Fifty-Fifty. Come back in two weeks.”

The bleeding stops, but the exhaustion remains. A good sign, I tell myself, and nothing to do with the fact that I can’t stop crying.

I take the maybe-baby to my interview at University College London—a coveted academic position—though my book isn’t published, and they have an inside candidate. I smile as I vomit into a Waitrose bag on the train. At the pub, I order a club soda, surrounded by the men who’ve wanted this job for as long as I’ve wanted this baby. They’ll probably have both one day. Will I?


“I’m sorry,” the technician says, her ultrasound probe sliding over the jelly, a snail’s trail forming across my flat belly. “There’s no heartbeat.”

The tears that have flowed for the last few weeks are suddenly dry, but the black flakes cloud my vision, encroaching at the edges. A darkening. 

They give me statistics: This happens to one in four pregnancies. There’s an 80-percent chance you’ll miscarry naturally.

My husband goes out for ice cream and wine when we get home, though my stomach roils at the thought of anything but crackers. I watch him sitting on our garden wall, shoulders heaving with the tears I can’t find, and pull the curtains. Two dead flies land on the carpet. The ice cream has melted by the time he comes inside.

I don’t get the job.


For two weeks, I carry around the not-baby. I am alive and dead all at once, my body both vivid cells and rotting corpse.  

Clouds pall the summer days.

I take the unalive fetus with me for an interview at Cambridge, the nausea rising as I try to force down a breakfast of scrambled eggs. A worm squishes beneath my heel as I walk to the college, and nausea rises again. Above, the proverbial spires reach to the heavens, lofty and indifferent.  

The computer won’t accept my flash drive, my carefully crafted PowerPoint rendered useless. But this has always been my forte. Why I am here. The air crackles with energy as I move through the students, taking questions, laughing. I make the past come alive. A popping flashbulb in the growing darkness, spots swimming before my eyes.  

The cramps are deep and gut-rending, threatening to wrench my body in half as my uterus tries to respond to the misoprostol.  My husband becomes an endless source of hot water bottles and painkillers. The dark edges are spidering out now, and the spots begin to join.  

The baby that is not a baby is still inside me, and we tell our families.  

“I’m so sorry. You can try again.”

I don’t get the Cambridge job. My publication record is slim, they rightly say.


“It needs to come out,” I tell the doctor at the John Radcliffe Hospital. I don’t want to call it “him” or “her.” 

“Give the medication time to work,” he says indifferently. He has not spent the last month carrying a dead fetus inside of him as he tours England’s premiere academic institutions.

I should be grateful I’m not at Planned Parenthood, scuttling beneath pictures of corpses and shouts of free speech. Calling back to the protesters, “I’m 30. We’re married. It’s a miscarriage. Did you know that one in four pregnancies end this way?”  

The doctor’s nose is like a giant beetle, bulbous and veined. I imagine it crawling down his face and into his mouth, imagine the doctor retching as he tries in vain to expel its body from his. Maybe then he would understand.   

“You have to get it out,” I say again. “Schedule the D&C.”

The world beneath my duvet is black, guilt and grief spiraling together as I mourn what might have been. If I’d tried harder. Wanted it more. Maybe this is my penance, carrying the life I have extinguished. My husband hovers like a moth above me, sad and uncertain.  

A century ago, I would have died of sepsis. I cancel the interview at Oxford, even though it’s for a one-year teaching job, and I already know everyone on the panel. 

A week later I leave the hospital feeling as if I’ve been cut in two. My body hollow.  Despite the emptiness, months of pain follow. Three rounds of antibiotics. Bleeding that won’t stop.  

I lie in my cocoon of blankets, enveloped in darkness and loss and the warmth of the heating pad against my distended abdomen. Spots and flakes invisible, black against black.  

There are no more interviews. I haven’t applied. 


“I want to take the job in New York,” my husband says as he throws back the curtains. “Amazing pay, a free flat. You can just rest and heal. It’ll be a new start.”

I blink up at him. The spiders have spun webs on the panes, leaving cobwebs in their reproductive wake. Outside, the leaves sparkle yellow and brown in the morning dew. Is it autumn already?  

Mellow light breaks through the spots in my vision until they dissolve. This must be what a butterfly feels like, emerging into a new world.

“Yes.” My relief is palpable, its wings fluttering in the room as I push away the duvet. “Let’s go to New York.”

“We’ll try again,” my husband says.

The wings falter, the darkness hovering just beyond sight.


I don’t know if I can.

Leslie Cooles is an American writer currently living in the English countryside. She has published short stories with Querencia Press, Bookends Review, and Saw Palm, and her novel, The Wickedest City, was long-listed for the Cheshire Novel Prize. When not writing, she can be found traveling, talking all things historical, and wrangling two small children.


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