While there’s still much that medical science doesn’t know about the causes and treatment of miscarriage, scientists have identified some of the major causes of these early pregnancy losses:

• Chromosomal abnormalities. Chromosomal abnormalities are thought to be responsible for approximately 60% of miscarriages. These randomly occurring genetic errors happen either prior to conception (if there’s a defective egg or sperm cell) or during the earliest stages of cell division. Researchers estimate that the incidence of congenital anomalies in new-borns would jump from 2-3% to 12% if miscarriage did not occur.

• Maternal disease. Certain types of health problems in the mother increase her risk of experiencing a miscarriage. These conditions include immune system disorders such as lupus, congenital heart, disease, severe kidney disease, uncontrolled diabetes, thyroid disease, and intrauterine infection.

•  Hormonal imbalances. Hormonal imbalances can also cause a woman to miscarry. If, for example, she has a luteal phase defect (her body does not secrete enough progesterone to sustain the pregnancy), she may end up miscarrying.

• Rhesus (Rh) disease. Rh incompatibility occurs when the mother’s blood is Rh-negative and the father’s is Rh-positive. If the baby has Rh-positive blood too, this can pose problems during their pregnancy. The mother may become Rh –sensitized if some of the baby’s blood cells get into her blood-stream, which can cause her to develop antibodies that may attack the baby’s red blood cells, leading to anemia and possibly even the death of the baby.

•  Immune system disorders. Immune system disorders are believed to be the cause of 5 to 10% of recurrent miscarriages. They occur when a pregnant woman’s immune system mistakenly concludes that her baby is an “intruder” and starts attacking the baby. Some forms of treatment are available.

•  Allogeneic factors. It’s also possible to develop to develop antibodies to her partner’s leucocytes (white blood cells), which can lead her to miscarry the baby that the two of you have conceived together. Sometimes this condition can be treated by immunizing her with either her partner’s or a third party’s leukocytes – a technique believed to trick your body into producing antibodies that prevent her body from rejecting the developing baby.

• Viral and bacterial infections. Viral and bacterial infections have been proven to play and role in miscarriage. Some of them are unlikely to recur during subsequent pregnancy while others are more likely to be a problem again (group B strep). Group B strep is more likely to be a problem during late pregnancy or during labor itself.

•  Recreational drug and alcohol use. Women who use recreational drugs or consume large quantities of alcohol during pregnancy face a higher-than-average risk of miscarriage.

• Exposure to harmful substances. Exposure to high-dose radiation, certain types of chemicals, chemotherapic drugs, cigarette smoke, and moderate to heavy doses of caffeine (more than five cups a day according to New England Journal of Medicine) may increase the risk of miscarriage.

•  Maternal age. A woman’s chances of experiencing a miscarriage increase as she ages. While women in their 20s have just 10% risk of miscarrying during any given pregnancy, the risk for women in their 40s is believed to be approximately 50%.

Men and Miscarriage

Many men feel that despite the sorrow a miscarriage causes, dealing with miscarriage have strengthened their relationship with their partner. You may feel that you and your partner are the only ones who truly can understand what it is to cope with the emotions associated with pregnancy loss and that this can provide your relationship with a more intimate bond.

However, miscarriage can put a strain on even the strongest relationships. You and your partner will often express your grief differently; for example, you may feel angry while she may feel sad, or you may wonder why it’s taking your partner so long to come to terms with the miscarriage, while she may feel anxious as to why life hasn’t gotten back to normal yet. This can create tension in your relationship as you both struggle to come to terms with the causes of the miscarriage and attempt to deal with the ensuing grief.

In addition, sexual intimacy is also often affected by the loss of a baby. While you may feel that intercourse is a way in which to provide your partner with affection and comfort, your partner may not feel emotionally or physically ready, or vice versa. In many cases, both individuals in the relationship associate sex with pregnancy and therefore another potential miscarriage, or you may feel guilty for thinking of your own happiness while dealing with miscarriage grief.

Women and Miscarriage

The general rate of depression in women is about 10-15%. After miscarriage, this rate is reported to be 22-55% and takes 12 months to return to the baseline rate of depression in the general community. The highest risk time for depression is the first 12 weeks after a pregnancy loss. Risk factors for developing clinical depression include previous depression, the further along in pregnancy that the loss occurred, a history of substance or alcohol abuse, a poor support system and a history of poor coping skills.

If a woman had a miscarriage, it can be one of the tougher emotions you have to deal with. None of us exists in a vacuum. Inevitably, after her miscarriage, at some point, she will bump into a pregnant woman or someone with a baby. Seeing that blossoming belly or that adorable baby can trigger real jealousy if she's had a miscarriage. Her jealousy can be directed towards other women, family members, even friends, who are pregnant or mothers. While these emotions can be appalling, they will eventually pass and fade. Community rates of generalized anxiety or panic disorder are about 3-5% in women. In the first 12 weeks after a pregnancy loss, 22-41% of women demonstrate these problems. As with depression these rates tend to return to baseline community rates within 12 months. Compulsive behaviors may increase during this time. Women who have had previous pregnancy loss are at greater risk of developing depression and anxiety in subsequent pregnancies.

Sadness, mild depression, guilt, anger, fatigue and somatic complaints are common to both grief and to a clinical depression. Grief will result more in disbelief, feelings of failure as a woman, and searching for meaning or the loss, while major depression has strong feelings of worthlessness, early morning awakening and persistent suicidal thoughts. Specific symptoms that require medical intervention include:

• serious or persistent suicidal thoughts
• significant feelings of worthlessness
• terminal insomnia - falling asleep ok but awakening predawn with increased anxiety or abnormal fear
• significant physical listlessness or agitation
• marked daily functioning difficulty - not eating, not bathing, unable to work or care for children
• prolonged symptoms (greater than one year)
• drug or alcohol abuse or significant increase in use
• increased jealousy or hidden feelings of anger towards other couples or mothers.