When you’ve had a miscarriage, it is totally normal to search for answers and question why. But speculation about the cause without medical proof, though understandable, isn’t always helpful.
Which is why comments made by Prince Harry in Part II of the Netflix series, Harry & Meghan, have hit a nerve with some charities and people who’ve experienced pregnancy loss.
In the documentary, Harry says he believes stress caused by the tabloid papers and a subsequent legal battle lead to his wife, Meghan Markle, miscarrying in 2020.
“Now, do we absolutely know that the miscarriage was caused by that – course we don’t,” he says. “But bearing in mind the stress that caused, the lack of sleep and the timing of the pregnancy – how many weeks in she was – I can say from what I saw, that miscarriage was created by what they were trying to do to her.”
Soon after the documentary landed, women took to social media to air concerns that these quotes could fuel misconceptions around miscarriage and potentially perpetuate blame and stigma.
The NHS, the Royal College of Obstetricians and Gynaecologists (RCOG) and leading baby loss charity Tommy’s all explicitly state that stress is not linked to an increase risk of miscarriage.
However, when you google the topic, you can easily find research papers that point to a potential link. It’s also important that we listen to couple’s experiences and not invalidate what they may feel.
To put it lightly, it’s a really complicated topic to get right – which is why charities urge caution when talking about it.
Ruth Bender Atik, national director of The Miscarriage Association tells HuffPost UK that after a miscarriage, “most people will ask themselves what caused it”.
“Unfortunately, very few people will have an obvious cause diagnosed, and in that situation, we tend to seek our own explanation: what we did or didn’t do (diet, lifting heavy things, phone masts, flying, not really wanting the pregnancy) and stress is one of those,” she says.
She adds that a number of research studies point to a link between stress and miscarriage, but there is “no evidence that stress on its own is a direct cause of miscarriage”.
“Even research that shows that sustained workplace stress (very demanding work, long hours etc) is linked to an increased incidence of miscarriage doesn’t say that the stress itself is a direct cause,” she explains.
Take for example this 2017 review of eight studies related to mental health and miscarriage. It found that “the evidence relating stress to spontaneous miscarriage is conflicting,” but it did conclude that some of the studies had found a link.
However, the study authors acknowledged limitations to most of the research out there, because women self-report stress, and reports are usually “retrospective with an associated risk of recall bias”.
Professor Siobhan Quenby, director at Tommy’s National Centre for Miscarriage Research, also emphasises that more research is needed before we can draw any conclusions.
“Research from Tommy’s National Centre for Miscarriage Research in The Lancet, shows a link between some factors, including persistent high stress, and increased risk of miscarriage,” she tells HuffPost UK.
“However, we need to do more research to understand whether this is a causal link, because stress is often linked with other lifestyle factors which also increase miscarriage risk, like lack of sleep and not eating well.”
Atik points out that fuelling speculation about stress and miscarriage can mean pregnant women who’ve experienced loss in the past can take on what is often referred to as a “double burden”.
“Most women who are pregnant after a miscarriage will have very high levels of anxiety, fearing that it will happen again – and they worry about the effects of that anxiety too, so a double burden. Again, there is no evidence that this increases the risk of another miscarriage,” she says.
“Even amongst people with recurrent pregnancy loss, very well documented guidance indicates that there is no evidence of a clear causal link between stress and miscarriage. In this case, they note that the link might be the other way round – that miscarriage is the cause of stress.”
Advising women to relax during pregnancy can be counterproductive, adds Amina Hatia, midwifery manager at Tommy’s. For this reason, if you know someone who’s pregnant, it’s better to be cautious when talking about stress and miscarriage in the same breath.
“We have very little control over stress in our lives, and in any pregnancy it is natural at times to feel a bit anxious or stressed. Therefore, telling people ‘not to stress’ for their own emotional and physical health doesn’t usually work,” she says.
“It can be counterproductive as it can cause more guilt and worry, and lead to women and pregnant people feeling even more concerned about whether that anxiety or stress can affect their baby’s growth and development.
“It’s important if you are feeling extremely anxious or are persistently stressed during your pregnancy that you speak to your healthcare team so they can provide additional support.”
Help and support:
- Sands works to support anyone affected by the death of a baby.
- Tommy’s fund research into miscarriage, stillbirth and premature birth, and provide pregnancy health information to parents.
- Saying Goodbye offers support for anyone who has suffered the loss of a baby during pregnancy, at birth or in infancy.
- The Miscarriage Association 01924 200799 Mon-Fri, 9am-4pm