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A miscarriage is the spontaneous loss of pregnancy before 20 weeks’ gestation. An estimated 15% to 20% of clinically confirmed pregnancies end in miscarriage, but the actual miscarriage rate per conception is even higher, since up to 50% of conceptions end in miscarriage before a person’s next period is due. While these very early pregnancy losses frequently go undetected in the general population, people who are inseminating tend to be extremely attuned to the signs of conception, and therefore many of our recipients have had to contend with the stress and sorrow of miscarriage as part of their preconception journey. If you have suffered a pregnancy loss using a TSBC donor, please complete our Pregnancy Loss Report. Below we survey some basic facts about miscarriage and offer words of encouragement to those of you who may face this difficult—but natural—experience.
Different issues may arise with pregnancy loss after 20 weeks gestation, losses associated with multiples births, terminations due to medical complications, and/or when a child dies in infancy. The organizations and books below may be useful resources for those facing these difficult events.
Pregnancy loss is not widely discussed or acknowledged in our society, which can exacerbate the confusion and loss people often feel when it occurs. Yet, as noted above, anywhere from 15% to 50% of conceptions end in miscarriage. Approximately 80% of miscarriages occur in the first trimester. First trimester miscarriages are so common that they are not considered abnormal or a cause for concern unless they occur at least twice.
Miscarriage rates go up for people in their late thirties and forties. At age 35, the chance of miscarrying rises to about 25%, and at age 40, it rises to about 40%. This is a natural result of declining fertility; the most common cause for miscarriage is chromosomal abnormality, and an older person’s egg follicles are more likely to have suffered chromosomal damage over time.
So-called “chemical pregnancies” are the earliest—and most common—form of miscarriage. The term “chemical” refers to the fact that these pregnancies are confirmed only through the detection of the hormone HCG by a home pregnancy test or blood test. HCG is released once the fertilized egg has implanted in the uterus, which can happen as early as six days after fertilization. In a chemical pregnancy, the fertilized egg either does not implant properly or the embryo never develops sufficiently to be visible on an ultrasound (a “clinical pregnancy” is one that is confirmed by ultrasound). Chemical pregnancies occur so early that, in most cases, they are never even detected in people who wait to take a pregnancy test until after their period is due.
Most miscarriages occur for physiological reasons for which we have little to no control. The most common cause is some type of chromosomal abnormality, which is believed to account for at least 50% of miscarriages. Less common causes include uterine, cervical, or hormonal abnormalities; immune disorders; or infections. Miscarriage is not caused by exercise, sexual activity, or any normal day-to-day activities. Miscarriage is not your “fault.”
After a single miscarriage, you are at no greater risk for miscarrying again than is a person who has never had a miscarriage. However, if you have a history of two or more previous miscarriages, it’s advisable to consult with your medical professional to determine what sort of testing and treatment could increase your chances of carrying to term.
After a miscarriage, you may wish to take a break from trying to conceive or you may wish to inseminate again as soon as possible. Your medical professional will probably suggest waiting for up to three normal menstrual cycles before inseminating again. However, if yours was a very early miscarriage, you may be able to inseminate again after one menstrual cycle.
There’s no one way to feel in the aftermath of a miscarriage, and we encourage you to honor whatever your emotional reaction may be. Some of our clients rebound quickly from their miscarriage, focusing on the positive that they have been successful with timing their inseminations and that they are clearly capable of conceiving. Others feel a deep sense of grief and loss and may go through a mourning period characterized by fatigue, mood swings, difficulty concentrating, and anxiety. Sadly, our culture doesn't have rituals in place to mourn the passing of a dream, and you may feel pressured to get back to “normal” before you’re truly ready.
We encourage you to be honest with your partner, family, and friends about how you’re feeling and to seek support and resources for healing. Suggestions are listed below.
SHARE: Pregnancy and Infant Loss Support
For those touched by the loss of a baby through early pregnancy loss, stillbirth, or in the first few months of life.
CLIMB, the Center for Loss in Multiple Birth, Inc
Parents throughout the United States, Canada, Australia, New Zealand and beyond who have experienced the loss of one or more, both or all of twins or multiples at any time from conception through birth, infancy and childhood.
Ending a Wanted Pregnancy
Support for parents ending a pregnancy after prenatal or maternal medical diagnosis.
This family-building resource has pregnancy loss resources and support groups for pregnancy loss and family-building.
H.A.N.D. Help After NeoNatal Death
Coping with the loss of a baby before, during, or after birth
S.A.N.D. Support After Neonatal Death
Free support group for those who have lost an infant due to early miscarriage or shortly after delivery. For more information, please call (510) 204-1571. San Francisco: (415) 282-7330
The Pregnancy Loss Support Program of the National Council of Jewish Women. Nationwide telephone counseling and New York metropolitan area support groups. Download the pamphlet entitled, Understanding Your Pregnancy Loss
The Legacy of Leo -A Bittersweet Motherhood | our journey through stillbirth, miscarriage and pregnancy after loss
Providers/Counselors (check for online availability)
Joelle Ehre, MA, LMFT provides supportive psychotherapy and reproductive counseling to individuals and couples seeking to build their families using gamete donation. Specialties include infertility, couples therapy and intended parent consultations for reproductive clinics. Also provides support around pregnancy loss, infant loss. American Society for Reproductive Medicine's Mental Health Professional Group member. LGBTQ affirmative and antiracist. Oakland and online; 510-788-0804.
Elaine Gordon, PhD. Elaine's goal is to help individuals build healthy families with the help of donors and/or gestational carriers. Also provides support around pregnancy loss. She is also the author of Mommy, Did I Grow in Your Tummy? Where Many Babies Come From, a children’s book dedicated to explaining a child’s unique reproductive beginnings. Be sure to check out resources at her website. American Society for Reproductive Medicine's Mental Health Professional Group member. Los Angeles area 310-454-0502 firstname.lastname@example.org
Madeleine Katz, Psy D provides consultations, education, and resources to help individuals and couples considering and/or doing family building through assisted conception, and with pregnancy loss. American Society for Reproductive Medicine's Mental Health Professional Group member. San Francisco CA, 415-937-0425
Robin Keating, LMFT. Individual, couples, and group psychotherapy. Women considering single parenthood. Also provides support around pregnancy loss. Marin and throughout California 415-246-1633
Carole LieberWilkins, MA, MFT, provides psychoeducational consultations and individual and couples counseling around family building with sperm, egg and embryo donation and/or surrogacy. Also provides support around pregnancy loss. Carole is well known for her work on talking with children about family building, including having co-authored Let's Talk about Egg Donation: Real Stories from Real People, the quintessential read for those pursuing or already parenting through egg or embryo donation. She is a founding member of Resolve of Greater Los Angeles and a member of the American Society for Reproductive Medicine's Mental Health Professional Group. Los Angeles area (310) 470-9049, email@example.com Also licensed in Idaho.
Michele Pomarico, LCSW. Experienced therapist helping individuals through major life transitions, difficult losses, and family building decisions. American Society for Reproductive Medicine's Mental Health Professional Group member. Seattle area 206-524-5066
Michelle Sicula, MA, JD, is an experienced Licensed Marriage and Family Therapist providing individual and couples therapy for clients building their families through sperm, ovum, or embryo donation or using a gestational carrier. Michelle supports clients experiencing infertility, coping with perinatal loss, and/or making decisions about how to build their family or whether to live child-free. Michelle is certified in Emotionally Focused Couples Therapy ("EFT") and is an active member of the American Society for Reproductive Medicine's Mental Health Professional Group member. San Francisco and Oakland CA, 510-457-1246, firstname.lastname@example.org
Dr. Deborah Simmons Expert in pregnancy loss & infertility counseling, including psychoeducation for donor eggs, donor sperm, and surrogacy. Twin Cities MN, 612-324-1207