The findings of a new survey investigating American's knowledge of miscarriage and its causes reveals there are widespread misperceptions about the condition.
Only 45% of respondents with a history of miscarriage received adequate emotional support from health care professionals.

Dr. Zev Williams, director of the Program for Early Recruitment and Pregnancy Loss (PEARL) at Yeshiva University's Albert Einstein College of Medicine and Montefiore Medical Center - both in New York, NY - and colleagues publish their findings in the journal Obstetrics & Gynecology.

According to Dr. Williams, miscarriage is a "traditionally taboo" subject that is rarely discussed in public. "We initiated this survey to assess what the general public knew about miscarriage and its causes and how miscarriage affects them emotionally," he adds.

Miscarriage is defined as the unexpected loss of a fetus prior to the 20th week of pregnancy. More than 1 million miscarriages occur in the US annually, with the condition ending 1 in every 4 pregnancies.

The majority of miscarriages are caused by chromosomal abnormalities that prevent the fetus from developing. There are a number of other possible causes, however, including hormonal problems, abnormalities of the female reproductive organs, smoking, obesity and substance abuse.

Most miscarriages occur before a woman realizes she is pregnant. Among women aware of their pregnancy, the miscarriage rate stands at around 15-20%, with the majority occurring in the first 7 weeks of pregnancy.

Widespread belief miscarriages are rare, primarily caused by lifestyle choices

The survey compiled by Dr. Williams and colleagues consisted of 33 questions - 10 of which applied solely to men or women with a history of miscarriage.

Using Amazon.com's crowdsourcing web service, MTurk, the team posted the survey online. Over a 3-day period in 2013, the team gathered 1,084 valid survey completions.

The surveys were completed by anonymous adults aged 18 and older from 49 US states, of whom 45% were men and 55% were women. A history of miscarriage was reported by 15% of respondents.

Respondents' gender, age, geographical location and household income mirrored 2010 national census statistics, according to the researchers.

One major finding of the survey was that - despite miscarriages being the most common of all pregnancy complications - 55% of respondents believed they were "uncommon" - defined in the study as occurring in less than 6% of all pregnancies in the US.

Twenty-two percent of respondents believed that lifestyle choices during pregnancy - such as smoking and substance abuse - are the primary cause of miscarriage, when 60% are actually caused by chromosomal abnormalities. This misperception was more common among men and less-educated individuals.

The survey also revealed that 74% of respondents incorrectly believed long-term stress or a stressful event can trigger miscarriage, while 64% thought it could be caused by lifting heavy objects.

Forty-one percent of respondents believed a miscarriage can be caused by a sexually transmitted infection, while 28% linked it to prior use of an intrauterine device (IUD), 22% thought oral contraceptives could cause miscarriage, and 21% thought it could be triggered by getting into an argument.

Many miscarriage sufferers feel guilt, shame and loneliness

Among men and women who reported that they or their partner had experienced a miscarriage, 47% said they had feelings of guilt, 41% felt they had done something wrong, 41% reported feeling alone and 28% said they felt ashamed.

What is more, only 45% of these respondents said they felt they received adequate emotional support from health care professionals.

However, 28% of respondents with a history of miscarriage said celebrities reporting a miscarriage helped ease their own feelings of loneliness, while 46% said a friend revealing a miscarriage made them feel less alone.

Among all respondents, 36% said they felt experiencing a miscarriage would be "extremely upsetting" and on a par with losing a child.

Eighty-eight percent of respondents said they would want to know the cause of a miscarriage if it could help prevent another, while 78% said they would want to know the cause even if this were not the case.

The researchers believe their findings emphasize the need for greater education about miscarriage among the general public. Dr. Williams says:

"The results of our survey indicate widespread misconceptions about the prevalence and causes of miscarriage. Because miscarriage is very common but rarely discussed, many women and couples feel very isolated and alone after suffering a miscarriage. We need to better educate people about miscarriage, which could help reduce the shame and stigma associated with it."

"We want people who experience miscarriage to know that they're not alone," he adds, "that miscarriages are all too common and that tests are available to help them learn what caused their miscarriage and hopefully to help them in subsequent pregnancies."

In February 2014, Medical News Today reported on a study linking passive smoking to increased risk of miscarriage, stillbirth and ectopic pregnancy.

Written by Honor Whiteman