Miscarriage, particularly early pregnancy loss. What causes miscarriage and is there anything we can do about it?

 

If you’ve been following along on Instagram this week, you know that I posted a few myths surrounding the topic of miscarriage as well as a few things that we do know. The purpose of this blog post is to dive a little deeper into the myths of what causes miscarriage.

I must reiterate that more often than not, the cause of miscarriage is unknown and it typically has nothing to do with what a woman did or did not do. That can be both reassuring and frustrating all at the same time considering the level of control that most of us like to have. However, it is important to know what’s not true AND also what could be something to take into consideration in regards to your own personal journey.

Before we go any further, if you’re reading this and have experienced a miscarriage, I must say that I am so deeply sorry for your loss. I see you. I wish I could give you a big ole hug and comfort you. It’s just hard, no matter how early your loss was. Women say to me all of the time, why is this so hard even though I miscarried so early? I’ll tell you why. Because you’re a human with a big heart and soul and feelings, you care deeply, and a life is precious from the very moment of conception. That’s why. Don’t negate your feelings. Allow yourself to grieve, and understand that it’s actually better to feel and live and let your heart be broken than to not care at all. 

Ok…let’s dive deeper into and explain the myths surrounding what causes miscarriage.

 

Myth #1. Miscarriage is rare. 

This is simply not true. Miscarriage occurs in nearly 1 in 5 early pregnancies. It feels rare because people aren’t posting on social media that they’ve had a miscarriage. All you typically see are happy pregnancy announcements and baby bumps. It feels isolating. I recently read a qualitative study posted in the U.S. National Library of Medicine looking at how miscarriage impacts women socially and emotionally. One of the points that really stood out to me was that women who were studied who had experienced a miscarriage felt that miscarriage was rare, BUT part of this was because society tells us not to share that we’re pregnant until the end of the first trimester (when most miscarriages occur). This societal “rule” may be doing more harm than good.

 

Myth #2. A stressful event or lifting something heavy causes a miscarriage. 

There is very little evidence to support this. A systematic review and metaanalysis published in the American Journal of Gynecology did find that women who have heavy occupational workloads and frequently lifted more than 25lbs were at a very slightly increased risk of miscarriage (odds ratio of 1.31, 95% confidence interval). However, this risk seems to be low and dependent upon other factors. A stressful event or season of stress has not been associated with miscarriage. Research does seem to link high* psychological stress with a decrease in infant birth weight, according to a prospective cohort study evaluating over 3500 women published in the American Journal of Gynecology in 2011 along with other similar studies. 

 

Myth #3. Having one miscarriage increases your risk for having another one.

Studies reveal that one initial miscarriage does not increase a woman’s risk for another above the general population at about 20%. However, after two consecutive miscarriages, a woman’s risk for a third miscarriage increases slightly to about 28%. After a third consecutive miscarriage, the risk increases to about 43%. Recurrent pregnancy loss is important to note here. If you’ve experienced 2 or more consecutive miscarriages, it is certainly warranted to discuss this with your Women’s Health provider as there may be additional underlying causes. However, after a first (and quite often even second) miscarriage, additional testing isn’t warranted.

 

Myth #4. Getting pregnant right after a miscarriage and before having a period increases your risk for another miscarriage.

It used to be considered standard recommendation to advise women to wait until one normal period prior to trying to conceive again after a miscarriage, but this has been refuted by research. In fact, a recent retrospective cohort study published this year in the American Journal of Gynecology found that the rate of recurrent first trimester pregnancy loss among women who conceived prior to their next menstruation was 10.4% in comparison 15.8% for women conceived after their next menstruation (p=0.604). Therefore, really no need to wait!

 

Myth #5. Past contraception use (i.e. IUD, birth control pills, patch, nuvaring, depo, etc) increases risk for miscarriage.

In a large Danish cohort study looking at over 4,800 Danish women, results found that in women attempting pregnancy there was little evidence that prior use of oral contraceptives is associated with an increase in the risk of miscarriage. Actually, very recent oral contraceptive use and longer duration of oral contraceptive use among older women may be associated with a decrease in the risk of miscarriage. Findings have been very similar among other types of hormonal contraception.

 

Myth #6. It’s easy to move on after a miscarriage.

This is a myth that the common public seems to believe. This actually tends to cause even more isolation among women who in fact do take longer to grieve and those who experience mental health disturbances post-miscarriage. In fact, a multicenter prospective cohort study published in the American Journal of Gynecology in 2019 concluded that women actually do “experience high levels of posttraumatic stress, anxiety, and depression after early pregnancy loss. Distress declines over time but remains at clinically important levels at 9 months” (Farren, 2019).

 

ok friends! I hope this article gave you a little more insight into the myths surrounding what causes miscarriage. Stay tuned for more to come on this subject! Also, feel free to follow along Instagram @girlhealthco and also schedule an appointment with me if you live in Georgia and would like to dive even deeper into your personal history, questions and concerns regarding your fertility journey. Click here to schedule or

Best,

Brookes Vaughan, WHNP-BC & Founder of The Women’s Health Company, LLC
miscarriage

 

References:
A prospective New Zealand study of fertility after removal of copper intrauterine contraceptive devices for conception and because of complications: A four-year study. Wilson, Jennifer C. American Journal of Obstetrics & Gynecology, Volume 160, Issue 2, 391 – 396
Bellhouse, C., Temple-Smith, M. J., & Bilardi, J. E. (2018). “It’s just one of those things people don’t seem to talk about…” women’s experiences of social support following miscarriage: a qualitative study. BMC women’s health, 18(1), 176. https://doi.org/10.1186/s12905-018-0672-3
Posttraumatic stress, anxiety and depression following miscarriage and ectopic pregnancy: a multicenter, prospective, cohort study. Farren, Jessica et al. American Journal of Obstetrics & Gynecology, Volume 0, Issue 0
Should Women wait for the first menstrual period following spontaneous miscarriage before becoming pregnant again? Reicher, Lee et al. American Journal of Obstetrics & Gynecology, Volume 222, Issue 1, S462
The impact of occupational activities during pregnancy on pregnancy outcomes: a systematic review and metaanalysis. Cai, Chenxi et al. American Journal of Obstetrics & Gynecology, Volume 0, Issue 0

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