In late September of 2020, celebrities Chrissy Teigen and John Legend announced on social media that they had experienced a pregnancy loss. The two shared pictures of their misfortune, sparking a wider conversation about miscarriages–a topic that is often avoided in wider conversations but one with which many women have some direct or indirect experience.
Conversationally, most people refer to nearly all pregnancy losses as miscarriages. Clinically, however, a miscarriage is a loss that occurs before 20 weeks gestational age. Pregnancy losses that happen beyond 20 weeks are referred to as stillbirths. Both are emotionally charged terms, which can help explain why, for example, Chrissy Teigen and John Legend might refer to their “miscarriage” when what they clinically experienced was a “stillbirth.”
A miscarriage can be an especially distressing time for women and their families. But it’s important to remember that miscarriages often happen for inexplicable reasons–they most often have nothing to do with the health, habits, or behaviors of the mother. Nor do miscarriages necessarily portend future trouble with conception or childbearing. Learning more about miscarriages can help ensure everyone understands there is no blame to assign–understanding instead that emotional support can help the healing process begin in earnest.
How Common Are Miscarriages?
According to most studies, something like 50% of all pregnancies end in miscarriage. If that number seems staggering–or nearly impossible–to you, that’s because most of these miscarriages occur before you know you’re pregnant or before you’ve even missed your menstrual period.
Once a pregnancy is recognized, roughly 15-20% of them typically end in miscarriage, and these miscarriages will occur before the 20th week. That’s why many informal and unwritten social norms have developed around delaying public pregnancy announcements until after the 20th week.
While it may not be often–or loudly–spoken about, miscarriages do impact a statistically small but significant number of women. So if you experience a miscarriage, know that you are not alone, and you’ll be able to find help and support in the community of those around you.
That said, there is also no reason to expect or anticipate a typical pregnancy will end in anything other than a healthy birth.
A miscarriage may occur at any point throughout your pregnancy, though they do tend to be significantly more common during the first trimester. Miscarriage symptoms may include the following:
- Bleeding: When the bleeding progresses from light to heavy, that could be a sign of a miscarriage.
- Presence of Tissue: Sometimes during a miscarriage, you may pass tissue that looks like small blood clots through your vagina. This could be an indication of a miscarriage.
- Belly or back pain
- Contractions or severe cramps: It’s not unusual to experience contractions during a miscarriage. The presence of cramping that does not diminish should be reported to your OBGYN or midwife.
- Discharge: A white, pink mucus or discharge can sometimes indicate a miscarriage has occurred.
- Sudden weight loss
- Fever: If fever accompanies any of these other symptoms, you may be experiencing a miscarriage and you should contact your OBGYN.
If you experience any combination of these symptoms, you should contact your doctor immediately. Your OBGYN or midwife will be able to tell you whether you should visit a clinic or head to the emergency room, depending on your individual symptoms.
What Causes a Miscarriage?
- The causes of miscarriages tend to vary from person to person, so there’s no single determinant that is easily identifiable (and, therefore, easy to avoid). In general, miscarriages are caused by a fatal genetic defect in the fetus. This genetic defect, then, leads to the fetus becoming inviable.
- In almost all cases, this genetic defect has absolutely nothing to do with the mother. A preconception appointment and exam can help evaluate your overall reproductive health if you’re thinking about having a child or have become pregnant.
There are some known issues that can possibly cause an increase in overall risk of miscarriage. Most of these risk factors do not cause a miscarriage on their own–they simply increase the statistical probability that a miscarriage could happen. Those risk factors include:
- The use of illegal or “street” drugs, especially while you’re pregnant.
- The use of alcohol or the smoking of tobacco products while you’re pregnant.
- Certain medical conditions, such as diabetes or genetic predisposition .
- Uterine abnormalities or physical problems with the mother.
- Issues with hormones or the immune system.
- Multiple miscarriages; having over three past miscarriages can increase your risk of having another miscarriage
How these risk factors interact isn’t always well understood. However, the fewer risk factors you have, the less likely you may be to experience a miscarriage. But it’s also important to understand that sometimes miscarriages occur regardless of risk factors–there’s most often no fault or blame involved.
Types of Miscarriages
Not all miscarriages occur or present in the same ways. As a result, doctors and researchers have identified several different types of miscarriages. The most common types of miscarriages include:
- Inevitable miscarriage: You have several signs and symptoms of a miscarriage and the cervix has dilated. In these circumstances, miscarriage is very likely.
- Threatened miscarriage: You have several signs and symptoms of a miscarriage, including bleeding, but the cervix has not dilated. In these cases, miscarriage may not always happen.
- Complete miscarriage: If your miscarriage happens before the 12th week, a complete miscarriage usually results. During a complete miscarriage, all tissue is expelled from the uterus.
- Incomplete miscarriage: In some cases, tissue from the pregnancy may not be expelled from the uterus. An incomplete miscarriage may require further treatment to remove those tissues. When this occurs prior to embryo formation, it’s called a “missed miscarriage.”
- Recurrent miscarriage: This type of miscarriage impacts only 1% or so of women who miscarry. A Recurrent miscarriage is the diagnosis when a woman experiences at least three miscarriages in a row during the first trimester of pregnancy.
Depending on the type of miscarriage you experience, additional treatment may be required for either your general health or your reproductive health. You can talk to your OBGYN about any wellness concerns you might have and what your treatment options are likely to be.
Does a Miscarriage Lower Your Chances of Having Another Baby?
There’s often a period of grief associated with a miscarriage. That grief is exceptionally normal. Those who experience a miscarriage may find solace in the support of their friends and family; support groups can also help families process the grief they feel.
One of the most common questions that springs from this grief is about the long term chances of expanding your family. For the vast majority of women, a miscarriage will not have any impact on your ability to have children in the future. Indeed, most women are able to eventually go on and have additional children.
Some research suggests that having children sooner after your miscarriage may be more likely to result in a successful birth. But it’s important that you take the necessary time to process your miscarriage and your experiences. In other words, you should only move forward when you feel ready.
Recurrent miscarriages impact only 1% of all those who miscarry. But for those who do experience multiple miscarriages, there may be treatment options available that can help increase your ability to conceive and have children in a healthy way.
Talking About Miscarriage
If there’s one thing Chrissy Teigen and John Legend’s transparency during their own experience with miscarriage taught us, it’s that they aren’t alone. Their experience resonated with millions of women and families who may have otherwise remained silent about their own miscarriages.
We can find comfort from our shared experiences, however. If you have concerns about a miscarriage or want to discuss your reproductive health, you should talk to your OBGYN right away.