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There is a common understanding among women that when they are pregnant they should not tell anyone until after the first trimester.  This news is kept secret so that in the event of a miscarriage, no one has to know about it.  Although this approach that will help avoid explaining repeatedly when a pregnancy is lost, it certainly makes women experiencing a miscarriage feel alone, and often surprised that the pregnancy is not going to result in a baby.

Truth be told, miscarriages are very common.  Probably more common than you could ever imagine.  Most miscarriages are a random event.  Mother Nature makes many mistakes during the process of egg and sperm development, fertilization and early growth of the embryo.  Chromosomes can break or be lost.  The result is an embryo that will implant and start to grow, but then stop.  Researchers that have studied causes of miscarriage have found that this is by far the most common explanation, and occurs in roughly 70% of pregnancies that stop developing.  From the graph below, you can see that the chance of miscarriage increases with age.  This is because women are born with all of the eggs they will ever have, and over time they are susceptible to damage.

There is a subset of women that will experience more than one miscarriage.  If this happens, it is valuable to have an evaluation to ensure that there is not an underlying reason.  The term “recurrent pregnancy loss” is a diagnosis for women who have experienced three consecutive miscarriages, and in approximately 50% of couples with this diagnosis, there will be a cause found.  Even after two miscarriages it is reasonable to have testing done.  Causes of recurrent miscarriage may include thyroid dysfunction, cervical infections, uterine pathology (i.e. something growing within the cavity of the uterus), a predisposition to form blood clots that interfere with pregnancy (known as a “thrombophilia”), or a genetic disorder.

Many women wonder if they have done something to cause their miscarriage.  The short answer is no.  It is very difficult to cause a miscarriage.  If you think about it, women are having babies all over the world, including areas of famine and drought.  However, there are a few things that can be done to help improve the chances of success.  Avoid of smoking and caffeine.  Do not take any medications, be it prescription, over-the-counter, or herbal unless you have spoken to a pharmacist and have been informed that it is safe in pregnancy.  There is no  evidence to show that bed rest will improve chances of pregnancy success.  Likewise, having sex has never been shown to be a cause of miscarriage.  Many women also wonder about the impact of stress.  Unfortunately, this is a very difficult thing to measure.  Researchers have shown that women receiving ultrasounds every week during the first trimester for reassurance that the pregnancy is progressing normally will have a higher chance of a live birth.  So maybe there is something to be said about stress.

The good news is that even after three miscarriages in a row, the next pregnancy is more likely to result in a baby than another pregnancy loss.  Persistence is the key!  That is easy to say, and hard to do, but it is the truth.   So keep trying.  Eventually it will work.

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