More than one in five pregnancies ends in miscarriage - around a quarter of a million in the UK each year. But many women still say they feel terribly alone when they have one. Here's our advice to try and help you get through such a hard loss

Sadly, miscarriages – the spontaneous loss of a baby – happen, and often. They can also happen to anyone, but unfortunately, women may feel a sense of failure, guilt or even shame, when they have one. Women who have suffered a miscarriage often have a lot of questions to ask, and are in need of strong emotional support. But the bottom line is that they need to know they can get through it.

It’s horribly common,” says Ruth Bender Atik, Director of the Miscarriage Association. “But often women don’t find that out until they’ve had one. Then, suddenly, other people tell them that they went through it too."

When do miscarriages happen?

Most miscarriages occur in the first three months of pregnancy - but they can happen up to the 24th week. Pregnancy loss after 24 weeks is known as stillbirth.

Physically there is obviously a huge difference between a miscarriage at seven weeks or one at 20 weeks, but the feelings of loss can be the same.

“The emotional experience doesn’t always tie in with the gestation,” says Ruth Bender Atik. “True, the physical experience is very different, but emotionally, it may be very similar.”

Why do miscarriages happen?

Any woman who is at risk of pregnancy is also at risk of miscarriage. But what’s important to remember is that your miscarriage is unlikely to have happened because of anything you did or didn’t do.

After suffering a miscarriage, many women (and their partners) will be desperate to find out just why it happened. They may blame themselves, or think that they did everything “right” and yet still suffered.

But it is usually very difficult to know the cause of a miscarriage, and unless you have, unfortunately, suffered from three or more losses (known as “recurrent” miscarriages), the medical services may not carry out investigations.

The main causes of miscarriage are thought to be

• Genetic – the baby does not develop normally, and cannot survive.
• Hormonal – women with very irregular periods may find it harder to conceive in the first place, and are more likely to miscarry when they do.
• Immunological – problems within the blood vessels which supply the placenta can lead to miscarriage.
• Infection – some illnesses or infections (such as Rubella - ‘German’ measles) can lead to miscarriage.
• Anatomical – if the cervix is weak, this may start to open once the uterus becomes heavier in later pregnancy. An irregular shaped uterus can mean there isn’t enough room for the baby to grow.

There has also been some recent research suggesting that underweight women are at a greater risk of early miscarriage. However, the new research also suggested that the risk can be reduced by taking supplements (particularly folic acid) and eating fresh fruit and vegetables.

What can I do?

Even after several miscarriages, most women have a good chance of a successful pregnancy, but that may not help you if you have just suffered one. You may feel depressed, guilty and very upset. All this is normal.

“Most people don’t get over it, they get through it,” says Ruth Bender Atik. "People often don’t talk about miscarriage, and it’s still something of a taboo. I’m not sure why that is – perhaps it’s general embarrassment when it comes to talking about negative things, or maybe it’s because we have a sort of general embarrassment in our culture about anything that goes wrong – especially with loss or grief."

Those who have suffered miscarriages need to know that whatever they feel, it’s a valid emotion.

• Some women will get through it quickly and others will take years.
• Some women will have suffered a miscarriage after years of IVF, and others will have got pregnant “by mistake.”
• Some will find they are jealous of those with babies, and others will want to spend time with babies.
• Some will want to talk about it, and some really won’t.
• But whatever your experience, you should listen to your own emotions.

What should I say?

If your friend/partner/sister/daughter has suffered a miscarriage, they will need support. However, they will not need comments that are supposed to be supportive, but actually show rather a lot of thoughtlessness.

Don’t say

Don’t worry, it was so early, it wasn’t a real baby yet.

At least you know you can get pregnant.

You’re young, you can have another one.

“People don’t mean to be cruel,” says Ruth Bender Atik. “But they need to know that they won’t make you feel better by minimizing your loss. For many people, it’s a very big deal. They might feel very sad, lost and full of grief for the baby that they wanted so much.”

What else should I know?

The physical process

In some miscarriages, the womb completely empties – in others, there may be some tissue remaining. You might then need a small operation called ERPC (or D&C).

You may also bleed afterwards, and have cramps. Contact your doctor as soon as possible if these get worse and not better.

In a later miscarriage, your breasts may stay larger and leak milk. Speak to your GP or midwife about this if you are concerned (paracetamol can help with the pain).

Trying for another baby

Most doctors suggest waiting until you have had at least one period before you start trying to conceive again. However, you should make sure that you are emotionally, as well as physically, ready.

Your partner

Your partner may also be suffering. Try and talk about what happened together. Remember that you may react in completely different ways – it doesn’t mean that one is “right” and one “wrong.”

Your children

You may want to think about telling them what happened, especially if they notice you are sad, and definitely if you had told them about the pregnancy. The Miscarriage Association have a useful leaflet to help with this.