It is a painful experience for many women, but it is often kept in the shadows. It can be physically painful and emotionally complex. Miscarriage, which affects an estimated 1 in 5 confirmed pregnancies, is a common occurrence. However, it’s often viewed as a minor or hidden event. The impact on women and their partners is not minor.
Dr. Sneha, a general practitioner and mother of two, has supported women for years through this experience. Shevonne Hunt, host of Feed Play Love, has an open, compassionate discussion with Dr. Sneha Wadhwani about what happens in a woman’s womb during a miscarriage and why it is so important to talk honestly about the experience.
What is a miscarriage?: Understanding Miscarriage
Let’s begin with the basics.
Dr. Wadhwani says that a miscarriage occurs when a baby dies before the 20-week mark. This is a clinical term, but it’s also a complicated interplay between biology, emotion and identity.
Miscarriage occurs incredibly often. Dr. Wadhwani says that “one in five women with a confirmed pregnancy miscarry,” but even more miscarry even before realising they are pregnant. These very early miscarriages–sometimes called “chemical pregnancies”– occur shortly after implantation and may be mistaken for a late or heavier-than-usual period.
This doesn’t lessen the impact or pain of miscarriage.
The Miracle of Pregnancy – And Its Fragility
The biological process of pregnancy is a wonder. A cascade of events begins the moment that a sperm fertilises an egg. It involves a delicate symphony involving hormonal balance, cell division, and complex timing. The success of each stage – implantation, embryonic development, and placenta – depends on many factors aligning perfectly.
Dr. Wadhwani takes us through the process. When we consider the process of an embryo being formed by an egg and sperm combining and fusing, then reproducing and replicating, each step is fraught with error.
Usually, these errors are not the result of anything that either mother or father did. They are more likely to be random disruptions, tiny missteps within the genetic blueprint of an embryo. She says that it is usually due to a failure in normal development. “And this is the most important thing we need to know when thinking about miscarriage.”
For many women, this loss is not caused by lifestyle, stress, heavy lifting, or exercise. This is often caused by chromosomal anomalies that occur by chance.
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Why do miscarriages occur?
Human nature is to seek answers, particularly after an event as devastating as a miscarriage. Understanding “why” miscarriages happen isn’t easy.
Dr. Wadhwani discusses some of the known causes. She is careful to point out that the exact reason for the death can sometimes be unknown. This can be frustrating and painful, especially for parents who are grieving.
- Chromosomal Abnormalities
Genetic error is the most common cause. She says that sometimes it is a spontaneous chromosomal issue. The embryo could have too many chromosomes or not enough, rendering it unviable. These errors are often caused by cell division, and we have no control over them. - Genetic factors in parents
In certain cases, either one or both parents can carry a chromosomal disorder that does not affect them directly but increases the risk of miscarriage. They are rarer and sometimes can be detected through genetic testing. - Hormonal Problems
Progesterone plays a crucial role in maintaining early pregnancy. Dr. Wadhwani says, “We know some women do not produce enough progesterone.” This hormonal imbalance can make it hard for the embryo to successfully implant or maintain pregnancy. - Blood Clotting or Immune Disorders
Conditions like Antiphospholipid Syndrome (APS) and other clotting disorders can disrupt blood supply to placentas and developing babies. - Diabetes & Thyroid Disease
Miscarriage risks can be increased by uncontrolled thyroid conditions and poorly managed diabetes. This highlights the importance of early and pre-conception care. - Infections
Untreated UTIs, even those that seem benign at first glance, can cause pregnancy complications. Other infections, such as rubella, toxoplasmosis, listeria or even the common urinary tract infection (UTI) can cause complications if left untreated.
Despite these causes being known, there are still many cases where there is no explanation. This uncertainty can make a miscarriage even more isolating.
What happens physically during a miscarriage
Each miscarriage is unique, just as every woman’s body and each miscarriage are. Physical symptoms can vary from slow loss of pregnancy and spotting to painful cramps and heavy bleeding.
There are different types of miscarriage.
- Miscarriage in danger– There is some bleeding, but the cervix is still closed. The pregnancy can continue.
- Inevitable Miscarriage– Cramping, bleeding and a dilated cervix. A miscarriage has begun.
- Miscarriage incomplete– Some pregnancy tissue is still in the uterus.
- Complete miscarriage– All pregnancy tissues have been expelled.
- Missed Miscarriage– The baby’s development has stopped, but no symptoms are present. This is often discovered during a routine ultrasound.
Miscarriage can cause intense cramping, heavy bleeding (sometimes with blood clots) and other symptoms, such as fatigue, back pain and hormonal changes. Medical management may include:
- Expectant management (letting the miscarriage proceed naturally)
- The uterus can be helped by taking medications to pass tissue
- Surgical intervention, such as a D&C
The choice of approach can have emotional and physical consequences. It is important to make the right decision with medical assistance.
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The Emotional Cost: More than Just a Physical Injury
A miscarriage is not just a medical issue; it’s also a deeply emotional experience. When you learn you are pregnant, many people feel their identity shift. You begin to imagine the future, create mental plans and form a relationship with your baby.
Dr. Wadhwani makes this important point: “For people on the outside, it may not appear to be such a big loss because no one has seen a physical baby. For the woman who is going through it, however, she has been pregnant. She has felt the hormonal and emotional effects of pregnancy. Losing that will cause symptoms. “It is going to cause grief.”
The hormonal fluctuations that follow a miscarriage may also intensify your emotions. Dropping estrogen and progesterone levels can cause mood swings and depression. It’s not just hormones, but real emotional effects.
Even though they are aware that they did not cause the problem, some women still feel guilty. Some women feel numbness or anger. Others are isolated. Many people grieve silently, especially if the news of their pregnancy hasn’t been shared yet. Even partners can feel helpless, unsure of how to express or support their sadness.
Breaking Silence: Talking about Miscarriage
The loneliness that is often associated with miscarriage makes it feel devastating. It’s a common occurrence, but it is still shrouded in secrecy.
Many women feel pressured to announce a pregnancy “just in case” before 12 weeks. But if it does happen, they will be grieving for a baby that no one knew about. While they may continue to go to work and carry out their daily routines, they are silently grieving.
Dr. Wadhwani feels that this silence can be damaging. Women must grieve in the same manner as they would any other loss.
Grief is not linear. Grieving is not linear. There’s no timeline. Some women may feel ready to talk about it right away, while others need more time. Both are valid. It is important to create a space where these conversations can take place, without shame, without judgement, and without minimising the experience.
Support after miscarriage
It takes time to recover from a miscarriage, both physically and emotionally. Support can take many forms.
- Medical care: Regular checks, ultrasounds and blood tests, to ensure that everything is in order and your body heals.
- Therapy or counselling: Speaking to a professional will help you navigate emotional complexity and process your grief.
- Support Groups: Speaking with other women about miscarriages, whether in person or on the internet, can be a deeply comforting experience.
- Support from family and friends: Tell your loved ones what you need, whether it is space, comfort or practical assistance.
- Rituals for closure: For some women, writing a letter or lighting a candle can be a healing ritual. Others may choose to plant a tree, name the child they lost, or light a lamp.
Do not rush into “trying again” until you are ready emotionally and physically. It is not possible to move forward in a uniform way.
Last Thoughts: You are not alone
Miscarriage can be an incredibly personal experience. However, it shouldn’t be kept quiet. Your experience matters, regardless of whether your pregnancy ended after five weeks, fifteen weeks, or if you tried for months.
Your grievance is valid. Your questions are valid. Your body, though it may seem like it’s let you down, is not broken. Even if it was only a brief time, your body has been able to sustain life. That is an extraordinary feat.
You may be reading this article while you are experiencing a miscarriage or supporting someone else who is.
You are not alone. Reach out. Ask for help. Speak up. By doing so, not only do you begin to heal yourself, but you also help others feel less lonely.
