Wisconsin Woman on Twitter: 'Thank Goodness' for Miscarriage

Penelope Trunk Episode Spurs Debate on How Much Info Is Too Much Online

By LARA SALAHI
ABC News Medical Unit

Oct. 1, 2009—

Penelope Trunk, 42, built her career advising others on how to create a professional online identity by telling them what to share and what to leave out.

But early last week, the professional blogger and CEO of her own company, "Brazen Careerist," posted on her Twitter account, "I'm in a board meeting. Having a miscarriage. Thank goodness, because there's a f***-up 3-week hoop-jump to have an abortion in Wisconsin."

Trunk's apparent relief and offhand attitude toward her unwanted pregnancy has fueled the debate among many women on whether she and others are overstepping their professional boundaries by going public online about controversial health issues.

"The issue of pregnancy stirs up a lot of emotions," said Scott Wetzler, clinical psychologist at Montefiore Medical Center in New York. "Her bravado suggests that everything is OK, but things are more complicated than she's making it out to be. There's nothing wrong with her brazen [attitude], but underneath I think there's more ambivalence she's not acknowledging."

Trunk's candor resulted in more than 70 of her Twitter followers jumping ship -- a consequence that Trunk told ABCNews.com she found surprising.

The Wisconsin resident said that her attempts to schedule an abortion in that state turned into a bureaucratic nightmare when she attempted to go through her insurance provider. She subsequently made an appointment to have one in three weeks in Illinois. But within three days of the appointment, she miscarried, she said.

"I thought a lot of people would be responding about having to cross state lines to get an abortion, but a lot of it has also been [about] whether you should be sad about miscarriage," Trunk told ABCNews.com. "I think the issue surrounding the three-week wait is controversial, but not the relief."

Trunk, who has two children and has recently had a divorce, said she had already experienced a miscarriage after the first of her two children were born.

"The first time I had a miscarriage I was sad about it, and it was a very typical experience," she said. "But I think it's limiting that it's only OK to talk about miscarriages if you're sad about it."

Trunk added that while many of the responses to her tweet criticized her for releasing too much personal information, some women in the blogosphere are applauding Trunk's frankness about her feelings.

"The idea that miscarriage is something personal that should be kept secret whether a woman wants to keep it secret or not, when so so many women have them, is a problem," wrote Rachel Walden, of Nashville, Tenn., in the blog, "Women's Health News." "The idea that people's bodies should effectively be hidden from the work environment where we spend so much of our time is problematic in its own ways."

"If the public at large had to face up to the fact that not every miscarriage is met with a vale of tears, that could have a dramatic impact on how we regard pregnancy, abortion, and women's diverse experiences with our reproductive functions," wrote Amanda Marcotte in the women's issue blog, "XX Factor."

How Much Information Is Too Much Information?

Still, at a time when anything goes in the digital realm, is it possible to share too much? Indeed, while online communities go the extra mile to assure users of privacy and confidentiality, some users indulge in an openness that is uncommon in other social settings.

Lisa Neal Gualtieri, adjunct clinical professor of the health communication program at Tufts University School of Medicine in Boston and an expert in social media and public health, said that while many people are aware that they are sharing personal health information through social networks like Twitter or blogs, they may not realize the effect their attitude toward a health condition may have on other readers.

"When you move to electronic ways of communication in general, there is a sense of emotional detachment even though emotions are being expressed," said Gualtieri. "Twitter is interesting because it's so public, and so immediate, and it's so contained; you're not going into detail, and it can be highly emotional."

According to Gualtieri, social media technology has introduced new ways to view health conditions that many people may not otherwise openly discuss.

"It's making a health issue, or opinions regarding a health issue, more of the common vernacular," she said. "But for all the talk about privacy online with these types of sites, this is a way you're being very public about health information."

Trunk, who bases her career on the use of social media, said that older and younger generation of social media users have different ideas of what information is acceptable to share online.

"My personal brand is transparency in the workplace," she said. "If there is a personal issue that is taking you away from work, then it becomes a career issue."

In fact, Trunk said, her tweet is her own experiential example of the advice she gives her readers about exercising transparency and honesty in the workplace.

"If you're pregnant or have had a miscarriage, you should tell your boss," she said. "Top performers [in careers] are communicative, so to tell my board that I'm going to Chicago to get an abortion, that's a no-brainer."

Miscarriage Not Uncommon, Doctors Say

Miscarriage is the most common type of pregnancy loss, according to the American College of Obstetricians and Gynecologists. The American Pregnancy Association reports that women ages 35 to 45 have a 20 to 35 percent chance of miscarriage, and the chances of miscarriage increase as women get older.

According to Wetzler, while many people may commonly associate miscarriage with feelings of disappointment or even despair, many women are ambivalent immediately after their experience.

"Miscarriage is enormously frequent, and in a vast majority of cases it's not met with depression," said Wetzler. "I think [miscarriage] is a natural and common medical event, and like other common and medical things, there are a multitude of reactions, some of which may be relief, disappointment and the realization that pregnancy is a risk."

The context of experiencing a miscarriage also factors into how a woman will react, he said. Generally, women who are older or who have been trying to get pregnant for many years may feel more upset than women who have had a miscarriage after already having a child.

And while many women express their reaction in different ways, Wetzler said for some women, sharing the news with an online community may feel just as comforting as sharing the news with family or close friends.

"The notion that it's shameful or personal to talk about your health in any capacity is unfair," he said.

"However, typically someone in control of their career is in charge of other things in their life, like their health," Wetzler added. "I'm personally skeptical that she's as brazen as she thinks she should be."