“It’s been estimated that one-third of all pregnancies end in miscarriage,” says Brian Levine, MD, practice director of CCRM Fertility in New York City, and a board-certified obstetrician-gynecologist specializing in reproductive endocrinology and infertility. He also explains that this number includes miscarriages that occur very early on in pregnancy before someone realizes they are pregnant. For some, repeated miscarriages—also known as recurrent pregnancy loss—can occur. The American College of Obstetricians and Gynecologists defines this term as having two or more miscarriages. It is estimated that 1% of women experience repeated miscarriages. Sheena Dohnal, a mother of one daughter in Norfolk, Virginia, has experienced multiple pregnancy losses, along with a rollercoaster of emotions. “Having a total of six losses in less than three years left me with varying degrees of painful emotions,” she says. After each loss, her initial gut-wrenching pain and grief were followed by lingering questions. “Did I do something wrong?” she would ask. “Why is my body not capable of sustaining a pregnancy?” Here, learn more about the reasons behind multiple miscarriages, along with real stories about coping with loss, staying hopeful, and gaining the strength to continue on the journey to a healthy pregnancy.
Causes of Multiple Miscarriages
The most common cause of miscarriage is a chromosomal abnormality or an issue with the genetics of the pregnancy, Dr. Levine notes. “Unfortunately, this is something that happens at the earliest stages of development but may not be recognized until quite far along in the pregnancy,” he explains. While most will go on to have healthy pregnancies after a miscarriage, there are factors that lead to multiple occurrences, he adds. “If there is tissue left inside [i.e., not completely expelled], or there is a cause of the genetic abnormality, the miscarriage can be a cause or a symptom of a bigger problem,” Dr. Levine explains. Structural disorders of the uterus, such as fibroids, polyps, septums, or scar tissue, can also play a role in recurrent miscarriages. Dr. Levine shares that there is ongoing research showing that treating patients for endometriosis can improve embryo implantation and lead to positive pregnancy outcomes. “It’s unclear how endometriosis could or does cause miscarriage, but it’s definitely on my radar when a patient has a history of miscarriage,” he says.
Testing and Examination
The American College of Obstetricians and Gynecologists states that in 50–75% of those experiencing repeated miscarriages, no specific cause can be found. While clues may be present, there is typically no sure answer. That said, there are certain tests and exams that may be conducted to try and determine the root of the problem. This includes physical and pelvic exams, a review of your medical history, and blood tests to detect genetic causes or issues with your uterus or immune system. If a specific cause is determined, your healthcare professional may be able to provide treatment to help prevent future miscarriages.
The Emotional Impact of Multiple Miscarriages
As a perinatal, child, adolescent, and adult psychiatrist, Nicole Derish, MD, has spoken to a number of people experiencing multiple miscarriages. “It’s normal to experience a wide variety of emotions,” she says. “Sadness, anger, and disbelief are common, but oftentimes patients also mention feeling numb, detached, or even relieved in some cases.” She explains that some feel very isolated after a loss, which can have a significant impact on personal relationships. They may not be sure how to share it with others, or feel that others may not be able to relate to their situation.
Unnecessary Guilt
For Dohnal, each of her six miscarriages was followed by feelings of isolation, incompetency, and guilt. Ultimately, that guilt translated to a moment that would otherwise bring waves of excitement: telling her husband. “[I felt] guilty even telling my husband I was pregnant again, not wanting to ‘get his hopes up,” she admits. “[I felt like] I was a burden to him or anyone I [told] early on I that was pregnant. Every positive test left me feeling more anxious instead of feeling joyful.” Even in the midst of so much pain, she and her husband remained hopeful that one day they would be given their chance. “Hope came from wanting to try again, knowing I tried everything I could, [and] so I wouldn’t feel regretful later on in life.” She stresses the importance of reaching out to others, even when you don’t think you should. “I felt bad for needing support when I did have a loss,” she says. “[Thinking] I shouldn’t have told anyone and should suffer in silence was damaging to my self-worth and left me feeling like I didn’t deserve support.” In the end, she stayed motivated to continue on her journey. “Knowing that the possibility of having a full-term pregnancy and having our baby here someday was worth going through all of the pain.”
Finding Strength
Ashley Bowles, a mom of four children in Clarksville, Tennessee, was ultimately able to grow her family after an unspeakable tragedy: infant loss. “I’ve had two miscarriages and an infant loss, so I am no stranger to pregnancy loss,” she says. She explains that her firstborn died at 15 days old from being born prematurely, suffering from brain bleeds. She adds, “I give you that background because that unbearable loss helped me with the miscarriages that followed as we grew our family.” Following Bowles’s tragic loss, she was able to give birth to twin boys. After, she experienced another miscarriage. She reveals that she initially felt shock and disbelief that her body was “giving up” on the ability to carry a child again. Then the rush of emptiness from her infant loss set in. She describes it as a feeling of void: “Something was missing, and I am certain that is why we wanted to try again.” Her advice to others experiencing multiple miscarriages is simple but profound: it’s not your fault. “Having a miscarriage does not mean that you did anything wrong,” she says.
Additional Resources for Miscarriages
Dr. Derish offers her professional tips: “For those dealing with multiple miscarriages, my advice is to be kind and patient with yourself. Take time to heal, whatever that may look like for you. That might mean taking some time off work or bringing in extra help at home. There are times to give and times to receive, and this is a time to receive.” Derish recommends Postpartum Support International if you find yourself in need of additional support. “[It] is a wonderful resource for finding providers and support groups,” she says. “They have local volunteer coordinators that can help find resources in your area.” She also suggests the Miss Foundation, a reliable resource for loss and trauma. Bowles believes going to a compassionate doctor can make all the difference. “Find a good doctor to be in your corner,” she suggests. “My OB/GYN has been amazing throughout my entire process of pregnancy, infant loss, and miscarriages. That support has been one of the most important to me because receiving her guidance as a professional means a lot.”
A Word From Verywell
For those trying to conceive, a miscarriage can feel like a devastating loss. You are bound to feel a range of detrimental emotions, but they do not define you or your ability to conceive. Whether you have had one or multiple losses, reaching out to friends, family, and a trusted healthcare provider can make all the difference. Speaking with a healthcare provider can help you determine your path to pregnancy and parenthood.
