Baby Health in Winter I’ve Been Pregnant Nine Times. I Have One Child.

The first time I felt the sharp twinge in my belly was during an important client meeting. Seated around the table were senior executives from a multinational information-technology company. We were developing the company’s long-term strategy when the twinge hit me again, this time followed by a familiar dampness in my underwear and then a slippery fluid sliding through me. I quickly handed the meeting off to one of my staff and ran to the bathroom. By then, a layer of sticky, dark blood had soaked through my black tights and adhered to my inner thighs. I couldn’t breathe. I couldn’t physically take in air. I slumped over on the toilet and finally allowed myself to sob, silently, so no one could hear.

I’d been eight weeks along. I was scheduled the following week for an early ultrasound. I’d already started thinking of names. As I cleaned up the blood on my legs and the floor, I searched for answers, but kept arriving at the same place of anger and self-blame. It was my fault. I must have done something wrong.

The third time I felt that twinge, I already knew what to expect. Blood loss and a humiliating trip to the drugstore for extra-large pads, followed by deep depression, insomnia, and a stream of questions with no answers. My husband and I saw the best fertility specialists in Manhattan and Baltimore, and we subjected ourselves to every test offered. In the end, nothing was medically wrong with either of us. We were in our early 30s. We were healthy. We could get pregnant. The problem seemed to be my ability to stay that way.

Read: The miscarriage taboo

What I didn’t know then is that my experiences were not unique. At lunch following my third miscarriage, a friend noticed my sullen expression and asked me what was wrong. I finally and unexpectedly opened up and talked about what was happening. She put her arm around me and welcomed me to the club. She’d had two miscarriages. And two healthy kids. And like me, she’d also felt completely alone, her self-worth degraded.

We do not talk openly about miscarriage and fertility in America, and yet miscarriage is more common than the flu. One in six women will miscarry during their lifetime, and there isn’t a singular reason. Most often, the cause is a chromosomal abnormality—something goes haywire as the embryo divides—that has nothing to do with the health or age of the parents. For women who know they’re pregnant, nearly 20 percent of their pregnancies end in miscarriage. Sometimes it happens during the first 12 weeks of pregnancy, and sometimes it happens much further along.

I’ve been pregnant nine times, and I have one child. For years, I never told anyone about my miscarriages, because as a professional American woman, I’d been indoctrinated to mute the implications of my gender. I should never hint at the idea that my body is capable of reproduction or that I might someday want to start a family. In a business setting, I learned that the mere mention of pregnancy could mean losing a potential client, or being passed over for a promotion or project. This wasn’t merely anecdotal. I observed it firsthand, many times.

Last year, riding the Acela between New York and Washington, D.C., I was seated at a four-top table with the head of human resources from a large investment bank, and he spent the entire commute working with his colleague on ways to legally fire a co-worker because she had the gall to take parental leave. Never mind that she was eligible for 12 weeks and only took three. There would be no way for her to catch up to the rest of the team, he argued. And what if she decided to have another baby? Best to “pull the weed now before she spoils the whole garden,” he said.

While I was waiting in line to collect my winter coat after a professional event in New York, two men behind me were trying to decide on a new hire. The woman under consideration had an incredible track record at her previous job, had won a prestigious industry award, and fit in very well with the culture of the organization. But there was a big, insurmountable problem in their eyes: She was in her mid-30s and recently married, which obviously meant she was actively trying to get pregnant. She’d get that “fuzzy pregnancy brain,” and then her productivity, no doubt, would wane. Before I’d even handed over my ticket to coat check, they’d decided on the male candidate, whom they’d described as less impressive—but also less inclined to reproduce.

Miscarriage is a frequent and normal part of the human experience, but we rarely talk about it, so a woman going through one often feels like she, or she and her partner, are alone. There’s something especially awful about needing the comfort of others and remaining silent while being subjected to certain types of men opining on women, pregnancy, and their productivity.

I’m a successful person who is in the public eye, and I never told anyone that I was pregnant—or that I was suffering through loss—because I didn’t want to be the topic of that kind of conversation on the train or in a coat line. Instead, I spent a good part of my 30s quietly feeling like a failure. My ob-gyn and I agreed on a strategy, and I was executing it without deviation: I took the prescribed regimen of prenatal vitamins, I continued to exercise, I got enough sleep, I cut out caffeine, and I gave up the occasional glass of wine with dinner. It was the first time in my life that I couldn’t achieve. I had no idea how to fix whatever was wrong.

My fourth pregnancy stuck. At 24 weeks, my stomach was protruding, and I finally felt confident that I was in the clear. I didn’t stop working. I keynoted a conference for prominent news editors, and after, the nearly all-male audience asked me questions along the lines of “Who’s going to run the company from now on?” and “Will you step down as CEO?” One editor in chief of a large metro newspaper simply said, “Thank you for showing up in your condition.” My tights were a little constricting, yes, but other than that my condition was perfectly normal.

Read: The high-tech future of the uterus

Those who would make assumptions about anyone going through fertility issues would do well to look beyond their own pregnancy-induced brain fog to see whether those correlations are real or simply the result of narrow-mindedness. More women than you realize are going through miscarriages: women married to other women, single women, women working through breakups or divorces, and women who have chosen to help others by serving as a surrogate. There are also women like me, whose husbands are supportive but ultimately feel helpless. Miscarriage affects the pregnant person’s partner, too.

I’ve had several miscarriages, including a traumatizing one at 18 weeks that required surgically removing the remaining fetal tissue from my uterus. I also gave birth to a healthy daughter, and by anyone’s measure she’s a terrific kid. The entire time I was miscarrying, staying pregnant to full term, and becoming a mother, I’ve written three books. (Two were best sellers and won awards; the other has been optioned for a movie.) I’ve produced nine editions of an annual report read by 8 million people. I’ve advised three-star generals and admirals, White House leadership, and CEOs of some of the world’s largest companies. I’ve taught 18 graduate classes. I’ve traveled to 17 countries for work. My company has enjoyed substantial growth. Of course, none of it has been easy. This has been the most challenging time of my life, at times straining my well-being, my relationships, my health, and my marriage. Like every working mom or would-be parent, I’ve made sacrifices. I’m sorting out life as it happens.

It would have been easier if I could have talked openly about the joys, challenges, and heartbreak of pregnancy when I was going through it. I’m older and stronger now, and with some distance I can see that refusing to talk openly about miscarriage is utterly and inexcusably ridiculous. America lacks a requisite societal maturity in how we discuss pregnancy and professionalism. Making sophomoric comments about gardens and weeds signals that a company and its executives aren’t planning for the future. Treating fertility as taboo is hurting us, not helping the bottom line.