Women and men have incorrect understandings about why miscarriages occur, with many people blaming miscarriages on a woman’s behavior at the beginning of pregnancy, including her use of contraception.
That’s according to a survey released earlier this month in the Journal of Obstetrics & Gynecology, which asked men and women to identify the causes behind miscarriages and questioned those who had experienced a miscarriage about their emotions. Couples who had experienced a miscarriage reported feeling guilty and ashamed.
Researchers surveyed more than 1,000 people ages 18 to 69. The respondents—55 percent of whom were women and 45 percent men—were from 49 states and represented a cross-sectional sample of adults nationwide. The researchers defined miscarriage as a pregnancy loss before 20 weeks.
Fifteen percent of respondents said that they or their partner had experienced a miscarriage.
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Respondents were first asked how common miscarriages were and most had very low estimates. The majority (55 percent) thought miscarriage were uncommon and estimated they occurred in less than 6 percent of pregnancies. Another 10 percent estimated that miscarriages occurred in less than 2 percent of pregnancies.
Health professionals say the percentage of pregnancies that end in miscarriage is between 15 and 25 percent. It is hard to know, in part because many of these occur so early in pregnancy that a woman might not know she had been pregnant.
When asked about what causes miscarriages, respondents had some correct information, but much of what they thought they knew was not in fact true.
A majority of participants (95 percent) knew that miscarriage could be caused by genetic problems and almost three quarters (74 percent) correctly identified genetic or other health problems as the cause of most miscarriages. Still, 76 percent of survey respondents incorrectly thought miscarriage could be caused by stress, 64 percent by lifting heavy objects, 41 percent by a past sexually transmitted infection (STI), 28 percent by past use of an intrauterine device (IUD), 28 percent by past use of the birth control pill, and 21 percent by arguing.
Moreover, 22 percent believed that use of alcohol, drugs, or tobacco were the most common causes of miscarriage.
The truth, according to the researchers, is that an estimated 60 percent of miscarriages are caused by chromosomal abnormalities in the embryo that would have prevented it from growing to full-term. As Dr. Zev Williams, an obstetrician who works with women suffering multiple pregnancy losses and one of the survey researchers, told ThinkProgress: “For the routine healthy woman, miscarriages aren’t being caused by anything she’s doing. If stress or aggravation or lifting something heavy caused miscarriage, none of us would be here today.”
The perception that a woman could have changed the fate of the pregnancy had she only behaved differently in the early days may be one reason why miscarriages are so hard on couples. The survey found that among those women and men who had experienced a pregnancy loss, 47 percent felt guilty, 41 percent felt that they had done something wrong, and 28 percent felt shame. In addition, 41 percent said they felt alone and only 45 percent felt they did not receive adequate support from the medical community. Moreover, 38 percent said they felt personally responsible.
Researchers believe education about miscarriage needs to improve—a change that could help people better handle pregnancy and pregnancy loss.
“The results of our survey indicate widespread misconceptions about the prevalence and causes of miscarriage,” Williams told ScienceDaily. “Because miscarriage is very common but rarely discussed, many women and couples feel very isolated and alone after suffering a miscarriage. We need to better educate people about miscarriage, which could help reduce the shame and stigma associated with it.”
One positive change could be helping women understand the cause of their own miscarriage. The majority of participants (78 percent) said that if they had a miscarriage they would want to know what caused it, even if that information would not help them sustain future pregnancies. Knowing the medical reason behind a miscarriage could help prevent self blame.
Among participants who’d experienced a miscarriage, those who had learned the cause were 19 percent less likely to report feeling guilty. Fifty-seven percent of participants who’d experienced a pregnancy loss never learned the reason behind it.
“We want people who experience miscarriage to know that they’re not alone—that miscarriages are all too common and that tests are available to help them learn what caused their miscarriage and hopefully to help them in subsequent pregnancies,” Williams said.
Williams has even more basic changes in mind. He pointed out that obstetricians often tell women not to share the news of their pregnancy until after the first trimester when the risk of pregnancy loss goes down. This advice, however, may put couples in a position in which they do not have the support of families and friends if they do face a miscarriage.
Williams suggested a better way of handling the situation might be unfiltered honesty with newly pregnant women.
“Maybe we should be giving them the information and just saying—you’re pregnant, congratulations, but I just want you to know there’s a 25 percent chance of having a miscarriage,” he said. “We could give that education before a miscarriage happens.”