In France, more than one in five women aged 40 to 49 years old has been through a miscarriage. And yet, miscarriages remain under-researched. In this latest Population & Societies, authors M C Compans, Hélène Malmanche, and Heini Väisänen (INED) combine several data sources to measure how frequent miscarriages are, identify the main factors linked to it, and better understand women’s experiences of the event. The study also addresses women’s expectations regarding medical miscarriage care.
More than one in five women have experienced a miscarriage
In France, more than one in five women between ages 40 and 49 (22%) have experienced at least one miscarriage. Of these, 16% have had one, and 6% have had two or more. Out of women who have ever been pregnant, nearly one in four have experienced a miscarriage. Depending on the data source used by the authors, between 10% and 14% of pregnancies end in miscarriage. The vast majority of miscarriages occur during the first trimester of pregnancy.
Frequency of miscarriage rises from the mid-thirties
Age is the main factor associated with the incidence of miscarriage. The risk of a pregnancy ending in a miscarriage is quite high before the age of 20. It then decreases before rising again from a woman’s mid-thirties onwards. For example, 8% of pregnancies occurring at the age of 35 end in miscarriage, compared with 14% at the age of 40. However, the analyses do not reveal any significant differences based on women’s educational attainment or financial situation.
New insights into a poorly understood phenomenon
Miscarriages remain difficult to measure. Administrative data record the medical procedures associated with them, but some miscarriages occur before any medical care is provided and are therefore not present in health statistics. Survey data rely solely on the responses of those interviewed and are thus exposed to respondents’ memory bias and their interpretation of survey questions. Each source therefore has its strengths and limitations. To better document miscarriage, researchers at INED have compared the results of the FECOND survey, administrative data from the National Health Data System (SNDS), and a qualitative survey called FISO. This multi-source approach provides a more comprehensive insight into the frequency of miscarriage and the experiences of the women who have gone through them.
Better care for women affected
Beyond epidemiological data, the study examines the experiences of women who have experienced miscarriage. Interviews conducted as part of the qualitative survey reveal a frequent discrepancy between women’s expectations of care and the care they receive. There may be a lack of information about the healthcare process, insufficient medical follow-up or lack of offers of psychological support, and an ill-suited hospital environment. The authors emphasize, however, that changes are underway. Since September 2024, women who have experienced a miscarriage have been entitled to paid sick leave from the first day. Forthcoming new clinical practice guidelines for the treatment of miscarriages—the development of which the SOC-MISC team was involved—should help to improve the care pathway for those affected. Certain deficiencies highlighted by the study such as a lack of information, a lack of medical follow-up or a failure to refer patients for psychological support, will be addressed in particular.
KEY FIGURES
• 22% of women aged 40 to 49 have experienced at least one miscarriage in their lifetime.
• Nearly a quarter of women who have ever been pregnant have been through a miscarriage.
• Between 10% and 14% of pregnancies end in miscarriage.
• 8% of pregnancies end in miscarriage at 35 years of age; 14% end in miscarriage at age 40.
