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Maternity Monday: Miscarriage, A Common Taboo

I thought a quick scan through a Google search about miscarriage would reveal more information than I could fit into this blog post.

Stories about preconception, pregnancy, childbirth and postpartum
Join us as we journey through preconception, pregnancy, childbirth and beyond in a series we call Maternity Monday.

I was wrong. In fact, my quick scan turned into a lengthy search, and the very large gap of information underscored a sentiment that seems pervasive:

You don’t talk about miscarriage.

But why? I wanted to know. Everyone online and the women I talked to for this story expressed the same thing: There’s silence around miscarriage. And it needs to be broken, because this taboo makes it a lonely, isolating experience, on top of the already-difficult physical and emotional loss.

The closest thing I could find for an answer was that the lack of medical reasons for miscarriage—and there’s more often than not no clear reason for it—leaves the why of what happened a blank. As Diane Rozycki, MD, told me, “Miscarriages can happen due to a variety of reasons. They can also be unexplained, with chromosomally and structurally normal fetuses in apparently healthy women.”

As with most mysteries humans face, we tend to fill in the gaps. Women who have miscarriages often feel responsible, at fault and ashamed; the pregnancy “fails,” and they feel they have failed, too.

Miscarriage Risk Factors

But even when a cause is implicated, most of the risk factors for miscarriage aren’t something a woman can control, like:

  • Maternal age: Risk increases with age
  • Maternal disease, acute infection as well as endocrine disorders (uncontrolled diabetes and thyroid disease, for example)
  • Structural abnormalities of the uterus
  • Fetal chromosomal abnormalities or congenital anomalies

Two risk factors, a woman being extremely overweight or exposed to certain medications and substances, can, in some cases, be controlled, but they certainly are not predictors of miscarriage.

Miscarriages Are Common

And the thing is, miscarriages happen more frequently than generally assumed. Rozycki again: “Miscarriage in early pregnancy is common. Studies show that about 8 to 20 percent of women who know they are pregnant have a miscarriage some time before 20 weeks of pregnancy; 80 percent of these occur in the first 12 weeks. Loss of unrecognized or subclinical pregnancies is higher.” (That is, you can have a miscarriage without even knowing you’re pregnant. You might experience symptoms, like pain and/or bleeding, but not necessarily.)

The situation seems like a catch-22: No one knows how common miscarriages are because we don’t talk about them, and we don’t talk about them because we don’t know how common they are. It doesn’t help that in the US, cultural convention tells us to hide pregnancy until after the first trimester, the time when most miscarriages happen. So paradoxically, the time when women arguably need the most support, feel the most tired and nauseaus as well as the most worried, is exactly when they are supposed to hide their pregnancy and, should it happen, their miscarriage.

One article talking about the misconceptions people have about miscarriage reported:

“The survey of more than 1,000 women and men found 65 percent believe miscarriage is rare, when in reality it occurs in one in four pregnancies. While knowledge of miscarriage rates was low, respondents accurately assessed that it is traumatic, with 66 percent believing the emotional impact is severe and potentially equivalent to the loss of a child. Research shows understanding the cause of miscarriage can reduce feelings of guilt or blame; however, currently the origin is only identified in 19 percent of patients.”

Life After Miscarriage

The good news about miscarriage is, it may be beyond your control, but it doesn’t mean you’re beyond hope for having a baby.

“If you have had a prior miscarriage, you can be at increased risk for another,” Rozycki says. “But it does not mean you are infertile. Even women with recurrent pregnancy loss (three consecutive miscarriages) have a good chance of eventually having a successful pregnancy.” She does advise that women wait for two to three months before getting pregnant again.

And, whatever the taboo or misperceptions, you are not alone. As one woman told me, “It’s still painful right now, looking back at it, but I have to say time decreases the intensity of what happened. Do whatever self-care works for you. Give yourself time, and reach out for support.”

Odds are, when you do, you’ll find someone who knows exactly what you’re going through.

Next Monday, we’ll hear a personal story about the mix of emotions that can occur with a miscarriage.

Worried About Miscarriage?

The best bet: Talk to your doctor. Find a caring, expert OB/GYN:

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