Miscarriage and pregnancy loss

It’s the unspoken grief that so many women carry in their hearts: the pain of losing a child due to miscarriage (before 20 weeks gestation) or stillbirth (after 20 weeks gestation). While it is often only talked about in hushed voices behind closed doors and is sometimes treated as a taboo subject, pregnancy loss is, unfortunately, not rare: it is estimated that 10 to 25% of pregnancies end in miscarriage and 0.6% end in stillbirth (which still translates to more than 20,000 stillbirths each year). This means that many women experience the physical and emotional pain of pregnancy loss but feel unsure of how to talk about their loss or how to grieve, because it is a topic that is not discussed enough. 

What is a miscarriage?

According to the American College of Obstetricians and Gynecologists (ACOG), miscarriage is defined as the loss of a pregnancy during the first trimester. Most miscarriages occur before the 12th week, while about 1-5 percent of miscarriages occur in the second trimester. Signs and symptoms of pregnancy loss include bleeding from the vagina or spotting, cramps similar to menstrual cramps, and severe belly pain. (Women who are experiencing these symptoms or who are concerned about the possibility of miscarriage, should contact their health care provider.) 

What causes a miscarriage?

Although it depends on each individual woman’s experience, many feel a sense of guilt after a miscarriage, and blame themselves for the pregnancy loss. They may go over the events of the recent weeks, searching for a reason why the miscarriage happened. They often fear that the heavy box they lifted or the exercise class they took was the causal factor. However, the reality is, there are many factors completely outside the mother’s control that may have contributed to the pregnancy loss. 

For example, according to the American Pregnancy Association, about 50-75% of all miscarriages occur right after implantation, which is sometimes called a “chemical pregnancy.” Additionally, ACOG estimates that about half of all miscarriages are caused by an abnormal number of chromosomes in the embryo. This is merely one example of the many circumstances outside of a woman’s control that can contribute to the loss of a pregnancy. 

If you or someone you know is experiencing feelings of guilt or blame for a miscarriage, it can be helpful to talk to a healthcare professional to see if you are able to identify why the miscarriage occurred. This may help alleviate those feelings of guilt. Additionally, you or your loved one may find it helpful to talk to a counselor to help you work through any feelings of guilt, blame, or shame.  

What puts me at risk for a miscarriage?

There are several factors that increase a woman’s risk for miscarrying a pregnancy, including:

• Having two or more previous miscarriages
• Being 35 or older
• Smoking, drinking alcohol, or using harmful drugs
• Exposure to harmful chemicals
• Having an autoimmune disorder (e.g., Lupus, antiphospholipid antibody syndrome, etc.)
• Being obese
• Having hormone issues like PCOS or low progesterone
• Having preexisting diabetes
• Having thyroid problems

The presence of one or more of these risk factors does not necessarily mean that a pregnancy loss will happen, but it may increase the chances of it occurring. Your healthcare provider can help you assess your personal risk.

What are my treatment options after a miscarriage?

You have three treatment options after a miscarriage.

• Expectant management
• Medical management
• Surgical management

See our comprehensive guide to each of these options below.

Confused by news articles equating miscarriage treatment options with elective abortions? Read our article below to get the facts.

What are the emotional effects of pregnancy loss?

While every woman copes with the physical and emotional effects of a pregnancy loss in her own way, many women go through a grieving process. They are mourning the loss of the baby as well as their hopes and dreams for that pregnancy. This grief is very normal regardless of how far along the woman was in her pregnancy. In other words, the degree to which a mother experiences a loss is not proportional to how far along she was in the pregnancy. Instead, each woman grieves differently according to what the pregnancy meant to her. 

Processing the loss and grieving takes time, and the emotional pain of pregnancy loss can often last longer than the physical pain. The American Psychological Association (APA) reports that experiencing a pregnancy loss increases a woman’s risk for developing depression, anxiety, and postpartum depression. In one study, about 15 percent of women developed depression and/or anxiety for up to three years after the pregnancy loss occurred. 

Because the pain of grief and loss and the risk for developing depression and anxiety is very real, it is crucial that those who have suffered miscarriage seek the support of a trained professional to address any mental health symptoms, and to help them process their grief in a healthy manner. Additionally, it is important for a woman (or couple) to be surrounded by supportive family and friends to help heal during this difficult time. 

There is hope for healing after a miscarriage, and with the help of targeted hormone testing and treatment, there may even be hope for some women in the prevention of future miscarriage. Both will take time and may feel overwhelming, but those who have suffered miscarriage deserve to have their health concerns taken seriously, and to be able to acknowledge their loss and to grieve in whatever way is best for them.

What is stillbirth?

Stillbirth refers to pregnancy loss anytime after 20 weeks gestation. While far less common than miscarriage, women and couples still want to know why stillbirth happens, how to reduce their risk, and whether it can be prevented altogether. For answers to these questions, see our articles below.

Learn more about infertility here, and find articles on miscarriage below.

This page was last updated April 4, 2024.