When a couple decides to begin trying for a family, it can be an extremely exciting, emotional, and even anxiety-ridden time. Tracking cycles, perhaps using fertility interventions, and of course, trying to enjoy the process itself are all just smaller parts of a bigger picture that, hopefully, will lead to a baby.
All of a sudden you might find yourself using new vocabulary, reading articles you may have never clicked on before, and talking about things that were once taboo for “normal” conversations. One of these conversations that are typically avoided are about miscarriages, a difficult but unfortunately extremely common part of the journey to forming a family.
Very few can understand the emotions, thoughts, and grief that surround miscarriage unless you’ve experienced it firsthand. Yet, the unfortunate truth is: many have. It’s just not something most people talk about freely.
But the reality is, as many as 20–25% of recognized pregnancies end in a miscarriage, according to Dr. Rony T. Elias, M.D., and Assistant Professor of Obstetrics and Gynecology Reproductive Medicine at New York Presbyterian Weill Cornell in Manhattan. And while they are physically and emotionally devastating, it’s important to know the facts, reasons, and resources that might help to navigate through a such a difficult time.
What is a Miscarriage?
By definition, Dr. Elias explains, a miscarriage is, “the unintentional arrest of a pregnancy before 20 weeks. Most physicians call a miscarriage a pregnancy that arrests any time from when it was first detected on ultrasound, and around 20 weeks. However, many pregnancies (up to 50% of all pregnancies) arrest much earlier, between the date a period is missed and up to one week later. These are called chemical pregnancies.”
Some miscarriages may occur at home, when bleeding or other signs/symptoms of miscarriage become apparent. Others may be discovered at a doctor’s appointment and are considered “missed miscarriages,” meaning the pregnancy has ended but the body did not yet recognize it. In very early miscarriages, the woman may not even know she was pregnant and experience what she believes to be a typical period.
Depending on the type and timing, miscarriages may be treated medically (with medication to help pass the tissue at home) or surgically (with a procedure to remove the tissue). Sometimes, there may be no need for assisted intervention, but of course your doctor should always be contacted as soon as you feel something is wrong.
Why do they Happen?
According to Dr. Elias, “most miscarriages are due to abnormal chromosomes in the fetus. This is very rarely genetic (parents carry a specific chromosomal rearrangement) and most cases are sporadic or random. The incidence of this increases as the woman’s age increases.” Aside from chromosomal or fetal abnormalities, there are other causes, too. “In a patient who experiences two to three miscarriages, other causes should be ruled out," says Dr. Elias. "Most commonly, anatomical problems like inflammation and fluid in the fallopian tube, polyps, fibroids, or acquired thrombophilia disorder, commonly known as clotting disorder can cause miscarriages as well."
Though worry, grief, and even guilt are common (and normal) feelings often experienced by couples going through a loss, Dr. Elias says: “It is very important to reassure the couple that nothing the mother or couple does early on in pregnancy can change the outcome. No specific item, intercourse, or special food can cause or prevent a miscarriage. This is probably true for everything except smoking, drugs, or excessive alcohol." He also finds it important to inform couples how common miscarriages truly are.
“I usually tell my patients that having one or even two miscarriages mostly tells us one thing—they can get pregnant," he says. "It doesn’t mean that every future pregnancy will result in the same outcome.” Yet, it is important to acknowledge the potential causes with your doctor, which can often be treated relatively easily with good chances of live births following treatment.
How to Get Through It
Whether you were two or 12 weeks along, or if it’s your first or fifth pregnancy, miscarriages can be extremely difficult on the mother, couple, and family. In the days that follow, it’s incredibly important to feel all the feelings that come your way, paying particular attention to caring for yourself and your relationships, too. Mental health therapist Jody. E. Smith, of Hoboken, NJ, stresses the importance of communication, and taking some time out in the wake of a loss.
To keep your relationship strong and healthy, Smith suggests: “Give each other time to express how the person is feeling but also be accepting that this is difficult for both parents during this time of loss. The other recommendation is possibly seeking therapeutic services due to the intensity of these emotions. Outside of speaking, it is recommended to try and stay active and do things that you both enjoy individually as well as a couple. These activities can include hiking/walking/reading/music, etc. There is no limit to the possibilities but it is vital to hear each other and respect yourself and your partner’s needs.”
In terms of the future, once you are medically cleared to try again, it’s important to make sure you are personally ready as a couple as well. Smith explains: “If a couple goes into trying again too soon without really coping with the miscarriage, the next pregnancy will be glossed over with fear and anxiety. Every couple trying to have a child deserves to be happy and deserves to give themselves the pregnancy they both hoped for. Remember, you aren’t alone in this and make sure both you and your partner are emotionally on the same page about trying again.”