By Alice Callhan

The Washington Post

When my husband and I first decided to try to have a baby, I looked forward to the exciting time. I was not prepared for a miscarriage.

How could I have known what it would be like? Pregnancy was a frequent topic in my high school health class, but the teacher made it sound like unprotected sex created instant babies. In my undergraduate physiology courses, my professors described in detail the intricate steps leading up to the fertilization of an egg and then the development of a fetus, but they didn’t emphasize how common it is for those steps to go awry.

When a friend had a miscarriage, I gave her a big hug and said I was sorry, but we didn’t really talk about the details. I didn’t know how to ask. So, like most people, I knew basically nothing about miscarriage until it happened to me.

This silence means that many couples are blindsided by miscarriage. We don’t know what to expect, what it means for the future, or why losing something so small makes us feel so sad. If we knew more about miscarriage, we’d be more prepared to cope with a loss — our own of a friend’s.

I ended up having five early pregnancy losses and two healthy babies. I feel lucky to have this family, but I think knowing a few things about miscarriage would have made the path a little easier:

1.You are not alone. Miscarriage is the most common pregnancy complication, ending as many as 30 percent of all pregnancies. Yet many Americans grossly underestimate it. A 2015 study found that 55 percent of U.S. adults believed that miscarriage occurs in 5 percent or fewer pregnancies. That discrepancy in the perceived and actual incidence puts an unfair burden on couples grieving a loss, making them feel more alone. You likely have close friends and family members who have experienced miscarriage, but they may have kept it to themselves.

2. It’s not your fault. That same 2015 study found that Americans blame miscarriage on many things, but they’re often wrong about that, too. People thought that a stressful event, lifting heavy objects, having an argument, or past use of oral contraception or an IUD could cause miscarriage. One in four respondents even believed that “not wanting the pregnancy” could cause it to end. I’ve also heard that yoga poses, foot massages, riding a bike, and even eating gluten can cause miscarriage. Of all of these cited causes, none are true and, incidentally, all blame the mother. Instead, most miscarriages are caused by chance chromosomal abnormalities. In the vast majority of losses, there was nothing the mother could have done differently to prevent it.

3. It can be helpful to share your sad news. When I had my first and second miscarriages, both very early in pregnancy, I didn’t tell anyone except for a handful of close friends and family members. Meanwhile, I opened my Facebook feed every day to see new pregnancy and birth announcements from friends, complete with ultrasound images of healthy fetuses and photos of red-faced newborns cradled in their parents’ arms. There seemed to be no space for my news of loss. Yet, over the years, I didn’t hesitate to pay tribute to other lost loved ones on Facebook: A note honoring the anniversary of my father’s death, a special photo of my aunt, who was dying of cancer, and even a RIP message when our beloved cat died. Why are we afraid to share miscarriage?

After our third miscarriage, I was tired of feeling alone with the grief, so I wrote a blog post about it. This wasn’t easy to do. Telling the world that my body had somehow failed and I was hurting made me feel uncomfortably vulnerable. If I exposed my wound, wasn’t I risking greater injury? But that’s not what happened. My inbox was flooded with messages, all telling me that I wasn’t alone and thanking me for telling my story. Four years later, I have healed, but I still get emails from people who are feeling alone with miscarriage. When we share the grief, it feels a little lighter for everyone.

4. There are many ways to lose a pregnancy. My first two pregnancy losses happened so early that I wasn’t even sure if I could call them miscarriages, much less grieve for them. We found out about the third at our 10-week ultrasound, when my OB couldn’t find a heartbeat. The fetus had stopped developing weeks before, but I still felt pregnant. I felt foolish and betrayed by my own body. I waited a couple of weeks for the miscarriage to happen, but finally had to schedule a D&C procedure to complete it. I’d had no idea that miscarriage could happen in either of these ways. I thought it was a dramatic event, with a gush of blood that leaves little room for doubt. It often is, and sometimes it is very painful, like childbirth. Other times, it can be a quiet process, maybe little more than a heavy period. Regardless of the physical process, they can all be emotionally painful.

5. Miscarriage can bring all kinds of messy feelings. First, there is grief that can linger for a surprisingly long time, taking you off guard on anniversaries of the miscarriage or the due date. But I had other emotions, too, and they made me even more uncomfortable. I felt hatred toward my own body for failing to do this one thing that I had always assumed it could do. I felt jealousy toward my pregnant friends. I felt resentment in yoga class when a glowing pregnant woman rolled out her mat next to me, even though I knew that her journey to pregnancy could have been even more difficult than my own.

6. You can’t control or predict the outcome, and that’s maddening. Studies show that you have a good chance of having a healthy pregnancy after miscarriage, and these statistics are reassuring. But nobody can tell you for sure what will happen. In the end, I am so grateful for the two healthy children we have, but those baby-making years were defined by both sorrow and sweetness. Every positive pregnancy test represented hope, but it also opened a door to uncertainty and the possibility of another loss. Coming to terms meant having patience and optimism, but also accepting that I couldn’t control the final outcome.

7. For better and for worse, miscarriage will change you. Miscarriage made me more anxious and fearful that something would go wrong in future pregnancies. I am not alone in this; a 2011 study found that depression and anxiety associated with miscarriage or stillbirth often persist through a subsequent pregnancy. But my experience with repeated miscarriages also made me more grateful when things went well, and it expanded my capacity for empathy for all the ways people can struggle to become parents. I realize now that it is part of who I am, as a person and as a parent.

Alice Callahan is author of “The Science of Mom: A Research-Based Guide to Your Baby’s First Year.”