'Women need to know it's not their fault': What actually causes a miscarriage

Counties Manukau DHB Perinatal Loss Midwife Specialist Debbie Davies says she’s never sat with a couple who haven't questioned "what if" after a loss.

"For many parents they’ll question and think through all of what they have and haven’t done in the pregnancy and try to find a reason. But in just about all cases - it’s nothing you’ve done," says Davies.

She says women need to know it’s not their fault.

Her colleague - specialist obstetrician/gynaecologist, Dr. Sarah Corbett agrees.

"Even if people don’t say 'was it because I did this or that?' I’ll always address it because I know they’re thinking about it. But I reassure them it was nothing they did," she told Newshub. 

"There’s no evidence that things like physical activity, cleaning the floor, lifting, sex, jogging and short-term stressful events cause miscarriages."

Dr. Corbett says the most common reason miscarriages happen is because of chromosomal abnormalities.

"It’s not usually to do with the parents chromosomes but most of the time it’s to do with the process of the egg and sperm dividing and making cells and in that process there can be errors." 

The Middlemore Hospital specialist says other factors can also play a part including certain viral infections such as CMV or it can be to do with a medical condition in the mother like uncontrolled diabetes or clotting disorders.

"There can be issues with the uterus in terms of different configurations of the uterus and then there’s things like obesity, age and smoking which can also have a link to miscarriage," she says.

Busting the myths: Women's health specialists reveal what causes a miscarriage
Busting the myths: Women's health specialists reveal what causes a miscarriage Photo credit: Getty Images.

With around one in four pregnancies ending in miscarriage, Davies says women need to know it happens more frequently then they realise.

But despite it being common she says that for many the loss is enormous.

"For most parents, a miscarriage is a loss of a baby rather than the loss of a pregnancy and that needs to be acknowledged.

"Comments like 'it wasn’t a real baby' or 'thank God you weren’t further along' - those are not helpful. Because in the parents eyes this was a loved and wanted baby and they’re often grieving the hopes and dreams of their baby as well as their baby."

However, Davies says as a society we are generally becoming more aware of the grief that comes with miscarriage which wasn’t the case 30-40 years ago.

She says back then many babies that were lost in pregnancy weren’t really acknowledged as a loss and that parents weren’t allowed to see the baby once it had been delivered.

Dr. Corbett says some miscarriages aren’t immediately clear cut and that there can be a waiting period before more tests are done to see if a woman has actually miscarried or not.

"In some cases it might be too early to see a heartbeat and if we haven’t seen one then that doesn’t necessarily mean the baby isn’t alive. Often it’s a matter of waiting a week for another blood test or another scan. It’s not always clear cut. But that’s a long and hard wait for many people."

Dr. Corbett says some women can also have very little knowledge of the physical aspect and how challenging it can be.  

"When a woman miscarries, the cramps, nausea, diarrhoea and bleeding can be a lot more than they were expecting. We definitely see women with heavy bleeding in the emergency room."

She emphasises that it is normal for women to have some type of light bleeding for up to two weeks after a miscarriage.

In terms of how miscarriage is managed, Dr. Corbett says most women opt for either the medication or the surgical procedure - Dilation & Curettage.

"Usually people have an idea of what choice they want - be it surgery or medication.  Other people will know straight away and for those who are unsure - we will do our best to guide them.  It’s a complete mixed bag."

Davies says the fact miscarriage isn’t really talked about means so many women don’t know what to expect.

"You have nothing to compare it to.  It’s only if you experience it yourself that you discover a lot more people who have been through the exact same thing.  It’s important because it makes you realise you’re not alone."