Why We Should Talk About Miscarriages
One in four pregnancies will end in miscarriage, but the women who experience them will often suffer in silence.
As a society, we've conditioned ourselves to avoid talking about miscarriages. But what women need during this time of grief is a group of supportive listeners. Here are the reasons why we should talk about miscarriages and some of the facts that many don't know about.
There Are a Lot of Misconceptions
Since there is still a stigma around miscarriages, misinformation runs rampant, and many people still have misconceptions about them.
"Most women, when they have a miscarriage, think they’re the only one they know who has had one — until they start to talk with everyone around them," says Dr. Sarah Prager, who does clinical work and research at the University of Washington in miscarriages and early pregnancy loss.
Miscarriage Doesn't Mean More Miscarriages
Prager says it's crucial women talk with their health care providers, so they don't become fearful that one miscarriage means they'll continue having miscarriages.
"Most women think even one miscarriage has very negative implications for future pregnancies and indicates there is something wrong with them. Women have the same risk for a future miscarriage after one loss as they do before the first loss," Prager says. "Almost always, miscarriage is caused by some chromosomal abnormality in just that [specific] egg or sperm, and doesn’t have implications for future pregnancies."
It Isn't Your Fault
By having an honest conversation with their health care providers, women will learn that they did not cause their miscarriage. "Women often assume they did something wrong to cause the loss, which is almost always not true," Prager says. "They blame the one drink they had before they knew they were pregnant or the fact that they went running or were spending too much time in the heat or working too hard or feeling stressed."
Dr. Lora Shahine, a physician at Pacific NW Fertility, a faculty member of the University of Washington and the author of "Not Broken: An Approachable Guide to Miscarriage and Recurrent Pregnancy Loss,” says one of the most common misconceptions people have is that miscarriages are the woman's fault. She says, "The most common cause of miscarriage is a chromosomal imbalance or genetic issue in the embryo and unique to that pregnancy. Women are quick to blame themselves, their bodies, but they shouldn’t."
Talking Leads to Normalization
Prager says women should talk about their miscarriages because "most women are relieved to learn so many around them have also experienced this. It can help to normalize the experience and make it seem like less of a statement about just them and their experience and fertility."
She adds, "Women often put a lot of blame on themselves and feel guilty, and speaking to someone can help alleviate that and hopefully provide them with accurate information and often reassurance."
You'll Learn About Incomplete Miscarriages
By having a chat with a health care professional or a friend who has also experienced a miscarriage, you might learn about a still relatively unknown aspect: incomplete miscarriages.
"[They are] a very common phenomenon, and many women end up needing to use medications or uterine aspiration to complete the process," Prager says. "Miscarriage can be managed very effectively and safely and comfortably in an outpatient setting, which often is preferred by patients; however, many providers insist on uterine aspirations happening in an operating room, which actually increases risk, not to mention cost and time."
You'll Help Others Communicate
Since we shy away from talking about our experiences with miscarriages most of us still don't know the right thing to say. But by having more conversations, we'll learn the best ways to communicate about this topic together.
"Other people often don’t know what to say and frequently are unthinkingly insensitive," Prager says. "It is usually not helpful for someone to hear one of a number of common responses like, 'At least it’s still early in your pregnancy,' 'You can just try again,' and 'Thankfully, you already have a child/children.'"
It’s OK If You're Still Processing
"Another challenge is that when the process of miscarrying is physically over, often partners and friends and family expect it to be over for the person who experienced the miscarriage. That person may still be processing for longer than the physical period of the miscarriage," Prager says.
By having conversations with those around you about your miscarriage, you are letting them know that you are still working through your emotions. "Patients and their partners often process and/or grieve in different ways or at different times/paces, and this can sometimes create discord if communication isn’t good," Prager adds.
Miscarriages Are Common
"The most common misconception is that they are rare occurrences. In reality, at least 15 to 20 percent of all recognized pregnancies miscarry," says Dr. Jessica Scotchie of Tennessee Reproductive Medicine. "If all pregnancies are factored in, meaning the patient may not even know she’s pregnant but hormone testing shows that she has had a pregnancy, the miscarriage rate can be as high as 30 to 50 percent of all conceptions miscarry."
By knowing the stats and sharing them with others, you'll help women who have miscarried and those who might in the future feel less embarrassed since miscarriages are just an aspect of the fertility journey.
It'll Help Your Partner Open Up
Scotchie says medical professionals encourage women to discuss their miscarriages with their partners.
"However, it is important to understand that everyone experiences grief in different ways, and just because another partner is not showing the same level of sadness as the patient may be feeling, it does not mean that they are hurting any less," she says. "They may just process their emotions differently."
It Might Lead to Therapy
It is common to want to confide in a friend, but doctors said women often feel like they can't share their miscarriage experiences with other moms or expectant moms. Instead of keeping all of your thoughts and feelings to yourself, consider speaking with a mental health expert.
"The most helpful person to speak to is often a licensed mental health therapist to help empower the patient with the tools to begin the healing process," Scotchie says.
There Might Be a Medical Issue
While miscarriages are common, sometimes there is a medical issue that is causing women to have multiple miscarriages.
"They could face difficulty conceiving again if the underlying cause of the miscarriage is related to anatomical or hormonal problems," Scotchie says. "If a woman suffers more than two miscarriages, seeking medical evaluation is highly recommended, as this is a rare occurrence affecting only 2 to 3 percent of the population."
It Could Reduce Guilt
Scotchie says women who have miscarried "often face self-inflicted guilt and shame about the loss. They also feel guilty about feeling resentful towards other people who have successfully started their family. They may also be made to feel guilty unintentionally from remarks from friends and family who tell them that everything will be OK and keep trying and not to worry."
Having conversations about their miscarriage with a medical professional can help women express their real emotions without worrying about hurting someone's feelings.
It's OK to Hurt
Kiley Hanish knows the pain of losing a child. She and her husband are creators of the Emmy-nominated film “Return to Zero,” which is based on their personal experience with their son Norbert, who was stillborn.
"Another [misconception] is that pregnancy loss shouldn’t hurt emotionally — the woman didn’t really know her baby," Hanish says. "Women are expected to 'get over it' and not let the loss affect them."
Sharing their stories of child loss can help women realize it is perfectly reasonable to feel terrible after a miscarriage. Hanish is also helping women who have miscarried in her role as founder of the nonprofit organization, Return to Zero: H.O.P.E., where her mission is to transform the culture of perinatal loss through awareness, education and support.
You'll Help Change Society for the Better
"In our society, pregnancy loss is a taboo topic of conversation. We encourage parents not to share news of their pregnancy until 12-weeks gestation," Hanish says. "This social norm communicates to women that if they have a miscarriage, they shouldn’t be sharing this with others — they would not only have to tell others that they were pregnant, but also they miscarried."
This forces women to handle their grief on their own, which isn't very helpful. By having more and more conversations about our experiences with miscarriages, we can help change society so that future pregnant women don't have to feel isolated and alone. "They desperately need someone with whom they can be real and share their emotional experience," Hanish says.
They're a Big Deal
As a society, we tell women not to talk about miscarriages, which sends the message that the experience and loss weren't worth noting.
"The most common misconception about miscarriages is that they’re not a big deal when in fact they really are," says Dr. Sharon Saline, a licensed clinical psychologist who also lectures and trains clinicians around the world. "When a couple or a woman learns about a pregnancy, they immediately start to experience a range of feelings and expectations about their new situation. These emotions and hopes are dashed when a miscarriage occurs, making the loss a significant one."
You Might Have All the Feels
"It’s natural to have grief, anger and sadness about a miscarriage," Saline says.
Some women will feel all of those emotions, plus disappointment and fear, while other women might only feel a few. "Either way, talking about your reactions helps women fully process what’s happened and move on," Saline adds.
You Deserve Support
"Miscarriage is grieving and a time in our lives that we need support," Shahine says. "Unfortunately, as with any difficult situation — the people we share grief with do not always respond in a way that makes us feel better."
If the first person you reach out to isn't helpful, don't feel pressured to continue the conversation. Permit yourself to try again with a more supportive person. "Finding that support team and taking care of yourself through the journey is key," Shahine says. "Most women with miscarriages will go on to have their family if they can find the resilience to keep trying."