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Understanding Miscarriage

Miscarriages are a devastating and mentally challenging event for women and couples. They’re often not talked about at all, or if they are, usually quite a while after the event. This can leave women feeling isolated, alone, depressed and often as a failure.

However this is not true and understanding why miscarriages occur is an important step in acceptance and in finding a solution.

Just to note, in this blog we have used the term miscarriage throughout for ease, however when a pregnancy ends before 24 weeks, it is know as a miscarriage, and for post 24 weeks it is considered a stillbirth.

So firstly, what causes a miscarriage?

For a baby to successfully reach full term there are a number of carefully orchestrated biological steps that must take place.

  • Fertilisation of an embryo between two healthy cells (the female egg and the male sperm)

  • Successful implantation of the developing embryo to the uterine wall

  • Adaptation of maternal physiology to accept the foetus, for example reduce immune response to avoid rejection of the foetus.

  • The mother’s ability to grow a placenta that can meet the foetus’ nutritional and physical demands

  • The ability of the uterus and cervix to hold the pregnancy

  • Appropriate growth of the foetus and timing of birth. This includes DNA and cell replication avoiding any congenital defects

At any one of these stages there is a risk, meaning there are many possibilities why a miscarriage can occur.

Reasons for miscarriage:

  1. Anatomical/Structural: Heart shaped uterus, incompetent cervix, uterine fibroids (10-15% of cases)

  2. Genetic defects: This applies to either the egg or sperm or both. Missing chromosomes or damaged DNA account for 60-80% of genetic defect miscarriages

  3. Blood clotting factors: Blood too thick or clotting

  4. Immune system issues: Body mistakes pregnancy as a foreign object and rejects the pregnancy

  5. Hormone imbalance: Low progesterone, hyper/hypothyroidism, diabetes, PCOS, high prolactin

  6. Environmental: Such as exposure to chemicals, x-rays or toxins, or drug use

  7. Weight: Being extremely under or over weight can also cause the pregnancy to be rejected. A safe BMI range is 20-25

  8. Infections: Rubella, STI’s, etc

  9. Unexplained reasons, accidence or violence

  10. Mental health: Anxiety, depression and PTS is strongly associated with miscarriage

1 in 4 pregnancies result in a miscarriage

1 in 100 women experience recurrent pregnancy loss

The risk of recurrent miscarriages unfortunately increases as women get older:

By 35 years of age it’s 9-12%

By 40, it’s 50%

Repeat pregnancy loss is diagnosed after 3 or more miscarriages are experienced.

What can the timing of a miscarriage reveal?

Before 4 weeks: Likely a thrombotic event, issue with the uterine lining, lack of progesterone, genetic defect within the embryo from either the egg or sperm, or oxidative stress

4-8 weeks: Majority of causes are genetic defaults as the embryo divides rapidly

After 8 weeks: At this stage, it is more likely a cause other than genetic, as the majority of chromosomal abnormalities are lost earlier.

What do you do if you think you’re having a miscarriage?

This depends on your stage in the pregnancy. If it’s within 4 weeks, you will likely mistake this as your period and can therefore wait for the tissue to past naturally.

If you know you’re pregnant, recommend contacting your GP or midwife. Again, depending on how far along the pregnancy is you will likely be advised the following:

  • Wait for the tissue to pass naturally

  • Medical management – a pessary is inserted to encourage the body to pass tissue

  • Surgical management with a suction device – this is called a Dilation & Curettage (D&C)

As with any medical concerns, if you’re concerned, worried or your symptoms are not dissipating contact or visit your GP or hospital immediately.

Support after a miscarriage is available

1 in 3 women who have suffered a pregnancy loss suffer post traumatic stress disorder. If you, a loved one, a friend or family member has suffered a miscarriage there are some great resources and charities that provide emotional support and help with grief including Petals, The Miscarriage Association and Tommy’s.

If you would like to reduce your risk of miscarriage, planning for a baby, or want to find out more about how nutritional therapy can support you conceiving, why not book in a free discovery call with Gail today.

There’s no commitment, and all calls are a private and safe space to discuss your concerns.


Gail Madalena

Registered Nutritional Therapist


Gail Madalena is a registered nutritional therapist specialising in fertility, pregnancy and women’s health. Her expertise lies in hormonal imbalances, such as irregular cycles, debilitating PMS, PCOS, endometriosis, thyroid issues and sub-optimal fertility. Her goal is to reduce hormonal side effects and symptoms by addressing the root cause of the issue. Gail helps couples optimise your nutrition and lifestyle choices, supporting you on your journey to achieving a healthy pregnancy.

I am not attempting to prevent, treat or cure any physical, mental or emotional issues. Do not disregard medical advice or delay seeking medical advice because of information you have read on this website. Do not start or stop taking any medications without speaking to your primary health care provider.


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