In recent years, a zeitgeist shift surrounding the way we talk about postpartum bodies has stormed through culture. The preoccupation with “bouncing back” after the birth of a baby, while not completely erased, has begun to fade. In its place, a dialogue borne mainly through social media encourages grace, acceptance, and self-love for women whose bodies have changed in the wake of growing a human. You made a person. Of course things are different. Wear these changes with pride, the messages say.

It’s a well-intended and much-needed societal shift – women needn’t expect themselves to return to their pre-partum body overnight, if ever. But unfortunately there are countless women who may not feel included by these mantras about loving your postpartum body, as they imply one crucial element: a live birth.

One in four pregnancies result in miscarriage and one in 100 in stillbirth. So there are millions of women who also experience bodily changes during pregnancy – those who were pregnant, and looked pregnant, but were left with empty arms. With no tangible evidence of what their pregnancy created, messages of pride and bodily acceptance may not resonate.

What happens to our inner dialogue about our bodies when we don’t have the proof of a “successful” pregnancy to offer the world – and ourselves? What does it feel like to live in a once-pregnant body after loss, when there is no baby to show for it? These bodies are still changed, and they continue changing, but they are now also imprinted with a life lost. There probably isn’t room for the ideas of grace, gratitude and being kind to yourself in the moment when breast milk comes in with no baby to feed, or when the feeling of fetal movement is replaced by an empty uterus, and when the weight gain that began with so much promise reverses (or doesn’t). Their bodies have changed exponentially, but with no baby to prove why. It can all feel so futile.

The strident trifecta of silence, stigma and shame that shroud the topic of pregnancy loss prevent open dialogue and emotional support about these physical changes. This can complicate often already fraught relationships with our bodies, as women burrow their reactions, which can mutate into guilt, embarrassment and self-blame.

This is made worse by the fact that pregnancy and childbirth are typically narrativized as inherently natural – a pedestrian experience all women can undertake. It’s a promise that simply isn’t true, as many women find out first-hand. “The purpose of my body is to have a baby and it could not,” says Christina, 33, who has had two miscarriages in the first trimester. “I keep telling my wife: I have a body that is not useful. I am supposed to be able to have babies and I can’t stay pregnant. What is the point of this body?” In a culture that does not openly talk about miscarriage – which, too, is natural and common – thoughts like Christina’s can affect self-image. There is no blueprint for how to exist in one’s skin post-loss. Lowri, 33, who has had three miscarriages and an ectopic pregnancy, explains: “I have way more negative feelings about my body since my losses, because of what I feel my body should have been able to do. Every time I have a loss, I feel a little more disconnected from my physical self. I find myself sometimes wishing I didn’t have a body, because I am so betrayed and hurt by it.”

These feelings of betrayal can morph into an intolerance for one’s body and even an inability to look at it. The reflection becomes, in part, a projection of our thoughts and feelings about ourselves. “I was disgusted with my body after losing my babies,” says Kristen, 34, whose twins were born still. “Seeing myself in the mirror was embarrassing. I felt ashamed. I felt like a failure.” These emotions are not uncommon following pregnancy loss. Still, the trap of self-blame grabs many who experience it. “When I look at my belly, I see my loss,” says Dana, 33, who had a first-trimester miscarriage. “I blame myself. I am angry with my body,” she says. Rhylee, 26, who had a stillbirth and a miscarriage, can relate. “For months, I couldn’t bear to look into my own eyes because I was too afraid of what I would see. They say the eyes are the window to your soul, and I didn’t feel like I had a soul. I’m still angry with my body, and with myself, too.”

Sometimes, there is no clear medical explanation for why a loss happens, and since human nature craves answers, women may accuse their bodies of betrayal. “I learned that unexplained miscarriages can be caused by something underlying with the mother, so I began to blame myself,” says Alyssa, 32, who had a second-trimester miscarriage. “I have struggled ever since with guilt and shame that my body failed me. And my body held on tight to the pregnancy after it ended, which I really resented. It now feels impossible to look at myself and not nitpick at every single thing. When I look in the mirror, I don’t recognize who I am.”

Watching the changes of pregnancy reverse can be just as difficult as seeing reminders of it. The disappearing signs can be seen as an erasure of the experience. “It was devastating to bounce back after my first loss. To have my body return to what it was before. It was almost cruel how fast it happened,” says Beth, 35, who lost a pregnancy to placental abruption and terminated another for medical reasons in an emergency c-section. Jenn, 46, fought her body’s attempts to return to her pre-pregnancy state after her full-term stillbirth. “I held onto the weight for as long as I could. It was my emotional blanket. It was proof that my daughter really existed,” she says.

While pregnancy can be physically unpleasant for some, when it is lost, even the hard parts are missed. “After the losses, I had a desire to still feel pregnancy symptoms, even the ones that had been difficult while living through them,” says Cristella, 32, who has had two first-trimester miscarriages. “I wanted to be pregnant still, and now I wasn’t. My body was mine again, but at what cost?” And as pregnancy symptoms go from nausea and exhaustion to fetal kicks and wiggles, these emotions evolve. “No longer feeling the movement in my womb after the twins died may have been the worst part,” says Kristen.

With later losses, the body is essentially unaware that the baby didn’t survive, and behaves as a postpartum body does. “When my milk came in, after my stillbirth, I thought I could be a hero to someone else’s baby by pumping and donating it,” says Rhylee. “But after leaving the hospital, I just couldn’t. I was so bitter, so angry. I couldn’t allow someone else to have this milk. This milk was for my baby.” Plus, the physical evidence of birth becomes an intense private trauma when there isn’t a live baby. For Beth, the scar from the emergency c-section during her loss haunted her. “The scar stared at me. I cried every time I took a shower. I had so much self-hate around this tiny incision. Others didn’t see it, but I couldn’t hide it from myself. I looked normal, so people thought I was normal. I wasn’t.”

When one has been visibly pregnant, and then no longer is, the comments that come in can be inadvertently gutting. “I shared the news that I was no longer pregnant, but people still thought I was,” says Brittany, 33, who terminated for medical reasons. She became obsessed with trying to lose weight in order to avoid having to explain her situation. “I was going through body dysmorphia. I had an empty body because of the loss of my son, and all I wanted was to look as non-pregnant as possible.” Well-meaning comments are often the most unwelcome. Rhylee recalls a family member saying: “Wow, you look so good, you don’t even look like you just had a baby! I was depressed and hardly eating. Don’t you think I wish I was still big? Don’t you think I wish I was still pregnant?”

Some women go on to conceive a healthy pregnancy, which can aid in the restoration of their self-image. Beth recently had a baby who was born through the same c-section incision as the son she lost. “This has helped change my relationship with my scar,” she says. “I no longer look at it with disdain or guilt. I look at it now as the way this beautiful miracle was brought into my life.” Kristen had a son after her twin loss, and is currently in her second trimester. “Being pregnant after my loss was terrifying, but I felt like I had no other choice than to trust my body, which actually felt empowering. I could do this, physically and mentally. I could get pregnant again. I could carry a baby to term. Now, I feel like I have no other choice than to trust my body.”