Miscarriage is common, but because many women never talk about it after the fact, misconceptions abound.
Miscarriage is the loss of a pregnancy that occurs within the first 20 weeks. Even though miscarriage, also known as spontaneous abortion, is common, many women have misconceptions about it, doctors say. And many women who have a had a miscarriage simply don’t talk about it.
One exception to keeping a low profile was the announcement in 2015 by Facebook founder Mark Zuckerberg and his wife, Priscilla Chan, that they were expecting a baby and had previously experienced three miscarriages. Doctors applauded their openness, reasoning that the more women know, the better equipped they are to handle the loss should they experience their own miscarriage.
Here are eight miscarriage facts every woman should know:
1. Miscarriage Is Common
“It’s much more common than you think,” says Siobhan Dolan, MD, MPH, professor of obstetrics and gynecology and women’s health at the Albert Einstein College of Medicine and Montefiore Medical Center in the Bronx, New York, and a medical adviser to the March of Dimes.
While the American Congress of Obstetricians and Gynecologists (ACOG) estimates that 10 percent of known pregnancies end in miscarriage, the actual number is probably higher, Dr. Dolan says.
“A lot of them happen before women realize they’re pregnant,” says Sarah Prager, MD, associate professor of obstetrics and gynecology and director of the family planning division at the University of Washington School of Medicine in Seattle. “I tell women they’re very common, and potentially up to a third of women will experience a miscarriage at some point in their lives.”
With age, the risk goes up, notes ACOG.
2. Bleeding and Cramping Are Miscarriage Symptoms
In fact, they’re among the most common symptoms, according to ACOG. In early pregnancy, you may experience a small amount of both bleeding and cramping; you should get checked by your doctor if either happens.
When you have these symptoms during pregnancy, your doctor will do a physical exam and may order an ultrasound, as well as blood tests to measure hormone levels, before making a definitive diagnosis.
3. Post-Miscarriage, You Have Treatment Options
After a miscarriage, you can choose from the following three treatment approaches, which are all equally effective, according to ACOG:
- One option is to wait and let the pregnancy tissue that remains in your uterus pass naturally. This may take up to two weeks, ACOG says.
- Another option is to take a medication under the guidance of your ob/gyn called Cytotec (misoprostol), which helps to expel the tissue within one week.
- A third is dilation and curettage (D&C) — surgery to remove the tissue — which may be advisable if your bleeding is heavy or an infection is suspected.
Dr. Prager helped to develop the updated recommendations on early pregnancy loss for ACOG that were released in April 2015. Of the three methods, she says, “They’re all equivalent enough and safe enough that as long as the patient doesn’t have a contraindication [a medical reason not to do it] for one of the methods, it should be based on what she wants to do.”
4. You Don’t Need Any Special Tests After a Single Miscarriage
According to Dolan, it’s typically not necessary to do tests and evaluations at this point. “Only after two or more miscarriages does the risk of a future miscarriage increase,” Prager agrees. After two, she says, there’s an increased risk, but it’s not significantly higher from a statistical point of view. Only after three miscarriages does the risk rise to a significant level, she says.
After several pregnancy losses, your doctor may advise testing and evaluation to try to pinpoint problems that are hampering the progression of a healthy pregnancy.
5. Feelings of Guilt Are Expected After a Miscarriage
Women tend to beat themselves up needlessly after a miscarriage, according to Dolan and Prager, saying things like, “If only I had taken that prenatal vitamin sooner,” or “If only I hadn’t exercised so strenuously.”
According to ACOG, ”Working, exercising, having sex, or having used birth control pills before getting pregnant do not cause early pregnancy loss.” In addition, women sometimes think that a fall, blow, or having a fright caused the miscarriage. In most cases, according to ACOG, this is not true.
“Most of the time, there’s nothing a woman could have done differently to change the outcome of her pregnancy if she has a miscarriage,” Prager says.
Many miscarriages are due to chromosomal abnormalities in the fetus, Prager says. She tells women that a miscarriage is often the body’s way of correcting what wasn’t going to be a healthy pregnancy.
6. Grieving After a Miscarriage Is Normal and Healthy
“Women should take time to process that loss,” Dolan says, and so should their partners. Prager tells women and their partners, “It’s really normal to grieve, even if it’s very early” in the pregnancy, because you may have already begun to bond with the unborn baby.
Experts agree that grieving the loss is very natural. “Conversely,” Prager says, “some women can be relieved if they weren’t planning the pregnancy.” And that’s perfectly normal, too.
7. Partners May Grieve a Miscarriage in Different Ways
Both partners may grieve after a miscarrige, though possibly for different periods of time and in different ways, says Prager.
“Women may grieve longer,” she says, adding that she always offers the option of seeing a social worker or other mental health professional if a woman is having trouble.
8. Most Women Who Miscarry Can Get Pregnant Again
Most women who have a miscarriage do go on to become pregnant again and have a healthy child, Dolan says. She tells women, “You may not get to the outcome [of a healthy baby] tomorrow. But keep in mind you will probably get there. The end is achievable for most women and most families.”