It is estimated that one in four pregnancies ends in miscarriage, and yet it is an experience that remains largely ignored  –  a grief that the world seemingly doesn’t know how to talk about. In The Brink of Being, psychotherapist Julia Bueno draws on her own personal experience, stories from her consulting room, and interactions with experts, to examine miscarriage within its broader cultural, medical and historical context  – encouraging us to think more, and think differently, about pregnancy loss.

The heartbreaking loss of twin daughters, Matilda and Florence, at 22 weeks ripped Bueno’s world apart, leaving her irrevocably changed  – time now divided into the “before”, and the “after”. The acute feelings of despair, sadness, guilt, shame, bitterness, anger (and every other emotion in between), that so often accompany miscarriage, were only exacerbated by the lack of understanding of her suffering.

I often say that the worst thing about my (unsuccessful) journey through multiple rounds of IVF and two losses wasn’t just the gnawing sadness that we might never have a child, but the profound sense of isolation. It wasn’t that I felt ashamed about having had a miscarriage, but rather the emotions that followed in the aftermath. Losing a baby is such a big part of so many people’s lives, yet we’re mainly living it in the shadows – weighed down by incredibly heavy feelings and fears that can feel stifling.

It’s through this lens that Bueno explores different experiences of pregnancy loss: early, late and recurrent miscarriage; the impact of these losses on partners and loved ones; and finally, how to memorialise the family member who never made it to the family tree.

Each chapter examines some of the more specific aspects of these different experiences  –  such as the development of powerful maternal attachment to the recently conceived; the visceral physicality of having an early miscarriage at home, and the agony of having to flush your baby down the drain; giving birth to, and capturing memories of, a baby born dead in a second trimester loss; the psychological impact on long-term mental health in cases of recurrent miscarriage; social conditioning and gender expectations that shape the experience of the male partner; and the creation of funeral rituals and memorials to commemorate these losses.

Bueno’s choice of language is considered and thoughtful, unpacking difficult issues that are so often avoided for fear of causing distress. She writes with sensitivity and compassion ,  filling a much-needed void in discussion around the subject, and opening the door to more candid conversations.

Criss-crossing these discrete experiences are universal themes and ideas that invite reflection on some of the fundamental assumptions and expectations that shape the experience of miscarriage. The narrative around pregnancy loss is intrinsically defined by the entrenched belief that a bond with a child can only begin after a living baby is born –  establishing a hierarchy of grief, whereby the further along in the pregnancy, the more valid the loss; the ease with which early miscarriages may be so glibly dismissed by medical staff as “just a ball of cells” –  something that had never really existed in the first place; the unwritten rule that one must not outwardly acknowledge the existence of a pregnancy before the 12-week milestone, and the conspiracy of silence that surrounds a miscarriage before this time; the arbitrary boundary between a late miscarriage and a stillbirth, which grants official recognition to one loss, yet erases another that happens just a couple of weeks earlier.

This book offers a different, and more satisfying, perspective: that the stage of gestation does not determine the meaning of a pregnancy, nor the impact of its loss  –  rather that every pregnancy, and every miscarriage, is tethered to its own meaning, “annotated with yearned-for dreams, hopes and imaginings of a future life  –  a difficult to quantify, privately held, memory of memories”.

Attitudes towards miscarriage are continuing to evolve: women suffering recurrent miscarriage were described as “habitual aborters” until as recently as the 1980s, and more and more women are beginning to open up about their experience of loss  –  but Bueno is clear that we have a long way to go before the anguish of miscarriage “earns settled coordinates on the map of grief”.

Katy Lindemann is writing a book that shares real women’s stories about the emotional experience of infertility and pregnancy loss.

• The Brink of Being: Talking About Miscarriage by Julia Bueno is published by Little, Brown (£18.99). To order a copy go to guardianbookshop.com or call 0330 333 6846. Free UK p&p over £15, online orders only. Phone orders min. p&p of £1.99