Dr. Ashley Uvanni addresses common mistaken notions about miscarriage with facts about the symptoms, causes and prevalence to help women feel less alone and more hopeful.
If you are reading this, the odds are that you yourself or someone you love has experienced the unfortunate heartbreak of a miscarriage, which is defined as pregnancy loss before the 20th week of pregnancy. Or maybe you worry about experiencing a miscarriage in the future. Either way, we know that pregnancy loss can be a difficult topic to discuss, and thus many people rely on assumptions about miscarriage symptoms, causes, and prevalence.
While the experience of a miscarriage is unique to each person, the lack of open discussion on the topic can leave individuals feeling isolated, with often with a misunderstanding of why it happened and what it means for their fertility outlook. Today we are going to talk FACTS and hopefully bring light to several misconceptions about miscarriage.
Misconception #1: Miscarriages are rare
Miscarriages are actually quite common. In fact, 12-15% of clinically recognized pregnancies end in a pregnancy loss. In actuality, the number of pregnancies ending in miscarriage is believed to be as high as 30-60% since many women experience a miscarriage before they ever see a provider or even realize they are pregnant.
Misconception #2: Spotting means you are miscarrying
Bleeding during pregnancy can be alarming, but spotting is common in early pregnancy and often unrelated to a miscarriage. Spotting can be a sign of implantation bleeding, a vaginal infection, or even a sensitive cervix! It’s normal to see some spotting after intercourse or after a pelvic exam. One study even showed that young women who had bleeding in the first trimester only had a 5% chance of miscarrying if they had had a prior normal ultrasound.
However, if bleeding worsens, you should give your OB/GYN’s office a call.
Misconception #3: You have done something to cause your miscarriage
This is not your fault.
The most common cause of a miscarriage is not stress, exercise, lifestyle choices, or anything you may have done, as many believe. The most common cause of miscarriage is a spontaneous genetic abnormality – something that is out of our control. On the contrary, the word spontaneous infers that there is NO known cause for the genetic abnormality and means that it is NOT inevitable to happen again.
At least half of all miscarriages are due to chromosomal abnormalities such as excess or missing genetic material. More recent studies that utilize newer technology for genetic testing show that the true incidence of chromosomal abnormalities in early pregnancy loss may even be closer to 75%. These abnormalities occur by chance and are usually incompatible with life. That means there’s nothing you can do (or could have done) to prevent them from resulting in a miscarriage.
People sometimes think that exercise and stress may have caused their miscarriage, and if they had avoided these things, they could have been able to prevent it. This is simply not true. Exercise programs have not been shown to cause an increased risk in miscarriage. Contrary to popular belief, bed rest has not been shown to prevent a miscarriage either.
Misconception #4: There’s nothing you can do to decrease your risk of miscarriage
This is also a myth. Here are a few modifiable risk factors that you can alter to help decrease your own risk:
Tobacco use
Smoking tobacco has been shown to increase the risk of miscarriage, so reducing or cutting out tobacco can lower your risk.
Caffeine intake
Data is currently conflicting on this topic, but recent studies show a modest increase in miscarriage when consuming greater than 300mg of caffeine a day. This is equivalent to 3 cups of coffee a day. Current guidelines recommend less than 200mg of caffeine in pregnancy as this amount has NOT been shown to increase the risk of miscarriage. This is great news for all my coffee drinkers. You can enjoy your coffee, just in moderation!
Alcohol or drug use
One large study showed that women who have four or more drinks a week are 2.65x more likely to have a miscarriage. We understand that abstaining from alcohol or drugs can be difficult to do on your own, so if you or someone you know is currently struggling with addiction, we are happy to help guide you toward resources that can help. A great place to find local rehab centers, counseling, and support groups is startyourrecovery.org.
Maintaining an unhealthy weight
A body mass index (BMI) greater than 30% has been shown to substantially increase the rate of miscarriage. In one study, women who had a BMI greater than 30 had a 59% chance of miscarrying as compared to the 44% in the normal BMI group. Maintaining a healthy weight can be difficult, but we are certainly here to help.
Misconception #5: A miscarriage means you have infertility issues
This is not usually the case. Although a miscarriage can be difficult physically and emotionally, it means the sperm was able to find and fertilize the egg. This can be reassuring information with regard to fertility.
Many women who have a miscarriage find themself asking, “Will this happen again?” Miscarriage risk does increase with the number of previous pregnancy losses but rarely exceeds 40-50%. With one prior miscarriage and no history of prior delivery, the subsequent rate of miscarriage is only 19-24%. If there has been a successful delivery in the woman’s past, the risk of a subsequent miscarriage is as low as 4-6%.
Often, couples are eager to conceive after a miscarriage, and waiting for another pregnancy to occur can be difficult. Here are a few statistics that will hopefully ease some doubts or anxiety during that waiting period:
Approximately 85-90% of healthy young couples conceive within one year of trying, and most within 6 months. However, less than 30% conceive in the very first month. Women under the age of 30 have about 25% chance of getting pregnant naturally each cycle. That chance drops to 20% for women over 30. By age 40, the chance of getting pregnant naturally each month is just 5%. As you can imagine, becoming pregnant can take some time for many couples, whether they have experienced a miscarriage or not.
If you have concerns about infertility, we’re more than happy to look into them and discuss your options. Check out Dr. Draper’s blog post, “Fertility Treatment Options: A Comprehensive Guide” and as well as her patient’s guest blog post, “Why I Sought a Second Opinion About My Fertility: Brittany’s Story,” to learn more. If you are over 40, you might also find Dr. Brim’s blog post, “Getting Pregnant At 40: FAQs And Tips For Optimizing Your Fertility Health” helpful.
Facts: Miscarriage is common, you have options, and you are not alone.
If you are struggling through miscarriage or think you may be experiencing one, please reach out. Our experienced and compassionate medical advice team can answer questions and advise you on whether you need to be seen by your doctor. If you have further questions, don’t hesitate to ask your provider. They can help you understand what is happening and how it might affect your journey to a healthy pregnancy.
We also want to share this list of pregnancy loss resources and ways to find support, compiled by a VPFW patient who has been there before. In fact, many of your friends and family members might also be able to empathize with your situation and share support. We know that having a miscarriage can feel isolating, but please know that you are not alone. We at VPFW are here for you every step of the way.
To schedule an appointment with a VPFW provider, you can call us at 804-897-2100 or set an appointment online.
