HYANNIS – When a person loses a friend or family member, there is usually no hesitation to tell others about the death. But somehow talking about a miscarriage can be difficult. As a result, many women don’t know very much about miscarriages until it happens to them, which leaves them unprepared for the physical and emotional toll a lost pregnancy can have.
Obstetrician/gynecologist Tara Chute, MD at Cape Cod Hospital OB/GYNoffered the following information about miscarriages.
You are not alone.
“No one wants to talk about it, but it happens to a lot of women,” she said.
In fact, miscarriage is the most common complication in pregnancy, affecting anywhere from 10 to 30 percent of all pregnancies, according to Dr. Chute. She typically cites the fact that one in four pregnancies ends in miscarriage. It’s so common that gynecologists usually don’t do a workup to see if there is a reason a woman had a miscarriage until she’s had at least two, but usually three miscarriages in a row, she said.
It wasn’t your fault.
Guilt is a common feeling after a miscarriage. A 2015 national survey of public perceptions on miscarriage found that of the women who had miscarriages, 47 percent felt guilty, 41 percent felt they had done something wrong and 28 percent felt ashamed.
The survey included both men and women. Some of the common misconceptions about what causes a miscarriage included a stressful event (76 percent), lifting a heavy object (64 percent), previous use of an intrauterine device (28 percent) or oral contraceptives (22 percent).
“Most of the time it is just bad luck,” said Dr. Chute. “There are some risk factors, but a lot of times there was some sort of irregular chromosome abnormality.”
Feeling grief is very common.
A 2012 study in Germany found that 59 percent of women who had miscarried were still grieving two years later. Furthermore, even though they had never had a relationship with the infant outside the womb, the intensity of the grief was comparable to any other life loss. Women who had already named their babies, bought things for them or felt them move were more apt to grieve longer.
“It’s a very emotional, very challenging time in a woman’s life,” Dr. Chute said. “I tell patients that it’s normal to feel upset and that it’s likely going to be an incident they won’t forget and will emotionally respond to for the rest of their life.”
While women are often quiet about miscarriage, men are more likely to be silent. But that doesn’t mean that men don’t feel the loss just as much. Potential fathers grieve the end of the dreams they had for their unborn child, but not as intensely as women, according to the American Psychological Association.
Whether to tell others the news is an individual decision.
Patients often ask Dr. Chute when they should share the news that they are expecting. She advises them to consider their own personal level of comfort and desire for privacy.
“Most miscarriages occur in the first trimester, so if you’re someone who isn’t going to want to discuss that if it happens then you might want to wait until you are out of the first trimester before you start sharing the news,” she said. “Other women don’t mind having that risk and share the news right away as soon as they have a positive pregnancy test. It really is an individual decision.”
Talking about it can help.
While openly sharing the news that you’ve had a miscarriage is a very individual decision, talking to a therapist or psychiatric professional can help you process the difficult emotions.
“Women who have a history of depression are at higher risk for exacerbation, so I talk to them about seeking treatment because this is certainly a big stressor,” Dr. Chute said.
Not every miscarriage is the same.
For women who know their pregnancy is no longer viable, they have three choices of how to proceed, she said. They can let things happen naturally and will experience bleeding, passing of tissue and heavy cramping. They can opt for minimal medical treatment in the form of a medication to facilitate that process and speed it up. Or they can choose surgical resolution in the form of a D&C procedure.
There is no definitive best medical choice most of the time.
“Typically when you give the news, it’s a very upsetting conversation, so I tell them the options and tell them they don’t have to decide right away.” Dr. Chute said. “They can take some time and talk it over with their partner or others in their support system and then call me back. There is rarely an emergency surrounding this.”
How soon can we try again?
It’s only natural for women who have experienced this loss to want to try again to get pregnant. Dr. Chute said that research shows that women should wait at least one to two menstrual cycles before trying to become pregnant again. If you haven’t gone through a normal cycle of menstruation, there is a higher risk of subsequent loss because of abnormal implantation.
Women who have miscarried once have a higher risk of miscarrying again and the risk goes up with each subsequent miscarriage, but most women will go on to have a normal pregnancy.
“I typically tell women to stay on prenatal vitamins, wait one or two menstrual cycles and then try again,” Dr. Chute said.
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