Why Miscarriages Happen and Recovering from Pregnancy Loss

Pregnancy loss can be physically and emotionally challenging, especially after multiple miscarriages. If you’ve experienced the loss of a pregnancy, it’s important to not blame yourself. In most cases, miscarriages are not preventable.

Understanding what may cause a miscarriage and how to recover can help with emotional healing during this difficult time.

What happens during a miscarriage?

Unfortunately, miscarriage is not uncommon. Ten to 30% of known pregnancies end in miscarriage, according to the American College of Obstetrics and Gynecology (ACOG). During a miscarriage, women experience pain, cramping, bleeding and hormonal changes.

Most miscarriages (80%) happen within the first three months of pregnancy. When a miscarriage occurs before 20 weeks gestation, women usually pass the fetal tissue within a couple of weeks.

With an early pregnancy loss, medication may be given to help pass the tissue sooner and avoid infection. A surgical procedure called dilation and curettage (D&C) is often done to remove fetal tissue from the uterus. This can be done at the start of a miscarriage or after an incomplete miscarriage to prevent infection.

If a pregnancy loss occurs beyond 20 weeks of gestation, it is considered a stillbirth. This may require an induction to help facilitate labor. Recovery from a stillbirth is typically more physically and emotionally intense. Depending on the size of the fetal body, small vaginal tears can occur, and the recovery process may be similar to a full-term birth.

“The further along a woman was in her pregnancy, the longer recovery will take,” shares Kristine Brogan, FNP. As part of  Maternal-Fetal Medicine at ProMedica Toledo Hospital, Kristine cares for women with high-risk pregnancy, including those with a higher risk for miscarriage.

Why does miscarriage happen?

Miscarriage can happen for many reasons. Often, doctors cannot find a specific cause for it. It is rarely, if ever, caused by something the mother or father did or didn’t do.

Chromosomal Abnormalities

Chromosomal abnormalities are the most common cause of miscarriage in the first trimester. They occur when the egg and/or sperm have too many or too few chromosomes. Abnormalities occur as the fertilized egg begins to develop, often resulting in a miscarriage.

Usually, these abnormalities do not indicate a larger issue. However, if they recur in future pregnancies, it may mean that one partner’s egg or sperm has too little or too much DNA.

Ectopic Pregnancy

Some miscarriages may be a result of an ectopic pregnancy. According to a study published in the National Library of Medicine (NIH), 1-2% of pregnancies in the United States are ectopic. An ectopic pregnancy is a pregnancy that develops outside the womb, usually in one of the fallopian tubes. The pregnancy cannot be successful when this occurs and can pose serious risk to the mother if not identified and addressed.

Sometimes the pregnancy stops developing on its own, resulting in early miscarriage. Other times, medical or surgical intervention is necessary.

Other Risk Factors

Other factors that may put you at a higher risk of pregnancy loss include:

• Being over 35 years of age.
• First pregnancy.
• Having an autoimmune disease.
• Having an unusually shaped uterus, scarring or polyps in the uterus.
• Having a chronic health condition, such as diabetes or high blood pressure.
• Having hyperthyroidism or hypothyroidism (an over- or under-active thyroid).
• Having antiphospholipid syndrome, which causes abnormal blood clots.

Tobacco and alcohol use are preventable factors that increase your risk for miscarriage. If you use tobacco or alcohol, stopping before you become pregnant can reduce your risk of miscarriage.

What To Do if You Have Recurrent Miscarriages

“If you have more than one consecutive miscarriage, consult with your OB-GYN. They can refer or direct you towards further testing,” shares Brogan. Testing may include blood work, radiologic tests and/or genetic testing.

Recurrent miscarriage may happen because of an anatomical problem, like a bicornate (heart-shaped) uterus. It can also be caused by hormonal imbalances or genetic issues, such as abnormal chromosomes in either partner. Additionally, unmanaged health conditions, like diabetes or high blood pressure, can lead to recurrent miscarriage.

“If you are healthy and have one miscarriage, we typically have little reason to believe that you won’t go on to have future healthy pregnancies,” shares Brogan. 

Emotional and Physical Recovery from Miscarriage

If a miscarriage occurs during early pregnancy, you can usually resume moderate activity after one to two days. In later stage pregnancy loss (beyond 20 weeks gestation), consult your OB-GYN.

“After a miscarriage, take care of your body by doing simple things like eating healthy, getting outside and exercising,” Brogan recommends. “Once you are a week or two out from a miscarriage, you can usually resume your normal routine.”

However, it’s important to not only take time to recover physically but also allow yourself to recover emotionally. "Keeping what you’re going through to yourself for too long may delay your own healing. Find a trusted person to talk to and consider doing a memorial for the loss of your baby. Do not hesitate to see a mental health professional for additional support,” shares Brogan.

Brogan recommends that partners be present and ask how they can be of the greatest support to themselves and their loved one. “A patient and/or their partner may feel the weight of loss at any point in the journey,” shares Brogan. “It’s important to give each other consistent grace while navigating this difficult process.”

Remember that grief is different for everyone. Allow yourself to grieve in your own way and make time for self-care. Lean into the kindness offered from friends, family and support groups.

Kristine Brogan, APRN-CNP
Kristine is an advanced practice registered nurse - certified nurse practitioner with ProMedica. View her profile.