Miscarriage – Why does it happen to me?

When parents lose a child through a miscarriage, it is one of the most painful things that can happen to them. For couples who learn of the loss of their child, it is initially unimaginable how they will be able to cope with the difficult journey that now lies ahead. Obstetricians estimate that at least one in five pregnancies ends in miscarriage, though the actual number is likely higher. Yet even though so many women are affected, miscarriage remains a taboo subject even today and is rarely discussed, either in private or in public.

The moment a couple holds a positive pregnancy test in their hands, the silence often begins. But isn’t the joy so great that you just want to tell everyone right away? Doctors, however, often advise waiting, because the risk of miscarriage is known to be highest in the first twelve weeks. Yet life has already begun, and the couple loves the unborn child from the very start, making plans and preparing for a future together. Why should it be easier to lose a child before the 12th week of pregnancy than later? If a miscarriage does occur, most women and couples keep the devastating loss to themselves, withdrawing further and further, feeling lonely and empty. In their deep grief, they feel neither understood nor adequately supported by those around them or by doctors. For those affected, silence is often unbearable. Denying a miscarriage and keeping the grief to oneself often only makes it worse. We hope for more openness and sharing among one another! Many couples who eventually speak publicly about a miscarriage hear surprising confessions from loved ones who have gone through similar experiences. This gives strength, courage, and hope, because you are not alone!

Background

80% of all miscarriages occur during the first 12 weeks of pregnancy and are referred to as early miscarriages. The risk of losing the baby is highest at the beginning of every pregnancy and decreases as the pregnancy progresses. The most common miscarriages occur by the 4th or 5th week of pregnancy.  Medical professionals estimate a rate of up to 50% during this period. In the past, women often did not even know they were pregnant at this stage. Today, pregnancies are often planned well in advance, and women know very early on that they are expecting a child. Thanks to sensitive modern technology, a heartbeat can now be detected on an ultrasound machine as early as the sixth week. By this point at the latest, pregnant women form a close bond with the developing child. Between the 6th and 8th weeks of pregnancy, the risk of miscarriage drops to approximately 18%; from the 17th week onward, the risk of miscarriage falls to just 2–3%. If a miscarriage occurs after the 16th week of pregnancy, doctors refer to it as a late miscarriage. The fetus is generally not yet viable outside the uterus before the end of the 22nd to 24th week of pregnancy and when weighing less than 500 grams.

Why me?

The causes of early miscarriage up to the 12th week of pregnancy are usually serious chromosomal abnormalities in the embryo, abnormal cell division, malformations, infections, and many other factors. Luteal insufficiency or immune reactions—that is, the mother’s immune system rejecting placental tissue—can also be causes. However, women are not sufficiently informed about the causes of miscarriage and blame themselves severely: If only I hadn’t gone jogging! If only I hadn’t carried that heavy shopping bag! But: It’s not your fault! Early miscarriage is a “protective mechanism” of nature when the embryo would not have been viable. Every pregnancy is a miracle of nature and a highly complex process.

What happens next?

In Germany, once fetal death is confirmed in the early weeks of pregnancy, a dilation and curettage (D&C) is typically performed. This is a surgical procedure in which the fetal tissue, the placenta, and the uterine lining are removed. However, there are other options as well: accelerating the expulsion of the fetus using a medication that induces labor, or waiting until the body naturally expels the embryo on its own. In any case, you should seek information and advice from your treating gynecologist. The choice between these options, which in some cases could make the conscious process of saying goodbye and the grieving easier, can be crucial for women. From the 16th week of pregnancy onward, the baby is usually born through a normal delivery. Even though cesarean sections have become significantly safer today than in the past, they still carry a higher risk for the mother than a natural birth. The potential consequences for a future pregnancy and birth should not be underestimated either. Giving birth to the child step by step with each contraction, using one’s own strength, makes the farewell “tangible” for many mothers. This so-called “silent birth” and the early farewell to the child will remain unforgettable for the parents.

After a miscarriage, a woman experiences a rapid drop in hormone levels. This can further intensify the grief. In the days and weeks that follow, it is especially important to take care of yourself until your body has recovered and the physical healing process is complete. To come to terms with this life-changing experience, it is now particularly important to talk openly with your partner about your feelings, fears, and concerns regarding your relationship.

Places of Mourning

Many parents often feel a deep connection to their deceased child for the rest of their lives. Consciously planning a farewell can help make the loss more bearable and give them renewed courage. Couples can sometimes cope better with their grief if they have a place to mourn where they can return at any time. Today, most states recognize the right to a burial for both early and late pregnancy losses if the parents so desire. Farewell rituals and burial ceremonies can be a comforting and profound experience. At the same time, they can help in finding new strength. Small mementos, such as ultrasound images or baby clothes that have already been purchased, can also help with the grieving process. Not all parents are able or willing to bury their child individually—for example, if they lost the child very early on. In such cases, it is usually possible to have the child buried by the hospital.

You’re not alone!

A miscarriage is an emotionally devastating experience for the woman and the couple. The number of women who have experienced a miscarriage is high. However, this also provides an opportunity for women and parents who have gone through similar experiences to share their feelings and thoughts. Many women find it helpful to connect with others in self-help groups. Social media platforms can also bring together women with similar experiences—often anonymously—to share their stories, grieve, and remember.

Throughout Germany, there are psychologists, independent support groups, and organizations that offer assistance and support to those dealing with grief. Accept help! Midwives can also provide support in cases of pregnancy loss. Health insurance often covers care by a midwife in the event of a miscarriage before the 24th week of pregnancy. Above all, however, it takes time for emotional wounds to heal. Anyone who cannot overcome their grief or develops significant fears about a new pregnancy should still seek psychological help.

Useful links:

• Regebogen Initiative “Unfortunate Pregnancy, Inc.” – www.initiative-regenbogen.de/
• What rules are currently in effect – Familienportal.de
• Counseling, support groups, and more – www.Eltern.de