Isabelle Oderberg on writing to break the silence around miscarriage

ASTRID: Isabelle, welcome to The Garret and congratulations on an extraordinary work, Hard to Bear: Investigating the Science and Silence of Miscarriage.

ISABELLE: I cannot tell you how happy I am to be here. Thank you so much for having me.

ASTRID: Isabelle Now, you are a journalist, and you have worked in the world of words in the media for all of your career in Australia and around the world. You are no stranger to putting words on the page, but this book is a little bit different. It is your first long form work of nonfiction, and I want to start with perhaps an unexpected question. I suspect you have an easy answer for this, but I really want to place this interview in context for the listeners of The Garret. Who did you write Hard to Bear for?

ISABELLE: I wrote this book for everyone. I wrote this book to give comfort to people who've experienced loss, whether that's directly or indirectly, early pregnancy loss. I wrote it for medical practitioners to get a better insight. I wrote it for the people who've never experienced a loss, and don't understand it, and want to understand it better so that they can be supportive to friends and family. I wrote it for young people with uteruses who might not know how their bodies really work and the challenges that can come. I wrote it to dispel the myths around you can have it all anytime you want, and I wrote it to unpack some of the history and culture and really some broader issues like access to healthcare, and how we don't all have the same experience.

I wrote about feminism, and how feminism lets down certain people because it's not inclusive, because it's not keeping up, and because it takes one issue over another thinking that one issue is the most important, and they're all important. I really did try to make this book accessible, but also engaging on a number of different levels, and some of the best feedback I've had is from people who said, ‘Look, I read it because you wrote it. I didn't think it applied to me, but actually there's so much in here that I found fascinating’, and that's a real compliment.

ASTRID: Isabelle That is such a compliment when someone reads a book not thinking it has anything to do with them or that it applies to them, and then they find out that it does. Isy, there is a great deal of you in this book. It is both traditional, nonfiction. There is so much research, and science, and evidence in here, but there is your personal story. I guess structurally you are sharing your story, which is a gift to the reader, but in terms of how the storytelling works, that really elucidates... It brings the whole thing home, but it also elucidates the silence part, the silence that surrounds miscarriage and you refer to in your title.

I was really interested as a reader to go through this work and to kind of see how you structured it, but also how you positioned yourself within the work, not just your story, but your entire background. You are a cis woman, a white woman, a Jewish woman, how all of this helps you access, but also doesn't always work out very well.

ISABELLE: Yeah.

ASTRID: Isabelle After that long-winded spiel, Isy, can you talk to how you put yourself in there? Not just why you did it, but why it helps the work?

ISABELLE: There's a lot of different aspects to that question, all of which are fascinating, but I think what I would say is that I really wanted this work to have that journalistic integrity of interrogation. It wasn't supposed to be an argument. It was supposed to be an investigation. So I am very used to putting on that hat, that journalistic hat and kind of approaching it from a data-driven, evidence-based point of view. That's the way my brain works anyway having done this job for so long. So that kind of covered the journalistic chapters, but I knew that it would get heavy, and I knew that I would have to look at data and all this sort of stuff, and I have at this point, I'm not interested in memoir. It's just not on my radar.

I'm also very sensitive to trauma porn, especially given the nature of the topic, and so what I decided to do was alternate the chapters of journalism with just snippets of my story enough that you knew about me and what was driving me, and also, I guess, as another case study of someone, but also enough to give the reader for the reader never to lose connection with the fact that this is a story about people. As much as we talk about institutions, and sectors, and whatever, it's a story about people and human beings, and I have a story that drives my work. I was asked, I was offered as part of my auction of the book, one or two publishers said to me, ‘If you just do it as a memoir, we'll make an offer’. And I just wasn't interested. That wasn't the point of the book.

What's interesting is when I started to show it to friends who work in publishing or work in the literary space, or I sort of would pitch it verbally and say, ‘I'm working on this book. Would you read a couple of pages for me, tell me if you think there's life in it?’ Some of those people, for instance, Sally Heath and Angela Savage, they were very sceptical, and they were like, ‘What do you mean alternating chapters and voices? It won't work? It's not...’ And then they read it, and they're like, ‘Oh my gosh, this really works. How the hell did you do that? On paper it shouldn't work’. But I knew that I could do it because journalists have different hats that they put on for different reasons, and I really wanted to give the reader time to breathe.

One of the pitfalls of that, which I'll just talk to because it's one of the more interesting aspects of the way my brain worked, was I never really wanted to write a book. It was never on my radar. My husband very much I expect him to be a prolific book writer, but I just wasn't interested. When they said to me, ‘It has to be this many thousand words’, I panicked, and when I did my proposal, I was like, ‘That's okay. That's okay. That's okay. Each chapter I'll just bite it off like a feature, right? Each chapter would be a feature article. We're done, right? You need 10 features or 16 features, it'll be done’. But the problem with that was that there was no overarching narrative arc because I was approaching them in these little capsules.

And so my agent, Melanie Ostell, who has also been on this podcast, who I adore beyond words, really had to beat me into shape and be like, ‘You can't give me these compartmentalised. It has to weave together’. It was way out of my comfort zone, but she pushed, and she pushed, and then finally was like, ‘You did it. You clicked your brain into out of journalism mode and into book mode’, and there's this beautiful kind of overarching narrative that runs through the whole thing, or an arc, I should say, that runs through the whole narrative. Yeah, but that was so challenging because it was just too big for my poor little brain to wrap itself around.

ASTRID: Isabelle You mentioned trauma porn, and you also mentioned that publishers only wanted this if it was going to be memoir, and they kind of didn't get it at the beginning. Because so many writers listen to this podcast, I'd really like to interrogate with you why publishers think they can sell a memoir that might very well be trauma porn.

ISABELLE: There is so much about publishing that I just do not understand. I don't understand why there are certain stories that are elevated when there are others that are untold. I mean, the number of... And I say this as a cis, married to a man, woman, I mean, who is white, I don't know whether I can bear to read more of these sort of white woe is me memoirs. I guess I also find it odd because I'm 43. I would never think that I have enough perspective on my life to write a memoir. I feel like that's something I would do down the track, unless it was obviously extraordinary, and there are some extraordinary memoirs out there, but I think that there's definitely been a lot of challenges around this book and perception that this topic is so unpalatable that no one wants to know about it.

That's kind of why I wrote the book, so it's like a catch 22, and as well because I had somewhat of a happy ending, which I don't think is giving anything away, and that I do actually have two live children. I think maybe they thought the memoir would make it more palatable because it did end up I did end up having a second child. I don't know. I wish I knew. There is so much about publishing I wish I knew. Melanie often tries to explain it to me, and it still flies straight over my head.

ASTRID: Isabelle I spend a great deal of my time talking to writers and sometimes publishers, and I don't understand what is happening either. Melanie is a fantastic agent, and I don't mean monetary details or anything, but was it hard to get to a publisher?

ISABELLE: It's a difficult question. I didn't think I needed an agent. I have reasonable connections because of the proximity of journalism to publishing, and we had tended to sort of move vaguely around and about those circles a little bit, and there was just a lot of skepticism. There was a lot of skepticism about the structure that I wanted, that I was absolutely unmovable on, and there was, I think, a skepticism. I think there's a lot of skepticism around journalists writing books as well. The number of times I was told, ‘Yes, but you're a journalist, not a writer’, was I can't tell you how many times, sometimes by my agent herself, but I think that was her way of saying, ‘You've got to trust me. I know what I'm doing. I mean, to say that she knows what she's doing is like... I think in the end there were four publishers that we were in talks with. One of them was immediately excluded by virtue of the fact that they wanted me to just write a memoir.

The others that came to the party came to the party very, very hard. I think this was a book that needed a really experienced hand like Melanie to help me really visualise it. The other thing that's very different is with a book like this, I pitched it with four chapters, I think it was in the end. I think it was sort of like two journalism chapters and two or three vignettes. That's very different to how fiction works. Fiction, you're pitching the entire thing, and while they might be reworking, they have to know the ending, right? Whereas with a work like this, I was going to take at least a year to write it, and so they weren't necessarily dealing with a full book from the outset.

They were certainly dealing with a full proposal for a book and a very, very well-articulated plan for what was going to be in that book, but there was a certain amount of trust that I could execute it with the same level of quality the whole way through. It's interesting because when I went into the interviews, they do these get to know you interviews with publishers. I think it's so they make sure that you're not completely bonkers before they sign up to work with you. I walked out of the interview with the woman who became my publisher, who's Brigid Mullane at Ultimo Press, and I called Melanie, and I just said, ‘I don't care what the money is. I'm going with Ultimo’. And I mean, this was a book that was never about money, as you can well... Well, I don't think any book is really about money from the outset, because we don't make any, but you know what I mean.

And there was just a degree of trust between us. Yeah, I fell in love with her platonically from the minute we started talking, and we were very much very, very happy, both very, very happy to be working together. Hard to sell? I don't know. You'd have to ask Melanie. I think four interested parties means it's great. I think in terms of publicity, there have been some really difficult moments where friends of mine who've published books on sort of I would call adjacent topics are going on breakfast TV on every channel, and I'm being told that my subject matter is unpalatable to a breakfast audience, those sorts of things, and that's really hard. That's a bitter pill to swallow, but the good news is I'm stubborn as hell, and I keep fighting, and the doors eventually open, because they just want to get rid of me.

ASTRID: Isabelle Look, there's nothing wrong with that. So you've spoken to this not being a palatable topic. Miscarriage is not a palatable topic. It is deeply personal. It is deeply human. It is incredibly common, and it is often very painful. You share your experience in the work, but also you go to great lengths, and I was continually surprised as a reader about how you kept pushing me further to think about people beyond my experience, locations, backgrounds, circumstances that I haven't considered, and even though you are limited by your own experience, you represent a lot of people in this work. And when I think about marketing and selling a book, there's like a huge public health emergency in this book, and I'm a little bit disturbed that people don't take on that part of it as opposed to the miscarriage is not a breakfast TV kind of topic.

ISABELLE: Yeah. I think that, look, the book was only released on the 5 April 2023, and it is a big chunky book, right? And I'm operating in a space where there are a lot of good books around, so I think there are a lot of people who haven't actually read the book yet. And as people read it, I'm getting a lot of messages saying, ‘Oh my gosh, this book is a lot more than I thought it was. This book is completely different to what I thought it would be’, all of those things. I mean, the two books that really inspired me or sadly made me realise I had to write a book was Gabrielle Jackson's Pain and Prejudice and Jess Hill's See What You Made Me Do. I'm lucky enough to call those phenomenal women my friends, and they were incredibly helpful, but they know the pain of writing a book that in some ways no one wants to read, right?

And I should add both are incredibly successful books, but the one thing that they have sort of warned me about is a book like this, it takes a while to feed into people, for people to pick it up, for people to read it, for people to understand it. And this is the kind of book that has a long tail and will be relevant in some way for many years to come. I take heart in the fact that I have a window that is much wider than a lot of other people in which to kind of allow people to digest it and do the publicity that I need to do. And ultimately I think the thing that people walk away... Well, that they tell me that they walk away from the book with is that it is actually a book of hope.

There are sad bits. There are bits where it's depressing because it's an awful thing for many people to go through, but there's some amazing work that we could do to make it so much better. And it is a book of hope, so it's not as much of a downer as people think it's going to be because there's so much light at the end of the tunnel.

ASTRID: Isabelle I have read Jess Hill and Gabrielle Jackson's work, and I think yours, they almost become a little trilogy, a little troika of powerful books that are on fucking depressing topics, but also make the world... Like us reading them, and us acting on them, and policy being changed, and practise being changed actually makes the world a little bit meaningfully better, and, of course, there are linkages between the books. Miscarriage in some cases can be linked to family violence, and also miscarriage is very much linked to the patriarchy that still dominates medical research and healthcare. So I'd like to talk a little bit about the science part. You're a journalist. You know how to research, but it is difficult to make research readable. I'd like to ask how you did that whilst having multiple audiences in mind, because this is a book for everyone, but I mean, within that it's a book for the medical community. It's a book for policymakers. It's a book for a lot of people in positions of power.

ISABELLE: I am very careful to acknowledge my privilege in terms of I am a white cis woman. I am in a straight passing or straight relationship, I should say. I'm straight passing. But being the wife of an aboriginal man and being a parent to aboriginal children has given me a totally different understanding of the way that privilege really works. I'm also conscious that I'm able-bodied. I'm also conscious that English is my first language. I mean, there are so many different ways in which I am kind of the best candidate, if I can put it like that, in terms of ease to navigate the system. If I didn't acknowledge that, I think that would be to my own detriment, to the detriment of the book, and to the detriment of the audience.

I had originally planned to have a separate chapter just about people from marginalised demographics, if I can put it like that, and my writer's group, which includes people of varying backgrounds, and sexualities, and all the rest of it, they said, ‘No, you can't do that. You can't relegate it. It's not one chapter. It has to be all the way through the book’, and I went away, and I thought about it, and I went, ‘Oh, you're right. You're right’. And so I scrapped the book, and I started again. And instead of kind of relegating it just to one area as sort of a checkbox, I tried to weave it all the way through, and that was a really important part of my job, I think.

ASTRID: Isabelle It really comes across for the reader. I think that you just articulated what I tried to mention, what I tried to articulate a little while ago. It feels like you are although one person, speaking to the experience of many people in a way that is successful, not in a way where it's all in one chapter, and therefore no one can accuse you of leaving someone out, but really the impact is different. I would like to ask you about the chapter Gagil Marrung, and I'm sorry, I know I will have said that incorrect. Jointly written-

ISABELLE: It's okay. It's Gagil Marrung, and it's Biripi, which is the language of my husband's family.

ASTRID: Isabelle You jointly wrote that with Dr. Cherisse Buzzacott and Arrernte midwife. What was the co-writing process like, and why was that important for the overall work?

ISABELLE: From the very outset, I had said to my husband, ‘I want a separate chapter on the Aboriginal experience. I think it stands alone. I write on stolen land’. It was very important to me that it get not just woven through, but more than that, elevated to its own position. The issues facing Aboriginal and Torres Strait Islander communities is woven all through the book, but then it is directly addressed in this chapter, and being a person who is not aboriginal, I knew I couldn't write it, but equally I didn't want to outsource it because that's not appropriate either. I approached Cherisse who I knew, and we knew of each other. We weren't particularly close, but I am a huge... like I was properly fangirling over her, like massive fan of her work, the way that she's able to articulate some of these issues and with her own lived experience, and she's just a phenomenal human.

And I approached her. I was so nervous. I called. I'm like, ‘Look, how would you feel about this?’ And she was like, ‘I'd love to’. And so basically the way, if I can describe it, she decided on the topics that would be included, her weight would be given to different issues, and then together... I mean, she really decided who we were going to interview, but we both put suggestions forward, but she always made the final decision. And then I was like admin support, so I did all the scheduling. I did all the Zoom meetings. I did all the data pulls. If she wanted data on a particular thing, I would go and get it, and then she wrote it so that it was sort of her controlling the narrative of the chapter, and I just cleaned it up so that it matched the tones of the other journalistic chapters, so that it was sort of like seamless in terms of being incorporated.

She had right to say, ‘No’, to anything. I said to her, ‘You are in control of this chapter. This is your chapter. I'll do the grunt work, but you get the control’. And that's what she got, and she also included some of her own story, and it was truly collaborative, but very much led by her, which is exactly what I wanted. I'm now happy to say that she's basically a member of our family. Our kids call each other cousins. I miss her enormously. She's lives in Mparntwe, but is in Perth in hospital, but getting better. Yeah, it was just a phenomenal way to work with someone. Yeah.

ASTRID: Isabelle You are collaborative in your approach, and I think you mentioned it like three or four times in the work itself. You did a lot of Twitter call-outs. Now, those call-outs were a asking for people's experience, also asking for data or asking to get behind academic paywalls because, oh my goodness, they are expensive. I would like to ask two questions really, that kind of crowdsourcing approach to both the personal and the research?

ISABELLE: I feel like, I mean, it became part of the book. I mean, I would ask for an example of something super specific, and I would get five people going, ‘Yeah, that happened to me’. Things like, ‘Did you have a miscarriage in this month of this year while there was a bushfire in Sydney?’ And I would have so many people contact me and go, ‘Yeah, that was me’, that I was like, ‘Oh my gosh, now how do I choose which story, because they're all relevant?’ I mean, that was amazing. And that's a practise that is definitely used by journalists a lot now to find the human element of any story. So I was okay accessing older research, but current research was really hard. I don't have an attachment to a university or anything, so often I did have to ask academic friends to help me get access to papers, and it was incredibly frustrating because it slowed the whole thing down, but I spent a lot of time in libraries, and photocopying, and looking at books, and people were just so generous with the support of the book and of me.

I genuinely feel like this is one of those books where, yes, it's got my name on it, but it was such a village in making this book come to life. And I even like there's a amazing doctor on Twitter called Kyle Sheldrick, and he does a lot of debunking of medical research that is not quality research and all this sort of stuff. And he did these amazing sessions with me where he taught me how to read a medical paper and understand whether it was kind of red flags to look for, like, ‘Well, how many people were in the study, and what's the difference between a literature review and a study’, and all of these things that I... I did a lot of prep work to be able to do the analysis on the data and on the medical research, and then I also did some training with Karen Percy of the MEAA around trauma informed reporting. It's like interviewing people who've suffered trauma without exacerbating their trauma, but also taking care of yourself when you are reporting on traumatic issues.

I did a lot of work in the background to kind of be ready to do the job, if you like. Yeah. And also there was a lot of listening and not as much talking as I'm doing in this forum. There was a lot of listening, and a lot of guidance, and a certainly a lot of... Like for instance, the environmental chapter, which is about the way that our environment and elements, chemicals in the environment can affect our bodies and our fertility, and it was terrifying.... That was terrifying to write, and it still stays. One of the biggest takeaways is it's really sort of given me some scarring, that chapter, and especially having young children in the house. And when I was writing it, I was like, ‘I mean, you can't be alarmist, right?’ I worked for the Herald Sun a long time ago. I don't work for the Herald Sun anymore. I wanted this to be taken seriously, and if it's too alarmist, it won't be taken seriously.

And I wrote it, and I'm like, ‘I tried to make it as not alarmist, if that's a phrase I can use, as possible’. But I ended up sending it to a scientist that I had interviewed and saying, ‘Is this fair? Have I overstated it?’ And he said, ‘Oh, no. This is very, very understated for the issues that we're facing’. And I was like, ‘Oh, no. That's awful too’.

ASTRID: Isabelle It is awful. I confess, I think it's in that chapter where you mention The Handmaid's Tale and Children of Men, both books and movies, which I have seen in the TV show as well, and I'm like, ‘Oh, no’. But if you're comparing your chapter to those works in a nonfiction book, this is not good.

ISABELLE: It's not good, and it's not overstated. It is absolutely terrifying, and I think that I'm definitely that's an area, the two areas of the book that I want to kind of keep pursuing, whether for another work of some kind or whether just for myself is certainly that, the way that chemicals are regulated in this country and put out into the environment, and the other one is reproductive justice, which is the movement that was sort of sparked by Loretta Ross and other civil rights campaigners in America, which is about basically everyone having the right to not have a child, but also everyone having the right to have a child. But that movement has to be centred around people of colour, Aboriginal and Torres Strait Islander communities. I can't start that. I have to wait and then support it when it moves, and it is moving, but much slower than it is in other countries.

ASTRID: Isabelle Remembering again that you are a journalist and have been putting stories out for a long time, what do you wish you had known at the beginning of the book writing process?

ISABELLE: Oh my god, how long have we got left? There is so much. I think I wish I'd known that I needed these long periods of space and time to write, because often I would start writing, and then I'd have to stop to do something, and it was painful to have to stop. And my Mother's Day present in the middle of writing the book was that I was allowed to go to a friend's shack, and I mean, it is a shack in Rosebud, and write for three days straight, so that I could do the rest of the writing, and that's never something that I've had to deal with because I've never written those sorts of really long... So that.

I think also sometimes putting out a book teaches you who your friends are. People let you down. I wish I'd known about that and better prepared for that. And I think that emotional drainage of putting the book out into the world has been... I'm so tired. I'm so tired, because it's your baby. I feel like I've got a newborn, and it's a weird comparison to use given the topic of the book, but it is. It's like you want it to succeed, and you want to give it everything you can to succeed, and be read, and change the system, and everything else, but there was a lot about this process that I really... It's doing a learning curve in so many ways.

ASTRID: Isabelle Isy, I don't know if I can call it a beautiful book, but I want to say that this is a meaningful book, and some of your language choices made me laugh. I mean, the whole thing is on one level, incredibly serious, but on the other level, you drop a few F-bombs, you make some call-outs to the medical community, you make some sometimes funny, sometimes bad jokes, but they all work, and they're all needed at that moment. So while it's not a pleasure to read, I also really disagree with the idea that it's an unpalatable topic to engage with. I would say it's meaningful and important for everyone to do so.

ISABELLE: Oh, thank you. That's so kind. I mean, it's I feel a great weight of responsibility because there are not just so many people who contributed to the book and supported me in writing it in various ways, as some of which I've outlined, but also shared with me the story of the worst day of their life, sometimes multiple days. And so I definitely feel this weight of responsibility, and I can quite safely say with my hand on my heart, there's not much I would change in this book. I think I really did what I set out to do, and I'm really proud of it. I am willing to do whatever it takes to get people to read it, because I think it does give us hope to go forward, and it is the starting point for another project that I'm going to be working on, which is the Early Pregnancy Loss Coalition, but the book forms the roadmap. But also I'd like to think it's a really good book too.

ASTRID: Isabelle Isy, it is a fantastic book, and congratulations.