Missing What You Never Knew You Had

Obie Editorial Team

When my next door neighbor told me she had suffered a miscarriage, I wasn’t sure how to react. I hadn’t even known she was pregnant, so the announcement came as a complete shock. It turned out, she had not known she was pregnant either. She had only discovered her pregnancy when the emergency room doctor confirmed that her sudden abdominal cramping, dizziness, and heavy bleeding was, in fact, a miscarriage. I couldn’t even imagine how she was feeling. What was it like to discover you had lost a baby you didn’t even know you were carrying? How often does this happen?

There are some terms associated with early pregnancy that, to many women, seem very dry and insensitive. One is “chemical pregnancy.” This is a term applied to pregnancies that occur before an ultrasound would be able to detect a gestational sac, but after small levels of hCG, the pregnancy hormone, can be detected. To qualify as a “chemical pregnancy,” the miscarriage must have occurred prior to or during the fifth week of gestation. Despite implications of the term, chemical pregnancies are, indeed, pregnancies. There was a conception, but for one reason or another, the fertilized egg did not implant in the uterus. Researchers estimate as many as 70% of conceptions end in this form of very early miscarriage. Most of these go completely unnoticed, as women who are not actively trying to get pregnant are unlikely to take a pregnancy test before or in the few days after a missed period, and these miscarriages result in bleeding within a few days of the expected date. Most women simply believe they were a couple of days late, and may actually get their periods on time.

When a pregnancy goes beyond the fifth week, it is then considered a “clinical pregnancy.” Miscarriages between the fifth and twelfth weeks of pregnancy are termed “early miscarriages.” It is thought that somewhere between 20 and 40% of pregnancies end in miscarriage, which is loss up to 20 weeks of gestation, with the vast majority occurring within this first 12 weeks. Women experience a wide range of emotional responses to miscarriages. Though some are able to move beyond a chemical pregnancy quickly and relatively easily due to the earliness of the loss, many others experience deep distress. Studies have indicated as many as 44% of women who experience known miscarriages are still experiencing clinical levels of negative psychological symptoms several months after the loss, and many will hold this grief for the rest of their lives. Links were not made between the severity of these emotions and the length of the pregnancy, desirability of the pregnancy, time since the loss or demographic.

Source: Jackman, Catherine, et al. The Experience and Psychological Impact of Early Miscarriage, The Irish Journal of Psychology, Volume 12, Issue 2, 1991.