For many couples who conceive, the fear of miscarriage looms throughout the first trimester of pregnancy, and sometimes longer. Sadly, a miscarriage (the loss of a pregnancy <20 weeks), is a relatively common experience, occurring in approximately 1 in 4 pregnancies. A small number of women may experience recurrent miscarriages (defined as having had 2 or more miscarriages). Fewer than 5 in 100 women have two miscarriages in a row. When a couple experiences several recurrent miscarriages, further medical investigation is usually indicated. 

What are some causes of repeat miscarriage?

Though as many as half of women who experience recurrent miscarriages may never receive a definitive diagnosis or explanation for their losses, some causes for repeat miscarriage include:

– chromosomal and genetic abnormalities

– uterine anomalies

– hormonal imbalances, including thyroid disease and diabetes

– blood clotting disorders

Your specialist will offer a number of tests, including but not limited to physical evaluations of the uterus, sperm quality assessments, genetic testing, and blood panels. 

It is important to remember that, generally speaking, environmental factors and stress are not thought to cause miscarriage. Experiencing a singular or recurrent miscarriage is not your fault.

The treatment for recurrent miscarriage will depend on the underlying cause of the losses. Treatment may involve genetic counselling, prenatal genetic studies of each partner, and in-vitro fertilization (IVF) with preimplantation genetic diagnosis (PGD).

Even if no specific cause for recurrent miscarriage is found, the chances of having a successful pregnancy are good: About 65 in 100 women with unexplained recurrent miscarriages will go on to have a successful subsequent pregnancy.

How will experiencing recurrent miscarriages affect my mental health?

While the physical recovery from a miscarriage may only take hours or days, the loss of a pregnancy may be difficult to bear emotionally. For couples experiencing recurrent miscarriage, their grief may be compounded by hopelessness for ever having a successful pregnancy, anxiety over finding out a cause for their recurrent miscarriages, fear over trying to conceive again, and feelings of self-blame. Remember, miscarriages are almost never caused by anything you did or did not do.

There is no “right” way to grieve your miscarriage(s). Your partner may feel and grieve very differently from you do. Some people express their grief through talking, crying, or writing, while others may seek behavioural ways of coping (e.g. keeping busy, working on a project). While there is no one correct way to grieve, what is important is to communicate with one another about your feelings about the miscarriage and seek support if you’re having difficulty coping.

Check out the blog, “Pregnancy Loss Counselling and Support” for more information about the grieving process, what to expect, and seeking professional support

Each of us on the team at Sage Mental Health & Maternal Wellness knows how devastating and hopeless it can feel to experience recurrent miscarriages. If you’re feeling like it might be time to talk about your losses and get some extra support, please consider reaching out [email protected] to get matched with a maternal mental health therapist today.