My first appointment this morning was with a young couple bursting with excitement over their new pregnancy. As I guided the sonogram across her belly, my mouth went dry as I searched the screen for the tiny flicker of the heartbeat only to sadly realize it was not there. I took a deep breath and said the phrase that makes my heart hurt each and every time the words leave my mouth, “I’m sorry but there is no heartbeat. Unfortunately, you are having a miscarriage.”
Later that night I received a frantic phone call from the patient. Though I had attempted to reassure her at the appointment that the loss was not her fault, a well-meaning relative had her convinced it was caused by the sushi she had ingested the week before. I reassured her that this was likely not the case. This scenario is all too common. In a couple’s search to find a reason for their loss they often end up swallowing misinformation. Miscarriage is painful enough without guilt from myths.
Here are the three most common myths:
Myth #1: It’s your fault
Over 70% of miscarriages are caused by chromosomal abnormalities. Meaning that the sperm and egg did not join properly at the conception and the pregnancy was simply not meant to be from the very start.
Miscarriage is not caused by lifting, sex, eating the wrong foods, missing a vitamin, raising your hands over your head, exercising or stress. It could not have been prevented by calling the doctor earlier or taking a pill.
Women often search for a cause for their loss, and in their search they will usually over analyze everything they have done, which leads to unwarranted guilt.
Myth #2: It will happen again the next time
The overall miscarriage rate is around 15% for healthy women under the age of 35. Having one loss before 12 weeks does not increase the risk of having a miscarriage in the next pregnancy.
With each advancing week of the pregnancy, the risk of loss begins to decline and in most incidences drops to less than 5% after a heartbeat is seen and to less than .5% after 12 weeks.
Having 2 miscarriages in a row or 3 total miscarriages is suggestive of a medical reason for the losses and testing is recommended. But even in these women with multiple losses, the majority will go on to deliver a healthy baby.
Myth #3: All bleeding means miscarriage
When you see pink streaks on the toilet paper, it is hard not to immediately think the worst. I get at least one call a night from patients who are experiencing spotting in early pregnancy and I can feel their anxiety through the phone. While spotting is not a good sign, it doesn’t always mean miscarriage either. Bleeding, especially a small amount that’s not associated with pain, can sometimes be coming from the cervix or vaginal tissue and not the uterus. Up to twelve percent of women that experience bleeding in the first trimester will go on to deliver a healthy baby. If you have bleeding, do follow up with your provider, but don’t immediately give up hope.
With 15% of pregnancies ending in loss, miscarriage is a sadly common occurrence. The rate is much higher if you take into account “chemical pregnancies” which are the losses that occur within the first week after the missed period. I encourage my patients to wait several days (a week if possible) after their missed period to take their home pregnancy tests. With the highly sensitive pregnancy tests we now have available, we are diagnosing a lot of early losses that cause a load of heartache.
I don’t point out the frequency to minimize the impact of the miscarriage, but to encourage you that you are not alone in your feelings of loss. Having a miscarriage doesn’t mean you are broken or that you are doomed to repeat heartbreak. If you have a miscarriage, do follow up with your doctor to discuss getting healthy for your next pregnancy when you are ready. And don’t lose hope based on myths and misinformation.