Of clinically recognized pregnancies, about 8-20% results in a “miscarriage”. Medical terminology for miscarriage is a “spontaneous abortion” which is defined by a pregnancy loss at less than 20 weeks into the pregnancy. The term “abortion” holds a stigma that deems it synonymous with “elective abortion”, which is why most people prefer the term miscarriage. For medical purposes, including physician jargon and medical record documentation, this medical diagnosis of “spontaneous abortion” persists. It is thought that the incidence of miscarriages, in actuality, is closer to 50% of women who have pregnancies that result in a miscarriage; however, many pregnancies are not clinically recognized. Many women may have what they feel is a “heavy period and passing clots” that truly was a pregnancy loss that they were not even aware existed. 

After a pregnancy loss, whether it is 5 weeks into the pregnancy or 20 weeks into the pregnancy, is a very difficult time for women and their loved ones. As a result of the grieving process, many women resort to blaming themselves.

Questions that run through a woman’s mind may include:

• Why me?
• What is wrong with my body?
• Will this happen again in my next pregnancy?

While the answers to these questions are not exceedingly lucid, there is comfort in having a sense of understanding.

The most common cause of a miscarriage is a chromosomal abnormality, which accounts for about 50% of all miscarriages. This means that after conception, there was a genetic abnormality. The majority of chromosomal abnormalities are incompatible with life. There are a few chromosomal abnormalities compatible with life, with a commonly known one being Down Syndrome. This is not the blame of the mother or the father. This is a spontaneous abnormality that no one could predict or prevent prior to conception. When the question is asked, “What is wrong with my body?”, the simple answer is usually nothing. The most likely reason for an unexplained early pregnancy loss is this chromosomal abnormality and there is nothing that a woman could have done to prevent it or predict it prior to conception.

Aside from the chromosomal issues, there are obviously other causes of miscarriages. From uncontrolled medical problems in the mother, to exposure to drugs and medications in pregnancy, to anatomical problems inside the womb, there are a wide array of potential causes. These other factors are not as common as the above mentioned chromosomal abnormalities, but that should not exclude these other factors when a practitioner is trying to determine etiology. Working closely with your physician, engaging in questions about what tests have been done to explore potential causes, is helpful in gaining further understanding. In most cases, practitioners cannot definitively state what the cause of the miscarriage was, but can give the most likely explanation based on your medical record. Gaining insight on the possible etiology can offer reassurance and help to remove the possibility of plaguing oneself with the heavy burden of self-blame. 

After grieving a pregnancy loss, a woman may ask herself, “will this happen again in my next pregnancy?”. Although this question cannot be definitively answered, statistics show that it is unlikely. It is estimated that about 2% of women that experience a miscarriage will experience another pregnancy loss consecutively. The majority of women go on to have a healthy pregnancy subsequently. In the rare instance of a woman having 3 or more consecutive losses, she needs to consult a physician to further explore this issue. 

Having a miscarriage is a traumatic time in, both, a woman’s life in addition to her loved ones. It is normal to grieve after this unfortunate loss, and also normal to seek counseling to aid in coping. Women should be reassured that they are not alone, as 50% of women have also dealt with this at some point in their life, and also find reassurance in knowing that the majority of miscarriages are caused by something that women have little to no control over. If you feel you are having a miscarriage or need counseling after experiencing one, please consult your physician.