As you can see by the posts on this page, we’ve been a little radio silent for a few weeks. I wanted to address that, as it gives me a chance to talk about something very important for women’s health.

A few weeks ago, someone very dear to me experienced the miscarriage of her first pregnancy. I was the main support person for them, and the rollercoaster of emotions and crippling grief were things I had never expected; it’s something people never really talk  about during first time pregnancies.

I think what shocked me the most is just how common it is, but because it is just something that my best friend described to me as “an unspoken evil”. You truly don’t realise the levels of risk, the number of women who experience this, the causes behind it, and most importantly the resources available and the positives that women and their partners can take away from this emotionally crushing experience.

One of the most important things for women to understand is just how common a miscarriage is. There has been a great deal of studies done about miscarriage. The figures show that the risk of miscarriage right after conception is anywhere from 22 up to 75%. The higher end of these numbers reflects a failed implantation.

Miscarriage Risk By Week And What The Figures Tell You

The Stats From Week 3 And On

Gestational week (completed)	All healthy women	Healthy women, one live embryo seen on ultrasound
	% risk of miscarriage	% risk of miscarriage
3-4 weeks	22-75%	n/a
5-8 weeks	10%	n/a
6 weeks	n/a	9.4%
7 weeks	n/a	4.2%
8 weeks	n/a	1.5%
9 weeks	n/a	0.5%
10 weeks	n/a	0.7%
8-14 weeks	5%	n/a
2nd trimester	3%	n/a
3rd trimester	1%	n/a

References: Tong S, Kaur A, Walker SP, Bryant V, Onwude JL, Permezel M. Miscarriage risk for asymptomatic women after a normal first-trimester prenatal visit. Obstet Gynecol. 2008 Mar;111(3):710-4. Wilcox AJ, Weinberg CR, O’Connor JF, et al. Incidence of early loss of pregnancy. N Engl J Med. Jul 28 1988;319(4):189-94. http://pregnancyloss.info/statistics/

In the above table, the n/a markers simply indicate that the data represents that, in the first 8 weeks, the pregnancy is not officially termed as an embryo until that point, which is why we switch columns.

As we move further along towards the 6-10 week mark, there are a myriad of issues that can arise. One such being known as an ectopic pregnancy. This is where the embryo has not left the ovary and firmly taken inside the uterus. Even if this happens, we are by no means out of the woods and the risks haven’t lowered until you are a few weeks in to the second trimester of pregnancy, usually around the 20 week mark.

Generally speaking, the most common statistic that you are going to hear is that 1 in 5 of all “known pregnancies” will end in miscarriage, and an OB/GYN will tell you that you’re in good company since this is quite a common occurrence for women. This will, however, provide cold comfort –  well, actually zero comfort whatsoever, if we are being honest. You will be assured that it is nothing that you caused or contributed to in any way, but that will not stop you from playing the blame game or help ease your sadness. In any known pregnancy where you have been planning and hoping for a child, the mother will almost immediately form an emotional bond with the life beginning to take shape inside them. If you do have a miscarriage, the first thing that is going to cross your mind is what caused it (this is where almost every answer will result in you blaming yourself) and what you need to do next time to stop it from happening again. If only we mere humans possessed such powers.

Women face all sorts of risk factors and I would love to be the one to tell you that there was some magic cure-all answer  that allowed you to breathe easy about the success of your pregnancy. Some women find that they have low levels of progesterone. While not a definitive factor, it can play quite a role in determining the success rate of entering your second trimester.

Progesterone, for the non-medically qualified (like myself), is one of the hormones in a woman that regulates various aspects of your system and assists in maintaining a pregnancy. One of the most important functions of progesterone is to stimulate the growth of the uterine lining (endometrium), as well as preparing it to nourish an implanted fertilised egg.

In dealing with this experience, and I think in many ways to assist in coping with my own grief, I reached out to a lot of women in my life who are mothers and I spoke to them about what they had gone through. Of the women I spoke to about their experiences, one of the most heartbreaking things that I had said to me was that when she had a miscarriage, she felt that somehow, she had failed her “primary function” as a woman. She was aware within herself that this was not the case but that she couldn’t keep that thought from entering her mind.

If you take any message away from this article at all, it’s that a miscarriage is not your fault nor were you the cause in any way. There is no evidence to suggest that a miscarriage is the result of exercise, stress, working or any of your normal day-to-day  activities.

High fever can result in a miscarriage, but this is only in some cases and is not definite. Should you find yourself with the common cold during winter or even a stomach bug, there is no evidence to suggest this raises your risk factors at all. Of course, if you are concerned at any stage, I would recommend consulting with your doctor or OB/GYN if you already have one. Keep in mind that even in the very healthiest of women, a miscarriage can occur;  please don’t let any minor health factors give you cause for concern. If a doctor isn’t worried, then you probably shouldn’t be either.

If you do have a miscarriage, then once you have grieved and taken time to heal physically and mentally, I would like for you to relax about your next attempt. Easier said than done right? However, there is some solace to be taken. Dr Henry Lerner (Clinical Professor of Obstetrics – Harvard Medical School) wrote in his book that “Since you got pregnant once, the odds are 80% that you will go on to have a healthy baby, and as many babies after that as you want” (source: Miscarriage: Why it happens and how best to reduce your risks). He also concurs with the generally held consensus that “the majority of the time, a miscarriage is a random, isolated event and we can’t pinpoint a cause”. So, even medical professionals who are widely recognised as esteemed experts in their field  cannot say conclusively that there is any attributable cause to a miscarriage, which confirms that you really need to accept the fact that you are not to blame, no matter how hard any voices in your head may wish to tell you otherwise.

From this experience and talking with the women in my life, the questions that came up during this period for me and that I believe need to be more widely asked including:

• – How supportive our workplaces in such a delicate time are?
• – Are there adequate if any provisions for spousal or partner leave from their workplace?
• – Should there be ‘reproductive’ (including IVF, miscarriages, Doctor’s appointments, complications etc) leave built in for both men and women as part of ‘flexible working arrangements for family’?

The patient in my scenario required two full weeks off work. Now fortunately, she happens to work for a very understanding employer who was more than generous with their time and support. However not ever woman is so fortunate. The last thing any woman really wants to advertise to their employer is that they are experiencing a distressed pregnancy or heaven forbid a miscarriage.

The medical professionals, from doctors to midwives, all recommend extended time away from work at first to look after your health during a complicated pregnancy so that you stand the best chances of potentially saving your child, and then if that doesn’t work out, it is absolutely crucial that you take the time to properly grieve with your significant other and members of your extended support network. During such a difficult time when you are grieving a loss, there should be the option available for a partner as well to take the time to spend with you in order to heal as a family. These are questions we need to raise and to be honest, I am dismayed that I even need to wonder if these are policies.

Admittedly, we face an uphill fight having things such as mental health and family emergencies recognised as being a hard reality that must be dealt with and must be allowed for in the workplace. A happier and more balanced employee has been repeatedly shown to pay incredible dividends to the bottom line for every company.

Should you experience a miscarriage, do not play the blame game with yourself. I know that is far easier said than done. I know that I personally blamed myself when this miscarriage was complete, somehow thinking I hadn’t done enough to help, be at enough medical appointments or take the signs seriously enough by racing everyone off to a hospital at the first symptom of heartburn.

Take solace in your family and friends, should this grief visit your life. There are some wonderful resources available to you and help you to cope, and realise that this isn’t where your pregnancy journey ends by a long shot.

The following organisations can be of assistance:

SANDS – Miscarriage, Stillbirth and Newborn Death Support (www.sands.com.au) (1300 072 637) Available 24/7, 365 days a year. A volunteer is always on hand and they even have a support line for men/dads.

Queensland Centre for Perinatal and Infant Mental Health (www.childrens.health.qld.gov.au/qcpimh)

Beyond Blue (www.beyondblue.com.au) (1300 224 636)