November 13, 2021 • 27 mins
Miscarriage is one of the most common pregnancy experiences, though rarely talked about openly. In this classic episode, Cristen and Caroline provide an overview of what miscarriage entails, what causes it, what doesn't and its psychological repercussions of pregnancy loss for women and men.
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Episode Transcript
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Speaker 1 (00:05):
Hey, this is Annie and Smith. Welcome to stuff one
ever told your protection of I Heart Radio. So today
we wanted to bring back a classic on infertility. So
content warning if that's something that is painful for you
(00:29):
to hear, just want to put that out there. We
wanted to bring this one back because we recently talked
about surrogacy and this is a big part of that conversation,
or it can be. And also we really appreciate listeners
who have written in about their experiences and hopefully you
can share that and future listener Maile episodes and yeah,
(00:53):
this is something that I think we'll be talking about
a lot more if once when we get to one
of the fictional stories that were infertility is a big
role in it. Well, we know it's like a big
horror like trope, but you and I talked about different levels,
whether it's miscarriage, not being able to have a child,
all of these things. Infertility like, there's a lot of
(01:13):
things to it that make sure to play on your
trauma and fears. Yes, and we absolutely, we absolutely should
and will talk about that because you know, we love
talking about our horror two and what baby. Yes, but
I do find it interesting that this story in particular
I wrote in high school. Yeah, I just think there's
(01:34):
a lot to unpack there, and there's a lot to
unpack in all of this, But before we get to that.
In the meantime, please enjoy this classic episode Welcome to
Stuff Mom Never Told You from how Stuff Works dot Com. Hello,
(01:56):
and welcome to the podcast. I'm Caroline and I'm Kristen.
Today's topic is one that has been refusted by a
lot of you listeners out there. It's a rather sensitive
topic for a lot of women and their partners. Um
it's we're talking about miscarriages today. It's a it's a
common health issue that a lot of people face, and
we have never done anything just kind of giving you
(02:18):
the one oh one on miscarriages before, so today we
thought we would talk about the whole issue. Yeah, And
I think it's also important for us to talk about miscarriage,
not just because so many women experience it, but because
it's something that we don't talk about very much, probably
among ourselves, especially considering how common it is. Um So
(02:39):
we're just gonna, yeah, walk through what it is and
why it happens, more importantly, almost why it doesn't happen
and the psychological repercussions. So, first off, what is a miscarriage.
This is coming from the National Institutes of Health, and
technically speaking, it's the spontaneous loss of a fetus before
(03:01):
the twenty week of pregnancy, because pregnancy loss after the
twenty week is actually called a pre term delivery, right.
And another term for miscarriage is spontaneous abortion, and spontaneous
being the key word, this refers to a naturally occurring event,
not anything to do with medical abortions or surgical abortions.
(03:22):
And there are other terms for early loss of pregnancy,
including what's termed a complete abortion, wherein all of the
tissue of conception leaves the body, and there's incomplete, inevitable, infected,
and missed abortion. All of those different terms relate to
(03:42):
how much of the tissue leaves the body, whether or not,
as infected abortion implies whether or not there was some
kind of infection in the womb. Um. Missed abortion, for instance,
is when the pregnancy is lost but the products of
conception as they're called, remain inside of the body. Right.
And there's also this term called threatened miscarriage. This is
(04:03):
basically when the symptoms of miscarriage occur whether without vaginal bleeding,
and half of threatened miscarriages do in fact in in
pregnancy loss. And so the signs of miscarriage include things
like cramping, bleeding, and lower back pain. And there was
one column that I was reading in Slate by a
woman named Sarah shem Kiss who was talking about how
(04:25):
miscarriage is often portrayed on television as this one time event,
like where a woman goes to the bathroom and she
sees blood and then it's over. And one thing that
a lot of people might not realize is that this
can be a process that can take at least in
shem Kisses case, as long as a week to happen. Um. So, yeah,
(04:48):
then that just is just kind of putting it out
there to clarify how the process can can vary for
different women. Right, And so we should take a look
at the causes of miscarriage because contrary to you know,
there's a lot of misinformation I feel like around around
things like this, having sex, exercise, mild falls, and most
(05:10):
medications do not cause miscarriage. Again, sex exercise, mild falls,
medications not a cause of miscarriage, and a lot of
times when it happens, there might be some guilt on
the part of the mother and her partner, thinking that
there might be something wrong with their genes that caused
this pregnancy loss, But in fact, most miscarriages are caused
(05:34):
by chromosomal problems that essentially make it impossible for the
baby to develop. But those problems are usually not related
to mother's or father's genes, right, And a common chromosomal
issue that comes up is that the embryo or fetus
has a chromosome that causes it to develop abnormally. And
(05:55):
this is not usually a sign of a condition that
could cause problems in future pregnancies, because it usually happens
by chance when the egg divides and grows. And this
is actually a problem that causes at least half of miscarriages.
And one thing that medical scholars have been looking more
closely at too in recent years is a correlation between
miscarriage and partners age, not the mother's age, um they're
(06:20):
the frequency. For instance, of these kinds of chromosomal anomalies
in spermatozoa appear to increase with male age, So, for instance,
in two thousand four, there was a study published an
American Journal of epidemiology, which found that pregnancies by fathers
fifty years or older carried twice the risk of miscarriage
(06:43):
compared with pregnancies with younger fathers and some other possible
risk factors for miscarriage include things like drug and alcohol
abuse during pregnancy, exposure to environmental toxins, hormone problems, infection, obesity,
or on the flip side, being extremely underweight, um smoking,
and problems with the body's immune response. Yeah. An age
(07:05):
can also be a factor for risk of miscarriage as well,
as we talked about in our episode on why it's
harder to get pregnant after thirty five, because the risk
of miscarriages hiring women who are older and at risk
starts to elevate after age thirty, but it really escalates
after forty. But no matter the age of the mother,
(07:30):
miscarriage is most likely to happen early. In fact, most
miscarriages occurred during the first seven weeks of pregnancy. Eight
out of ten miscarriages happened during the first three months
of pregnancy, and second trimemester miscarriages happened in just one
to five of pregnancies. Yeah, I kind of put another
way more than half of all pregnancies are spontaneously lost
(07:52):
before a woman even knows she's pregnant, before she even
misses a period. That's how common that's happened. So, in
other words, women might have miscarriages and not even know
it because they didn't even realize they were pregnant, right,
And you know, as as horrifying as the experience of
miscarriage is, typically, statistically it is usually a one time occurrence.
(08:16):
Most women who miscarry go on to have a healthy
pregnancy after the miscarriage. However, there is a recovery period,
and people kind of debate how long this period should
go on. You know, do you wait a long time,
do you try again immediately? Should you take you know,
basically mental health into consideration when you're doing that. And
(08:36):
while it of course varies from person to person, the
physical recovery from miscarriage in most cases takes only a
few hours to a couple of days. Yeah, I mean,
your periods will likely return within four to six weeks,
and it is possible to become pregnant during the menstrual
cycle immediately after a miscarriage. Now that said, the World
(08:57):
Health Organization recommends waiting at least six months before trying
to conceive. That six month waiting period seems to be
standard advice, although more recent studies are starting to call
that in a question because the w h O is
recommending that six month wait time based largely on maternal
(09:18):
health in developing countries where medical care is less reliable
and where women tend to get pregnant at earlier ages. Correct. Yeah,
and the British Medical Journal actually says that women who
conceive within six months of a miscarriage instead of waiting
up to a year, end up reducing their risk of
another miscarriage by a third, and they also increase their
chances of a healthy and successful pregnancy. But Julius Shelley,
(09:41):
who's an associate professor at Deacon University in Burwood, Australia,
wrote an editorial accompanying that British Medical Journal study offering
a little bit of a qualification, saying, quote, we cannot
really tell whether pregnancy is conceived very soon after a
miscarriage really do have better outcomes, or whether women in
poles too conceive quickly following a miscarriage have better outcomes
(10:02):
in subsequent pregnancy than couples who take longer to conceive, right,
And so I mean it kind of depends person to
person really on your own personal health and all of
that stuff. I mean, if you're healthy and feel ready,
doctors say there might not be a need to wait. Uh,
you know, if you're if you're taking your prenatal vitamins
(10:23):
or your full like acid supplements, you know that that
usually starts months before you even conceive, as long as
you're maintaining a healthy weight, including physical activity, uh and
eating a healthy diet and of course managing stress and
avoiding alcohol, smoking out sort of stuff. Yeah, and I
would imagine too that that weight time might also depend
on the type of miscarriage that occurs, like we were
(10:45):
referenced at the top of the podcast of the various
kinds that can happen. Um. But one thing too that
we wanted to mention is the question of whether or
not having a medical abortion of voluntary abortion in any
way predisposes you to miscarriage, because I think that is
a fairly common assumption. When I was just poking around
(11:06):
on Google looking for solid data on this, there were
a lot of uh, sort of inflammatory types of blog
posts that immediately pop up saying that if you have
an abortion, then you are risking you know, a subsequent
miscarriage or infertility. Um However, the Royal College of Obstetricians
and Gynecologists says, quote, there are no proven associations between
(11:29):
induced abortion and subsequent topic pregnancy, placenta, previa or infertility.
And one reason that some people have thought that misca
that abortion might lead to miscarriage is because it's based
on old data. Basically, abortion technology has improved and it
(11:50):
made it safer for the mother and left the uterus
and the cervix more intact, So there should not be
a great or risk of miscarriage right exactly. And one
risk factor that we didn't really touch on fully is
the idea that women who have had previous miscarriages are
(12:10):
at a greater risk of having future miscarriages. And yes,
this is a definite risk factor, but it is it
is small. Less than five percent of women have two
consecutive miscarriages and only one percent have three or more
consecutive miscarriages. And this is coming from the Mayo Clinic.
Uh they write that after two consecutive miscarriages, there's a
seventy chance the next pregnancy will be maintained. Now somewhat counterintuitively,
(12:35):
after three miscarriages, in fact, that risk drops to But
when looking for the reasons why someone might be experiencing
recurrent miscarriages, but in cases of recurrent miscarriage, the big
question mark often is why it's happening, because I believe
(12:56):
this was reported on in the New York Times that
in fewer than half of couples experiencing that will doctors
pinpoint a definite cause, and the causes of recurrent miscarriage
really tie back to miscarriage overall, UH, the overwhelming majority
of these recurrent miscarriages that happened because of chromosome or abnormalities, which,
(13:21):
as we already discussed, increase with the mother's age and
with the father's age. There could be genetic errors in
the egg or sperm that results in embryos with too
many or too few chromosomes, but environmental factors are rarely
linked to pregnancy loss, and there have been no associations
between environmental factors and recurrent pregnancy loss established. There could
(13:43):
also be an inherited disorder that raises a woman's risk
of blood clots um also called thrombosis, that can increase
the risk of fetal death in the second half of
pregnancy as well, and if you experience multiple miscarriages, there
there are tests that you can have when you go
to your doctor, things like blood tests. They can evaluate
(14:05):
it to detect problems with hormones your immune system. There
are chromosomal tests that you and your partner might both
have your blood tested to determine if chromosomes can be
a factor. If there is tissue from the miscarriage that's
remaining that can be tested, and these chromosomal analyzes can
basically see if there's some inherited genetic cause that happens.
(14:26):
And that's in less than five percent of couples. But
I mean, you know, talking about the immune system problems
and the hormonal problems, like you know we mentioned in
our thyroid episode that you know that is both when
you have something like graves or hashimotos, that's both a
hormone and an immune disorder problem. So having those tests
leading up to pregnancy, whether you've had miscarriages or not,
(14:47):
is very important. Yeah, and and again we want to
underscore that on the bright side, about sixty two of
women with unexplained repeated miscarriages still go on to have
healthy pregnancy. So even if you've had multiple miscarriages, it's
certainly likely that you can still have a baby. So
(15:07):
we've talked about the physical repercussions of miscarriage, what what
might be going on inside the body, but we also
need to talk about how miscarriage can impact the mind
and your emotional well being, not just for mothers, but
also for partners as well. So we're going to get
into the psychology of pregnancy loss when we come right
(15:29):
back from a quick break and now back to the podcast.
So we were talking a lot about the physical causes
and effects of miscarriages, but one thing we have not
talked about yet is the psychological effect, the burden that
the mother and her partner feel when this tragedy has happened,
and calling it a tragedy is I mean, I feel
(15:51):
like a lot of times when miscarriages are discussed, they're
kind of brushed off anyone outside of the couple or
the mother who is having the child. It's kind of
the attitude is like, oh, well, you'll be okay, just
try try again. Well, and especially if it's lost early
and the pregnancy to right there seems to be kind
of this general misunderstanding about the emotional toll that a
(16:13):
miscarriage can take on a couple or a mother. However,
early it happens, traditionally, it's kind of this private event,
you know. I know a friend of mine had a
miscarriage before she had her children, and I didn't even
know about it. You know, it was once she was
pregnant with her now two year old that you know,
she said, oh, yeah, you know, early on, I had
this thing. And and it's almost as if a lot
(16:36):
of moms feel like they're not allowed to be sad,
or they're not allowed to be sad in public. Yeah,
but a new research suggests that some women might actually
more in for a lot longer than expected, which is,
you know, part of why we wanted to to talk
about this issue, to kind of open up these conversational
lines for women to feel more comfortable talking about these experiences,
(16:57):
because it can last even after the birth of a
healthy child, although of course, the range and severity of
the symptoms are going to vary, right and uh. Janet Jaffee,
who is a clinical psychologist at the Center for Reproductive
Psychology in San Diego, says that it's kind of the
medical commonality of miscarriages that lead us to kind of
(17:19):
brushing them off, to underestimate the impact that they can
have on a family. Um Jaffe says that it's a
traumatic loss not only of the pregnancy, but of a
woman's sense of self and her hopes and her dreams
of the future. She has lost her reproductive story and
it needs to be grieved. Yeah, and a woman who
has a miscarriage is understandably at risk for symptoms of
(17:41):
depression and anxiety, not just immediately following the miscarriage, but
in in the years to come and even after having
a healthy child. Women who miscarry also have a higher
risk of postpartum depression. And there is a paper published
in the British Journal of Psychiatry in two thousand eleven
looking at this, and the researcher followed more than thirteen
(18:03):
thousand women for three years post birth, and of those
who had miscarriages, they were about hundred. Of those women
who had had a miscarriage, fient experienced clinically significant depression
and or exiety anxiety during and after the pregnancies for
up to those three years. And this can really affect
(18:25):
women as they become mothers, as they bear healthy children. UM.
A study looked at women who had delivered a child
within nineteen months after a miscarriage and found that of
the infants had disorganized attachments to their mothers, that it
was still affecting them in the way that they viewed
their healthy children. And not only can it take a
(18:47):
toll on mother's relationship with her children, but understandably it
can take a toll on her relationship with her partner. Um.
There have been there's been research into how miscarriage can
impact act uh sex life for instance, and a lot
of times you'll see in heterosexual relationships men might be
(19:08):
ready to move on and wanted reignite that flame, whereas
women might not be ready to have sex for a while. Yeah, exactly.
And we should look at at at partners, both both
male and female partners when it comes to having a
miscarriage because traditionally, the feelings experienced by the partner tend
(19:30):
to be dismissed, both within the family and without, and
studies have shown that men are not satisfied with the
support they get from others. Nonetheless, research also has shown
that that men absolutely grieve these losses as well, but
it might not be as intense or as enduring as
their partners, which is understandable because it's not as much
(19:52):
of a physical experience perhaps for them. Right In. The
study in the Journal of Psychosomatic Research found on that um,
for both men and women in these situations, giving up
their personal expectations, hopes for, and fantasies about the unborn
child is a major source of grieving. Some men, on
the other hand, feel burdened, particularly by their wives grief
(20:15):
or depressive reactions. I'm sure, feeling helpless, not knowing what
to do or say. They can't say anything right exactly.
I mean, there's no way to to magically fix that situation.
Um And So you see sort of gender stereotypical differences
emerging in these studies of how men tend to manage
their grief compared to women. For instance, one study publish
(20:39):
in n a Journal of Reproductive and Infant Psychology found
that men might display less what they call immediate active grief,
but they might also be more vulnerable to feelings of
despair and difficulty coping, probably because of a sense of helplessness.
Right And, While studies have shown that no matter how
advanced the pregnancy is, the woman and will likely feel
(21:01):
the same sense of loss. For men, the more advanced
it is, the greater their sense of loss, the more
it's almost like they're getting to know this little person
from the ultrasound on, whereas the woman's sense of grief
is heightened either way. Yeah, and there have been similar
studies on this conducted among lesbian couples as well, and
it finds for the non pregnant lesbian partner similar feelings
(21:25):
that that husbands or boyfriends might experience in heterosexual relationships.
Um for instance, in one study talked about how often
the response is, you know, a sense of having not
only lost the baby, but also kind of having lost
emotionally speaking, the partner not knowing how to sort of
(21:46):
rebuild that connection. How do you move forward from that?
Right and researcher Denuda M. Washner said that lesbian couples
do face kind of a unique situation psychologically and emotionally
in that they're going to be a lot of people
who didn't approve of this union and this pregnancy in
the first place, So there might even be a greater
(22:08):
lack of support for them in this time. Well, they
might have to go to greater links as well. To
go about getting pregnant in the first place, right, And
and that even ties in with other studies that have
shown that women who go through like fertility treatments or
IVF or something like that, their grief tends to be
extended past the point of where other women are starting
(22:31):
to move on. Yeah, and and I don't want to
leave gay fathers out of the equation as well, because
I'm sure there can be a similar process. For instance,
if you're, you know, hoping to adopt and that falls through.
I mean, any time you're going to experience some kind
of of loss of unexpected child, we need to be
(22:51):
able to to talk about it into to grieve with
them and for them, and and allow that process to happen.
So so the question would be, then, you know, if
you are the friend, what can you do if you
find out that that someone you know has experienced a miscarriage.
Well grief expert Robbie Miller Kaplan stresses that a miscarriage
(23:13):
is a death in the family, and just like any death,
the bereaved must grieve for the loved ones they have lost.
And so she says, first it's really important to acknowledge
the loss that your friend is experienced. Yeah, she says,
you should treat your friend just like you would treat
a loved one who had who has had a family
member die, send flowers, write a note, bring a meal,
or just offered to visit and listen, you know, right,
(23:36):
And she stresses that when you're talking with your friend
and listening to your friend, kind of repeat things back
to him or her so that she or he knows
you're listening, you're actually taking it all in and that
they're being heard. Yeah, and this is this also echoes
what we've heard from stuff I've never told you listeners
who have written and requesting this topic sort of not
(23:59):
only the knee to be able to talk about it
and sort of isolation that they felt, but also how
helpful it was in instances when they did have friends
who acknowledge the loss and took it seriously and didn't
just pat them on the head and say, oh, well,
you'll get pregnant down the road, which statistically, yeah, the
(24:20):
odds are definitely in your favor that that will happen,
but that doesn't discount the immediate grief that you're experiencing, right,
And I mean, researching for this episode was educational for
for me, definitely, because I mean, how many of us
really know what to say or how to act or
how to treat this, And so I think it's so
(24:40):
important that we show through all of these studies that
we cited that this, this is a huge ordeal that
families and women go through, and it is isolating. It
is isolating because you have kind of a general attitude
in the culture of like myth, you'll you'll be fine,
You'll you'll totally be fine. You're not you know, your health,
it's fine, whereas a lot of these women feel, you know, no,
(25:03):
it's not fine. I lost someone important to me. Yeah. So, UM,
I know, like you said at the beginning of the podcast, Caroline,
this was a sensitive topic to talk about, and I
can imagine that for some people listening it might have
been a difficult one an emotional one to listen to.
But we just want to invite you to share with us. UM.
You can email us mom Stuff at Discovery dot com.
(25:25):
You can tweet us at mom Stuff podcast, or share
with the whole community of Stuff Mom Never Told You
listeners and viewers over on Facebook as well. UM, and
we have a couple of messages to share with you
in fact right now. So We've got a couple of
letters here from listeners about our episode on cursing, swearing,
(25:51):
F bombs, and women, And this one comes from Jill,
who writes, Hi, guys, I was so excited when I
saw you did a podcast on swearing because it's honestly
one of my favorite things to do. I know that
sounds lame, but I feel such a release of stress
whenever I throw F bombs around. It just feels so free,
and it's one of the best things about being an adult,
not having to limit myself to vocabulary someone else's deemed fit.
(26:15):
With that said, I always make sure I'm not in
public when I do it in case it upsets someone.
It really shouldn't. They are just words, she writes in
all caps. Thanks for the enlightening podcast. I eff ing
love it. Um. Well, I have a message here from
Crystal Um. She says, being a professional, or as professionals,
(26:37):
one can be in a line of work where you
sometimes feel the need to scream out loud. Insurance claims,
I do feel that urge to curse out loud in
the workplace every so often, sometimes more than once a day.
But I digress. I've heard people say that cursing as
a lady makes you seem less educated, I e. She
couldn't find a better word in her vocabulary to express
(26:57):
that point. I hold a bachelor's degree and would consider
myself highly educated, But sometimes my old standby is such
as fiddle d d or goodness simply won't cut it.
I find myself letting an F bomb slip out at times,
and although I may not be the most pleased with it, later,
it just feels better. Thank you for offering an escape
from my day to day stresses. You're welcome, Crystal, and
(27:19):
I hope that us relieving you from some of your
stresses means you dropped a couple of fewer f bond
at the office. So thank you for writing in, and
thanks to everybody who's written into us. Mom Stuff at
Discovery dot com is where you can email us, and
you can also find all of our social media links,
every single podcast, blog post, and video. It's stuff Mom
(27:39):
Never told You dot com for more on this and
thousands of other topics. Does it how stuff works dot
com
Hey, this is Annie and Smith. Welcome to stuff one
ever told your protection of I Heart Radio. So today
we wanted to bring back a classic on infertility. So
content warning if that's something that is painful for you
(00:29):
to hear, just want to put that out there. We
wanted to bring this one back because we recently talked
about surrogacy and this is a big part of that conversation,
or it can be. And also we really appreciate listeners
who have written in about their experiences and hopefully you
can share that and future listener Maile episodes and yeah,
(00:53):
this is something that I think we'll be talking about
a lot more if once when we get to one
of the fictional stories that were infertility is a big
role in it. Well, we know it's like a big
horror like trope, but you and I talked about different levels,
whether it's miscarriage, not being able to have a child,
all of these things. Infertility like, there's a lot of
(01:13):
things to it that make sure to play on your
trauma and fears. Yes, and we absolutely, we absolutely should
and will talk about that because you know, we love
talking about our horror two and what baby. Yes, but
I do find it interesting that this story in particular
I wrote in high school. Yeah, I just think there's
(01:34):
a lot to unpack there, and there's a lot to
unpack in all of this, But before we get to that.
In the meantime, please enjoy this classic episode Welcome to
Stuff Mom Never Told You from how Stuff Works dot Com. Hello,
(01:56):
and welcome to the podcast. I'm Caroline and I'm Kristen.
Today's topic is one that has been refusted by a
lot of you listeners out there. It's a rather sensitive
topic for a lot of women and their partners. Um
it's we're talking about miscarriages today. It's a it's a
common health issue that a lot of people face, and
we have never done anything just kind of giving you
(02:18):
the one oh one on miscarriages before, so today we
thought we would talk about the whole issue. Yeah, And
I think it's also important for us to talk about miscarriage,
not just because so many women experience it, but because
it's something that we don't talk about very much, probably
among ourselves, especially considering how common it is. Um So
(02:39):
we're just gonna, yeah, walk through what it is and
why it happens, more importantly, almost why it doesn't happen
and the psychological repercussions. So, first off, what is a miscarriage.
This is coming from the National Institutes of Health, and
technically speaking, it's the spontaneous loss of a fetus before
(03:01):
the twenty week of pregnancy, because pregnancy loss after the
twenty week is actually called a pre term delivery, right.
And another term for miscarriage is spontaneous abortion, and spontaneous
being the key word, this refers to a naturally occurring event,
not anything to do with medical abortions or surgical abortions.
(03:22):
And there are other terms for early loss of pregnancy,
including what's termed a complete abortion, wherein all of the
tissue of conception leaves the body, and there's incomplete, inevitable, infected,
and missed abortion. All of those different terms relate to
(03:42):
how much of the tissue leaves the body, whether or not,
as infected abortion implies whether or not there was some
kind of infection in the womb. Um. Missed abortion, for instance,
is when the pregnancy is lost but the products of
conception as they're called, remain inside of the body. Right.
And there's also this term called threatened miscarriage. This is
(04:03):
basically when the symptoms of miscarriage occur whether without vaginal bleeding,
and half of threatened miscarriages do in fact in in
pregnancy loss. And so the signs of miscarriage include things
like cramping, bleeding, and lower back pain. And there was
one column that I was reading in Slate by a
woman named Sarah shem Kiss who was talking about how
(04:25):
miscarriage is often portrayed on television as this one time event,
like where a woman goes to the bathroom and she
sees blood and then it's over. And one thing that
a lot of people might not realize is that this
can be a process that can take at least in
shem Kisses case, as long as a week to happen. Um. So, yeah,
(04:48):
then that just is just kind of putting it out
there to clarify how the process can can vary for
different women. Right, And so we should take a look
at the causes of miscarriage because contrary to you know,
there's a lot of misinformation I feel like around around
things like this, having sex, exercise, mild falls, and most
(05:10):
medications do not cause miscarriage. Again, sex exercise, mild falls,
medications not a cause of miscarriage, and a lot of
times when it happens, there might be some guilt on
the part of the mother and her partner, thinking that
there might be something wrong with their genes that caused
this pregnancy loss, But in fact, most miscarriages are caused
(05:34):
by chromosomal problems that essentially make it impossible for the
baby to develop. But those problems are usually not related
to mother's or father's genes, right, And a common chromosomal
issue that comes up is that the embryo or fetus
has a chromosome that causes it to develop abnormally. And
(05:55):
this is not usually a sign of a condition that
could cause problems in future pregnancies, because it usually happens
by chance when the egg divides and grows. And this
is actually a problem that causes at least half of miscarriages.
And one thing that medical scholars have been looking more
closely at too in recent years is a correlation between
miscarriage and partners age, not the mother's age, um they're
(06:20):
the frequency. For instance, of these kinds of chromosomal anomalies
in spermatozoa appear to increase with male age, So, for instance,
in two thousand four, there was a study published an
American Journal of epidemiology, which found that pregnancies by fathers
fifty years or older carried twice the risk of miscarriage
(06:43):
compared with pregnancies with younger fathers and some other possible
risk factors for miscarriage include things like drug and alcohol
abuse during pregnancy, exposure to environmental toxins, hormone problems, infection, obesity,
or on the flip side, being extremely underweight, um smoking,
and problems with the body's immune response. Yeah. An age
(07:05):
can also be a factor for risk of miscarriage as well,
as we talked about in our episode on why it's
harder to get pregnant after thirty five, because the risk
of miscarriages hiring women who are older and at risk
starts to elevate after age thirty, but it really escalates
after forty. But no matter the age of the mother,
(07:30):
miscarriage is most likely to happen early. In fact, most
miscarriages occurred during the first seven weeks of pregnancy. Eight
out of ten miscarriages happened during the first three months
of pregnancy, and second trimemester miscarriages happened in just one
to five of pregnancies. Yeah, I kind of put another
way more than half of all pregnancies are spontaneously lost
(07:52):
before a woman even knows she's pregnant, before she even
misses a period. That's how common that's happened. So, in
other words, women might have miscarriages and not even know
it because they didn't even realize they were pregnant, right,
And you know, as as horrifying as the experience of
miscarriage is, typically, statistically it is usually a one time occurrence.
(08:16):
Most women who miscarry go on to have a healthy
pregnancy after the miscarriage. However, there is a recovery period,
and people kind of debate how long this period should
go on. You know, do you wait a long time,
do you try again immediately? Should you take you know,
basically mental health into consideration when you're doing that. And
(08:36):
while it of course varies from person to person, the
physical recovery from miscarriage in most cases takes only a
few hours to a couple of days. Yeah, I mean,
your periods will likely return within four to six weeks,
and it is possible to become pregnant during the menstrual
cycle immediately after a miscarriage. Now that said, the World
(08:57):
Health Organization recommends waiting at least six months before trying
to conceive. That six month waiting period seems to be
standard advice, although more recent studies are starting to call
that in a question because the w h O is
recommending that six month wait time based largely on maternal
(09:18):
health in developing countries where medical care is less reliable
and where women tend to get pregnant at earlier ages. Correct. Yeah,
and the British Medical Journal actually says that women who
conceive within six months of a miscarriage instead of waiting
up to a year, end up reducing their risk of
another miscarriage by a third, and they also increase their
chances of a healthy and successful pregnancy. But Julius Shelley,
(09:41):
who's an associate professor at Deacon University in Burwood, Australia,
wrote an editorial accompanying that British Medical Journal study offering
a little bit of a qualification, saying, quote, we cannot
really tell whether pregnancy is conceived very soon after a
miscarriage really do have better outcomes, or whether women in
poles too conceive quickly following a miscarriage have better outcomes
(10:02):
in subsequent pregnancy than couples who take longer to conceive, right,
And so I mean it kind of depends person to
person really on your own personal health and all of
that stuff. I mean, if you're healthy and feel ready,
doctors say there might not be a need to wait. Uh,
you know, if you're if you're taking your prenatal vitamins
(10:23):
or your full like acid supplements, you know that that
usually starts months before you even conceive, as long as
you're maintaining a healthy weight, including physical activity, uh and
eating a healthy diet and of course managing stress and
avoiding alcohol, smoking out sort of stuff. Yeah, and I
would imagine too that that weight time might also depend
on the type of miscarriage that occurs, like we were
(10:45):
referenced at the top of the podcast of the various
kinds that can happen. Um. But one thing too that
we wanted to mention is the question of whether or
not having a medical abortion of voluntary abortion in any
way predisposes you to miscarriage, because I think that is
a fairly common assumption. When I was just poking around
(11:06):
on Google looking for solid data on this, there were
a lot of uh, sort of inflammatory types of blog
posts that immediately pop up saying that if you have
an abortion, then you are risking you know, a subsequent
miscarriage or infertility. Um However, the Royal College of Obstetricians
and Gynecologists says, quote, there are no proven associations between
(11:29):
induced abortion and subsequent topic pregnancy, placenta, previa or infertility.
And one reason that some people have thought that misca
that abortion might lead to miscarriage is because it's based
on old data. Basically, abortion technology has improved and it
(11:50):
made it safer for the mother and left the uterus
and the cervix more intact, So there should not be
a great or risk of miscarriage right exactly. And one
risk factor that we didn't really touch on fully is
the idea that women who have had previous miscarriages are
(12:10):
at a greater risk of having future miscarriages. And yes,
this is a definite risk factor, but it is it
is small. Less than five percent of women have two
consecutive miscarriages and only one percent have three or more
consecutive miscarriages. And this is coming from the Mayo Clinic.
Uh they write that after two consecutive miscarriages, there's a
seventy chance the next pregnancy will be maintained. Now somewhat counterintuitively,
(12:35):
after three miscarriages, in fact, that risk drops to But
when looking for the reasons why someone might be experiencing
recurrent miscarriages, but in cases of recurrent miscarriage, the big
question mark often is why it's happening, because I believe
(12:56):
this was reported on in the New York Times that
in fewer than half of couples experiencing that will doctors
pinpoint a definite cause, and the causes of recurrent miscarriage
really tie back to miscarriage overall, UH, the overwhelming majority
of these recurrent miscarriages that happened because of chromosome or abnormalities, which,
(13:21):
as we already discussed, increase with the mother's age and
with the father's age. There could be genetic errors in
the egg or sperm that results in embryos with too
many or too few chromosomes, but environmental factors are rarely
linked to pregnancy loss, and there have been no associations
between environmental factors and recurrent pregnancy loss established. There could
(13:43):
also be an inherited disorder that raises a woman's risk
of blood clots um also called thrombosis, that can increase
the risk of fetal death in the second half of
pregnancy as well, and if you experience multiple miscarriages, there
there are tests that you can have when you go
to your doctor, things like blood tests. They can evaluate
(14:05):
it to detect problems with hormones your immune system. There
are chromosomal tests that you and your partner might both
have your blood tested to determine if chromosomes can be
a factor. If there is tissue from the miscarriage that's
remaining that can be tested, and these chromosomal analyzes can
basically see if there's some inherited genetic cause that happens.
(14:26):
And that's in less than five percent of couples. But
I mean, you know, talking about the immune system problems
and the hormonal problems, like you know we mentioned in
our thyroid episode that you know that is both when
you have something like graves or hashimotos, that's both a
hormone and an immune disorder problem. So having those tests
leading up to pregnancy, whether you've had miscarriages or not,
(14:47):
is very important. Yeah, and and again we want to
underscore that on the bright side, about sixty two of
women with unexplained repeated miscarriages still go on to have
healthy pregnancy. So even if you've had multiple miscarriages, it's
certainly likely that you can still have a baby. So
(15:07):
we've talked about the physical repercussions of miscarriage, what what
might be going on inside the body, but we also
need to talk about how miscarriage can impact the mind
and your emotional well being, not just for mothers, but
also for partners as well. So we're going to get
into the psychology of pregnancy loss when we come right
(15:29):
back from a quick break and now back to the podcast.
So we were talking a lot about the physical causes
and effects of miscarriages, but one thing we have not
talked about yet is the psychological effect, the burden that
the mother and her partner feel when this tragedy has happened,
and calling it a tragedy is I mean, I feel
(15:51):
like a lot of times when miscarriages are discussed, they're
kind of brushed off anyone outside of the couple or
the mother who is having the child. It's kind of
the attitude is like, oh, well, you'll be okay, just
try try again. Well, and especially if it's lost early
and the pregnancy to right there seems to be kind
of this general misunderstanding about the emotional toll that a
(16:13):
miscarriage can take on a couple or a mother. However,
early it happens, traditionally, it's kind of this private event,
you know. I know a friend of mine had a
miscarriage before she had her children, and I didn't even
know about it. You know, it was once she was
pregnant with her now two year old that you know,
she said, oh, yeah, you know, early on, I had
this thing. And and it's almost as if a lot
(16:36):
of moms feel like they're not allowed to be sad,
or they're not allowed to be sad in public. Yeah,
but a new research suggests that some women might actually
more in for a lot longer than expected, which is,
you know, part of why we wanted to to talk
about this issue, to kind of open up these conversational
lines for women to feel more comfortable talking about these experiences,
(16:57):
because it can last even after the birth of a
healthy child, although of course, the range and severity of
the symptoms are going to vary, right and uh. Janet Jaffee,
who is a clinical psychologist at the Center for Reproductive
Psychology in San Diego, says that it's kind of the
medical commonality of miscarriages that lead us to kind of
(17:19):
brushing them off, to underestimate the impact that they can
have on a family. Um Jaffe says that it's a
traumatic loss not only of the pregnancy, but of a
woman's sense of self and her hopes and her dreams
of the future. She has lost her reproductive story and
it needs to be grieved. Yeah, and a woman who
has a miscarriage is understandably at risk for symptoms of
(17:41):
depression and anxiety, not just immediately following the miscarriage, but
in in the years to come and even after having
a healthy child. Women who miscarry also have a higher
risk of postpartum depression. And there is a paper published
in the British Journal of Psychiatry in two thousand eleven
looking at this, and the researcher followed more than thirteen
(18:03):
thousand women for three years post birth, and of those
who had miscarriages, they were about hundred. Of those women
who had had a miscarriage, fient experienced clinically significant depression
and or exiety anxiety during and after the pregnancies for
up to those three years. And this can really affect
(18:25):
women as they become mothers, as they bear healthy children. UM.
A study looked at women who had delivered a child
within nineteen months after a miscarriage and found that of
the infants had disorganized attachments to their mothers, that it
was still affecting them in the way that they viewed
their healthy children. And not only can it take a
(18:47):
toll on mother's relationship with her children, but understandably it
can take a toll on her relationship with her partner. Um.
There have been there's been research into how miscarriage can
impact act uh sex life for instance, and a lot
of times you'll see in heterosexual relationships men might be
(19:08):
ready to move on and wanted reignite that flame, whereas
women might not be ready to have sex for a while. Yeah, exactly.
And we should look at at at partners, both both
male and female partners when it comes to having a
miscarriage because traditionally, the feelings experienced by the partner tend
(19:30):
to be dismissed, both within the family and without, and
studies have shown that men are not satisfied with the
support they get from others. Nonetheless, research also has shown
that that men absolutely grieve these losses as well, but
it might not be as intense or as enduring as
their partners, which is understandable because it's not as much
(19:52):
of a physical experience perhaps for them. Right In. The
study in the Journal of Psychosomatic Research found on that um,
for both men and women in these situations, giving up
their personal expectations, hopes for, and fantasies about the unborn
child is a major source of grieving. Some men, on
the other hand, feel burdened, particularly by their wives grief
(20:15):
or depressive reactions. I'm sure, feeling helpless, not knowing what
to do or say. They can't say anything right exactly.
I mean, there's no way to to magically fix that situation.
Um And So you see sort of gender stereotypical differences
emerging in these studies of how men tend to manage
their grief compared to women. For instance, one study publish
(20:39):
in n a Journal of Reproductive and Infant Psychology found
that men might display less what they call immediate active grief,
but they might also be more vulnerable to feelings of
despair and difficulty coping, probably because of a sense of helplessness.
Right And, While studies have shown that no matter how
advanced the pregnancy is, the woman and will likely feel
(21:01):
the same sense of loss. For men, the more advanced
it is, the greater their sense of loss, the more
it's almost like they're getting to know this little person
from the ultrasound on, whereas the woman's sense of grief
is heightened either way. Yeah, and there have been similar
studies on this conducted among lesbian couples as well, and
it finds for the non pregnant lesbian partner similar feelings
(21:25):
that that husbands or boyfriends might experience in heterosexual relationships.
Um for instance, in one study talked about how often
the response is, you know, a sense of having not
only lost the baby, but also kind of having lost
emotionally speaking, the partner not knowing how to sort of
(21:46):
rebuild that connection. How do you move forward from that?
Right and researcher Denuda M. Washner said that lesbian couples
do face kind of a unique situation psychologically and emotionally
in that they're going to be a lot of people
who didn't approve of this union and this pregnancy in
the first place, So there might even be a greater
(22:08):
lack of support for them in this time. Well, they
might have to go to greater links as well. To
go about getting pregnant in the first place, right, And
and that even ties in with other studies that have
shown that women who go through like fertility treatments or
IVF or something like that, their grief tends to be
extended past the point of where other women are starting
(22:31):
to move on. Yeah, and and I don't want to
leave gay fathers out of the equation as well, because
I'm sure there can be a similar process. For instance,
if you're, you know, hoping to adopt and that falls through.
I mean, any time you're going to experience some kind
of of loss of unexpected child, we need to be
(22:51):
able to to talk about it into to grieve with
them and for them, and and allow that process to happen.
So so the question would be, then, you know, if
you are the friend, what can you do if you
find out that that someone you know has experienced a miscarriage.
Well grief expert Robbie Miller Kaplan stresses that a miscarriage
(23:13):
is a death in the family, and just like any death,
the bereaved must grieve for the loved ones they have lost.
And so she says, first it's really important to acknowledge
the loss that your friend is experienced. Yeah, she says,
you should treat your friend just like you would treat
a loved one who had who has had a family
member die, send flowers, write a note, bring a meal,
or just offered to visit and listen, you know, right,
(23:36):
And she stresses that when you're talking with your friend
and listening to your friend, kind of repeat things back
to him or her so that she or he knows
you're listening, you're actually taking it all in and that
they're being heard. Yeah, and this is this also echoes
what we've heard from stuff I've never told you listeners
who have written and requesting this topic sort of not
(23:59):
only the knee to be able to talk about it
and sort of isolation that they felt, but also how
helpful it was in instances when they did have friends
who acknowledge the loss and took it seriously and didn't
just pat them on the head and say, oh, well,
you'll get pregnant down the road, which statistically, yeah, the
(24:20):
odds are definitely in your favor that that will happen,
but that doesn't discount the immediate grief that you're experiencing, right,
And I mean, researching for this episode was educational for
for me, definitely, because I mean, how many of us
really know what to say or how to act or
how to treat this, And so I think it's so
(24:40):
important that we show through all of these studies that
we cited that this, this is a huge ordeal that
families and women go through, and it is isolating. It
is isolating because you have kind of a general attitude
in the culture of like myth, you'll you'll be fine,
You'll you'll totally be fine. You're not you know, your health,
it's fine, whereas a lot of these women feel, you know, no,
(25:03):
it's not fine. I lost someone important to me. Yeah. So, UM,
I know, like you said at the beginning of the podcast, Caroline,
this was a sensitive topic to talk about, and I
can imagine that for some people listening it might have
been a difficult one an emotional one to listen to.
But we just want to invite you to share with us. UM.
You can email us mom Stuff at Discovery dot com.
(25:25):
You can tweet us at mom Stuff podcast, or share
with the whole community of Stuff Mom Never Told You
listeners and viewers over on Facebook as well. UM, and
we have a couple of messages to share with you
in fact right now. So We've got a couple of
letters here from listeners about our episode on cursing, swearing,
(25:51):
F bombs, and women, And this one comes from Jill,
who writes, Hi, guys, I was so excited when I
saw you did a podcast on swearing because it's honestly
one of my favorite things to do. I know that
sounds lame, but I feel such a release of stress
whenever I throw F bombs around. It just feels so free,
and it's one of the best things about being an adult,
not having to limit myself to vocabulary someone else's deemed fit.
(26:15):
With that said, I always make sure I'm not in
public when I do it in case it upsets someone.
It really shouldn't. They are just words, she writes in
all caps. Thanks for the enlightening podcast. I eff ing
love it. Um. Well, I have a message here from
Crystal Um. She says, being a professional, or as professionals,
(26:37):
one can be in a line of work where you
sometimes feel the need to scream out loud. Insurance claims,
I do feel that urge to curse out loud in
the workplace every so often, sometimes more than once a day.
But I digress. I've heard people say that cursing as
a lady makes you seem less educated, I e. She
couldn't find a better word in her vocabulary to express
(26:57):
that point. I hold a bachelor's degree and would consider
myself highly educated, But sometimes my old standby is such
as fiddle d d or goodness simply won't cut it.
I find myself letting an F bomb slip out at times,
and although I may not be the most pleased with it, later,
it just feels better. Thank you for offering an escape
from my day to day stresses. You're welcome, Crystal, and
(27:19):
I hope that us relieving you from some of your
stresses means you dropped a couple of fewer f bond
at the office. So thank you for writing in, and
thanks to everybody who's written into us. Mom Stuff at
Discovery dot com is where you can email us, and
you can also find all of our social media links,
every single podcast, blog post, and video. It's stuff Mom
(27:39):
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