Miscarriage and Recurrent Pregnancy Loss: What You Need to Know
Miscarriages—the unexpected loss of a pregnancy before 20 weeks—are very common, but that doesn’t make them any less difficult. You (and your partner, if applicable) may have just gotten excited about building your family, only to have your hopes abruptly cut short. Recurrent miscarriages, though much less common, can be especially vexing and emotionally taxing.
The first thing to know is that you are far from alone. Most estimates suggest that up to one in five known pregnancies ends in miscarriage, and the March of Dimes estimates that up to 50% of all pregnancies result in miscarriage, but because many may occur before the woman even knows she’s pregnant, the exact figure is much harder to pin down.
Miscarriage Symptoms and Causes
The signs of a miscarriage can include vaginal spotting or bleeding, the passing of fluid or tissue, and pain in your lower back and abdomen. Most miscarriages occur in the first trimester and don’t need medical testing to diagnose.
Depending on how far along you are and your personal preference, a miscarriage can either be allowed to proceed naturally, sped up with medication, or treated surgically. Your period should return within four to six weeks, and you may ovulate again within two weeks.
About half of all miscarriages just happen by chance—an issue of either too few or too many chromosomes rather than any health or genetic conditions in the parents. In rarer cases, miscarriage can be caused by the mother’s health condition, including diabetes, STIs, uterus or cervix issues, or thyroid disease.
Exercise and sexual activity during your pregnancy do not cause a miscarriage. However, women over the age of 35 and those who smoke or use illegal drugs are at a higher risk of miscarriage.
What Is Recurrent Pregnancy Loss?
When a woman has two or more miscarriages in a row, this is termed recurrent—or repeat—pregnancy loss. About 1% of women have repeat miscarriages. After three consecutive miscarriages, it’s generally recommended that a woman get a physical evaluation.
Although more than half of all miscarriages go unexplained, some tests can reveal likely factors. Your doctor may conduct a pelvic exam, an ultrasound, or a blood test to confirm a miscarriage and help determine the cause. If you’ve passed tissue vaginally, it can be tested in a lab.
Miscarriages and Emotional Recovery
It’s essential that you allow yourself to grieve a miscarriage. It’s perfectly normal—even healthy—to cry, be angry, or just need some time to feel okay again. Give yourself permission to feel whatever you’re feeling, even if that means resentment, guilt, or jealousy. You should also allow yourself to skip events that you’re not ready for, such as a baby shower or a child’s birthday party.
If you’ve experienced recurring pregnancy loss, you may need to wait until you’ve completed tests to try again. After your first pregnancy loss, however, your doctor might tell you that it’s safe to have sexual intercourse as soon as two weeks after your miscarriage, but you may not feel emotionally prepared to attempt to get pregnant again right away.
Talk about these issues with your partner, loved ones, or a counselor. Venting your frustrations or just saying your feelings aloud can provide emotional relief. If you want to grieve more privately, you can write out your feelings in a journal. Ask questions of your doctor or a counselor, and keep communication open with your partner.