DESPITE one in four recognised pregnancies resulting in miscarriage, with the obvious implication that the actual number is much higher, recent media coverage of Meghan Markle’s miscarriage strongly argues that we struggle to talk about this very common issue. Perhaps it is because during the first three months of pregnancy, during which over 80 per cent of miscarriages occur, many women feel unable to share their joy due to such great uncertainty, which unfortunately makes announcing their loss seem even harder.

The most common cause of miscarriage is a genetic abnormality in the developing baby, which would be incompatible with the pregnancy proceeding to term, or life after birth.

Not all bleeding in pregnancy is a miscarriage. An implantation bleed, at the time of your first missed pregnancy, signifies the fertilised egg attaching itself to the lining of the uterus (womb), and is an entirely harmless event.

Sometimes miscarriage occurs without any physical unwell, and the first time it is picked up is on a routine scan, when the baby’s heart beat cannot be detected. Some women report that they stopped feeling the typical symptoms of early pregnancy including morning sickness and breast tenderness. This is known as a missed miscarriage.

Without wishing to scare, any bleeding in pregnancy should not be ignored. Some expectant mothers suffer bleeding during pregnancy, termed a threatened miscarriage, but go on to complete a successful pregnancy. Other times a threatened miscarriage sadly ends with the event itself.

Any presentation suggestive of a miscarriage will be assessed in a dedicated Early Pregnancy Assessment Unit (EPAU).

Fifty percent of definite miscarriages don’t require any medical intervention, with bleeding subsiding within a few days, although it may take up to two weeks. If bleeding doesn’t settle, becomes heavier or you are unwell, you may require medical management or surgical treatment. If ignored, these have the potential to cause infection and for you to become seriously ill.

Miscarriages can be extremely distressing. Your GP will always want to know how you are doing. Dedicated organisations are there round the clock to listen.

The good news is that even two early miscarriages do not reduce your chance of a successful pregnancy.