Pregnancy Loss

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 woman’s next period is due. While these very early pregnancy losses frequently go undetected in the general population, women 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. 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.

The Facts

Pregnancy loss is not widely discussed or acknowledged in our society, which can exacerbate the confusion and loss women 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 women 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 woman’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 women 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 woman 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. 

The Feelings

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.
 

Websites

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.

Open Path Northern California
This family-building resource is sponsors Grief Recovery workshops.

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
 

Books

A Silent Sorrow by Ingrid Kohn, Perry-Lynn Moffitt, Isabelle A. Wilkins
Unspeakable Losses by Kim Kluger-Bell