When George W. Bush revealed on national television that he had witnessed a "little brother or sister" when his mother miscarried and carried a fetus in a jar to the hospital, online media and their followers were shocked.
It was just a passage in the former president's memoir, so why did this detail -- only five paragraphs long -- get so much attention in the digital sphere?
"Whoa! Just whoa," gasped one commenter.
"We'll never look at Barbara Bush the same way again," wrote another.
The former president commented on the reaction this morning on NBC's "Today Show."
"I had no intention of creating a national dialogue," Bush said. "My intent was to describe a relationship between my mom and her son and an interesting anecdote that helped the reader understand why my mother and I are so close."
That dialogue, say psychologists, illustrates the "ick" factor when discussing miscarriage and misunderstandings about a loss that is still treated in hushed tones.
"It's just the sight of blood and human tissue that is hard for people to see," said Sandy Robertson, a 52-year-old Colorado professor who had six miscarriages. "Then you're dealing with the death of a baby on top of it.
"Our society, at least in this country, is so sterile anyway," she said. "People just aren't used to seeing that."
People are also uncomfortable around those who are experiencing a miscarriage and don't want to cause further discomfort, she said.
A more level-headed online commenter opined, "While quite creepy and something I would never do, I have to remind myself that people respond to death and loss in their own way and in their own time, and I try not to judge. Is this any weirder than having your loved one cremated and keeping a box filled with their charred flesh on your mantle?"
The Internet does get things wrong.
According to the book, "Decision Points," Barbara Bush never paraded the jar around the house, nor did she put it on her bedroom shelf as a keepsake. And taking the remains of the miscarriage to the hospital is far from barbaric.
In fact, there is nothing weird about the practice. The American College of Obstetricians and Gynecologists in their 2010 patient education pamphlet recommends:
"If you have heavy bleeding and think you have passed fetal tissue, place it in a clean container and take it to the doctor for inspection. Your doctor will want to examine you."
Dr. Tracy W. Gaudet, an obstetrician and executive director of Duke Integrative Medicine in North Carolina, said when her mother miscarried her twin, she, too, took the remains to the hospital, just as the Bushes did.
The protocol is the same today, she said.
"If you can bring anything passed it allows us to first know if everything has passed or not, and secondly it allows us to send the fetus for genetic testing if indicated," said Gaudet. "I do think culturally we were closer to life and death. My dad grew up on a farm for example, and these matters were more fundamentally understood."
Talking About the Trauma of Miscarriage
Bush recounts the event in his book:
"One day, shortly after I learned to drive and while dad was away on a business trip, Mother called me in to her bedroom," he writes. "There was an urgency in her voice. She told me to drive her to the hospital immediately. I asked her what was wrong, She said she would tell me in the car.
"As I pulled out of the driveway, she told me to drive steadily and avoid bumps. Then she said she had just had a miscarriage. I was taken aback. This was a subject I never expected to be discussing with Mother. I also never expected to see the remains of a fetus, which she had saved in a jar to bring to the hospital. I remember thinking: There was a human life, a little brother or sister.
"Mother checked herself in to the hospital and was taken to an exam room. I paced up and down the hallway to steady my nerves. After I passed an older woman several times, she said, 'Don't worry honey, your wife will be just fine.'
"When I was allowed into Mother's room, the doctor said she would be all right, but she needed to spend the night. I told mother what the woman had said to me in the hall. She laughed one of her great strong laughs and I went home feeling much better."
The next day, when the future president picked her up, she thanked him for being so "careful and responsible." His mother also told him not to tell anyone about the miscarriage, which she felt was a "private family matter."
Only when Bush wrote his memoir did the story come out.
Bush himself told the media that while the incident influenced his staunch pro-life stance, it also had a big impact on his relationship with his mother.
"The purpose of the story [in the book] really wasn't to try to show the evolution or the beginning of a pro-life point of view; it was really to show how my mom and I developed a relationship," he told NBC interviewer Matt Lauer.
"She says to her teenage kid, 'Here's a fetus,'" Bush said. "No question it -- that affected me -- my philosophy that we should respect life."
Perhaps not as disturbing as the baby in the jar -- perhaps a more common practice in the 1960s -- was Barbara Bush's off-handed demeanor during the miscarriage.
"Based on some of the reading I've done, it sounds like women in the olden days may have actually welcomed miscarriage," Robertson said.
"That was back before there was reliable birth control and many women weren't necessarily happy with their pregnancies," she said.
She said a physician's assistant once told her to save the "products of conception," after they knew the pregnancy wasn't viable but had not expelled yet.
"I thought that was very strange," she said.
"Nowadays, so many people purposefully wait before they are completely ready to start a family," she said. "Every aspect of their life and fertility is planned out. I think it really is a bigger deal now to lose something you've been waiting for and planning for."
Robertson recommends in her book, "Get Pregnant Over 40, Naturally," to have a private memorial.
"This does make you feel like you've acknowledged the loss and may help you move on," she said. "I lit a candle and in my own way said goodbye."
Rituals Are Common in Mourning Miscarriage of Stillbirth
Many couples opt for rituals after a stillbirth, and even in a late miscarriage where there has been a delivery.
"Some choose to hold the baby and are often encouraged to," said Helen Coons, a clinical psychologist at Philadelphia's Women's Mental Health Associates. "We see some who would like photos and footprints. Others decline."
"Some seek an autopsy and others do not," she said. "Many find solace in noting the anniversaries of the expected due date, the day of loss. Others plant memorial trees or make donations to favorite charities.
"Some women are very sad and others are rattled to the core, but soon get their bearings and go on to the next pregnancy," she said.
Even with Barbara Bush's New England stoicism, who's to say what is normal, even in the Republican Party.
Former Pennsylvania Sen. Rick Santorum and his wife Karen have seven children, including the "one in heaven" that they lost in the 20th week of pregnancy in 1996. The child lived a few hours after birth.
According to Karen Santorum's book, "Letters to Gabriel," they brought his little body home to let the other children see and hold him before burial. They were a lot younger than George W. Bush, at 6, 4 and 1 1/2.
Santorum kept the framed photo of Gabriel Michael, his fourth child, on a shelf next to an autographed baseball in his Senate office.
"That's my little guy," he bragged to the Washington Post in 2005, nearly a decade after the miscarriage.