MISCARRIAGE is the most common complication of pregnancy, occurring in about one in five recognised pregnancies.
However, the impact of this experience on the woman and her partner may be underestimated and, unfortunately, misperceptions related to miscarriage abound.
A recent online survey of more than 1000 men and women in the US, investigating public perceptions of miscarriage, found that more than a third of people who had experienced miscarriage felt they had lost a child, and almost half felt guilty.
This highlights the fact that although miscarriage may be common, it is not an insignificant event. People experiencing miscarriage felt they had done something wrong and therefore contributed to their loss.
This study also confirms a widespread lack of understanding of the cause of miscarriage.
The majority of participants (76%) incorrectly believed that a stressful event could cause miscarriage, and almost two-thirds believed that lifting heavy objects could cause it. Other fears about causation included prior sexually transmitted infections and contraception.
The incidence of miscarriage was also underestimated, with 55% of respondents believing that miscarriage occurs in less than 6% of pregnancies.
The experience of reproductive loss, including miscarriage and infertility, is culturally and socially shaped. In Australia up to the 1970s, and even into the 1980s, issues related to pregnancy and parenting remained mostly within the private domain of families. The pregnant body was often viewed as embarrassing, and pregnant women had to leave their jobs.
Many women who experienced reproductive loss during this time grieved in isolation and in silence.
Since then, women have experienced both increasing autonomy and public dialogue in relation to their reproductive lives.
An interesting aspect of this public dialogue has been the increasing prominence of pregnancy and parenting in popular culture. This culture shift reached a tipping point in 1991 when Demi Moore posed naked during pregnancy on the cover of Vanity Fair magazine.
More than two decades later, magazine covers are dominated by references to “baby bumps”, babies and post-pregnancy bodies. This imagery mirrors public acceptance of pregnancy but also demonstrates new pressures on women to be idealised mothers who can maintain “sexiness” during and after pregnancy.
Parenting advice once provided by extended family members is now sourced from an almost infinite number of social media forums and support groups. This has led to the evolution of phenomena such as “oversharenting” — the oversharing of information about children and their milestones.
The boundaries of privacy in relation to raising children are now irreversibly blurred. Women experiencing reproductive loss may find it difficult to retreat from a world saturated with the “reproductive success” of others, which can compound feelings of failure.
The internet has also driven the rise of “wellness” bloggers and the growth of a new-age philosophy that promotes the idea that disease can be eradicated by commitment to specific foods or lifestyle choices. In the setting of reproductive loss, this is a particularly potent source of self-blame.
It is disappointing in this information age that misperceptions regarding miscarriage persist.
There is danger in believing that activities such as heavy lifting or stressful events could cause miscarriage. If these beliefs persist after pregnancy loss, it can amplify feelings of self-blame, lead to relationship difficulties and contribute to complicated grief, depression and anxiety.
It is therefore incumbent on clinicians who care for women experiencing reproductive loss to cut through this misinformation.
Women require validation of both the depth of their grief and the unique challenges of grieving in a world which is socially connected and in which motherhood is idealised. Incorrect beliefs about the cause of a miscarriage should be explored and explained, so that women and couples can be relieved of the burden of guilt.
This is a world that is more connected than ever before, and conversations relating to pregnancy and birth are more public. However, if misinformation regarding pregnancy loss remains prevalent, then that interconnection cannot provide all of the support needed after miscarriage.
It is what we, as doctors, say that can change the experience of pregnancy loss.
Dr Anne Coffey is a fertility specialist with Queensland Fertility Group and a senior clinical lecturer at James Cook University.
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