Pregnancy loss is not widely discussed or even acknowledged, which can exacerbate the confusion and loss people often feel when it occurs. Yet anywhere from 10% to 75% 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 more than once.
Most miscarriages occur for physiological reasons for which we have little-to-no control. The most common cause is some type of chromosomal abnormality. Less common causes include uterine, cervical, or hormonal abnormalities, immune disorders, or infections. Whatever, the cause, it is important to remember that miscarriage is not caused by exercise, sexual activity, or any normal day-to-day activities. Miscarriage is not your “fault.”
Miscarriage risk increases with age. At age 35, the risk of miscarrying is about 25%, at age 42 it is over 50% and by age 45, it is estimated to be 75%. This is the result of normally declining fertility, as 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 by those who wait to take a pregnancy test until after a missed menstrual cycle.
After a single miscarriage, your risk for miscarrying again differs little from a person who has never had a miscarriage. However, if you have a history of two or more miscarriages, or have a loss later in pregnancy, it’s advisable to consult with your medical professional to determine testing and treatment that could increase your chances of carrying to term.
Additionally, while some may wish to take a break from trying to conceive following a miscarriage, others may wish to inseminate again as soon as possible. Your medical professional will probably suggest waiting for up to three menstrual cycles before inseminating again. However, if yours was a very early loss, you may be able to inseminate again after one menstrual cycle.
It is normal to experience a range of emotions following the loss of a pregnancy. There’s no one “right” way to feel, and we encourage you to honor whatever your emotional response may be. Some may prefer to focus on moving forward quickly, finding hope for future conceptions through their recent pregnancy. Others may feel a deep sense of grief, loss, and mourning, which can include fatigue, mood swings, difficulty concentrating, and anxiety. Many will experience a mix of these emotions as they move through the healing process, and this may vary based on one’s own personal experiences. While you may feel pressured to get back to “normal” before you’re truly ready, it is expected that this process will take time. It is important to be gentle with yourself and offer yourself space in whatever ways are needed.
We encourage you to be honest with loved ones, family, and friends about how you’re feeling and seek support and resources for healing. Below are suggested readings and individual providers that may assist as you move through this journey.
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- 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. 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.
- Laura Goldberger, MFT is a therapist who sees individuals and couples who are in the process of making and supporting a family. Provides support around pregnancy loss. Laura has worked with LGBTQ+, trans/non-binary, and BIPOC parents, couples, and children for over 25 years and is a queer parent. Berkeley 510-665-7755; [email protected]
- Elaine Gordon, PhD. Elaine’s goal is to help individuals build healthy families with the help of donors and/or gestational carriers. 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 [email protected]
- 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. 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. 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 protected] 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, [email protected]
- Dr. Deborah Simmons Expert in pregnancy loss & infertility counseling, including psychoeducation for donor eggs, donor sperm, and surrogacy. Twin Cities MN, 612-324-1207
- Additional Providers