Last week on our radio talk show (Talk Radio 1370 AM at noon each Saturday), we discussed a very frustrating problem of miscarriage. Losing a pregnancy in the first trimester is so common that health professionals may not realize how devastating the event can be to a couple. Approximately 15% of all pregnancies end in a miscarriage. In younger women, the incidence may be slightly lower; however, in older women it can exceed 50% of all pregnancies! The most common cause of a miscarriage at any age is a genetic abnormality of the embryo. Most physicians view this as “bad luck”. A genetic abnormality usually leads to poor development of the conceptus and eventually lack of support from the hormonal environment for the uterus to hold the pregnancy. Consequently, the pregnancy tissue is usually passed from the uterus. Other causes of pregnancy losses include structural problems with the uterus, hormonal insufficiency, and immunological problems.

Whatever the cause of a miscarriage may be, it is a true loss to the couple and not just a medical event. Even when the loss is very early, not requiring medical intervention, the couple still suffers the emotional toll of the miscarriage. Health professionals need to be aware of the significance of the impact of a miscarriage on a couple’s emotions. The emotional effects of this sad event not only vary from couple to couple, but also, may be different for the woman and the man. Although the man may be sad, the pregnancy is more nebulous to him and he may not have felt as connected to the pregnancy as the woman. He may not have noticed any changes in his partner because the woman usually does not show any dramatic physical changes in her body in the first trimester of pregnancy to remind him that she is pregnant, in contrast to the second and third trimesters of pregnancy. However, because the woman experienced the pregnancy, she commonly feels more stress from the loss and will probably need longer to grieve. Although a woman may be told by her gynecologist that she is ready to attempt pregnancy after one normal menstrual period, emotionally, she may not be ready that quickly and she may need more time. The couple will be better prepared to proceed with becoming pregnant again once they are able to complete their grieving.