Understanding Pregnancy Loss

Pregnancy loss or miscarriage is a deeply emotional experience, no matter when it occurs. Even when women wait until the 12-week scan to share their news, the bond with the pregnancy often begins much earlier. When a loss happens, it can feel sudden and disorienting, leaving behind a storm of emotions—grief, fear, sadness, and uncertainty about what comes next.

In Chinese medicine, emotions are intimately connected to the body’s internal organs and overall health. Sadness is linked to the Lungs, worry to the Spleen, fear to the Kidneys, anger to the Liver, and shock to the Heart. These emotions are seen as both natural and meaningful responses to loss, and they help the healing process.

Miscarriage is more common than many realise, affecting around 10–20% of recognised pregnancies. In fact, many losses occur even before a pregnancy is confirmed. It’s estimated that only half of a woman’s eggs are capable of becoming a healthy, full-term pregnancy, and only about 15% of sperm are viable enough to fertilise an egg.

Despite this, miscarriage is still surrounded by silence and misunderstanding. In both conventional and Chinese medicine, there is much we can learn—not only about why miscarriage occurs, but how we can support healing in its aftermath. As a fertility acupuncturist and herbalist, I aim to bring clarity, compassion, and a truly holistic approach to this sensitive topic.

The causes of pregnancy loss vary widely, and investigations should follow a structured approach. A range of diagnostic tests is available, and identifying the root cause can often guide effective treatment. Key causes include:

1. Chromosomal abnormalities:
   This is by far the most common cause of miscarriage, particularly in the first trimester. Errors in cell division may occur during embryo development, and these are more likely with advancing parental age—especially in women in their mid-40s and beyond. High levels of sperm DNA fragmentation can also contribute to chromosomal instability.
2. Low progesterone (luteal phase defect):
   In this condition, progesterone levels after ovulation are insufficient to support implantation and early pregnancy. Treatment typically involves progesterone supplementation via pessaries, injections, or tablets.
3. Blood clotting disorders (thrombophilia):
   Around 22% of women with recurrent miscarriage may have an underlying clotting issue, such as antiphospholipid syndrome (APS), an autoimmune condition. During pregnancy, the blood naturally becomes thicker. Phospholipids are essential for proper embryo implantation, but if antiphospholipid antibodies are present, the blood may clot too easily, obstructing placental blood flow. Diagnosis involves blood tests, and treatment usually includes anticoagulants (e.g. Clexane) from the early stages of pregnancy.
4. Anatomical abnormalities:
   Uterine abnormalities such as a septate uterus, fibroids, scar tissue, or endometrial polyps can interfere with embryo implantation and development.
5. Reproductive immune system dysfunction:
   Some immune conditions cause the body to misidentify the embryo as a foreign invader. This can include elevated or overactive Natural Killer (NK) cells or imbalanced TH1/TH2 cytokine ratios, both of which can disrupt early pregnancy.
6. Endometrial receptivity issues:
   Problems with the uterine lining—such as inadequate thickness, poor timing, or inflammation—can hinder implantation. Testing the endometrial microbiome for infections or immune dysregulation can be helpful. When infections are found, targeted antibiotics are often effective.

Pregnancy Loss Through the Lens of Chinese Medicine
In Chinese medicine, a healthy pregnancy depends on the balance of three vital substances: strong Jing (Essence), abundant Qi, and well-nourished Blood. When these are harmonious, the body can support conception and sustain a pregnancy.

Kidney Jing is the foundation of reproductive health. Inherited from our parents, it governs fertility and the quality of eggs and sperm. Though Jing naturally declines with age, it’s also affected by stress, poor diet, toxins, and lifestyle choices.

The Spleen generates Qi and Blood from the food we eat. If Spleen Qi is weak, the Uterus may not be adequately nourished. Liver Qi must flow freely to avoid emotional stagnation and ensure healthy blood circulation to the womb. Blood deficiency may limit nourishment to the embryo, while Heat in the Blood can create instability and increase the risk of miscarriage.

Miscarriage, from this perspective, often occurs when these systems are out of balance—whether due to age, overwork, stress, emotional trauma, or underlying constitutional weakness. Treatment aims to restore harmony: strengthening Jing, tonifying the Spleen, soothing the Liver, nourishing Blood, and calming the spirit, but will not prevent a miscarriage that is destined not to survive, e.g. chromosomal damage.  The aim is always to bring patterns of disharmony into balance before pregnancy occurs.

Supporting Patients Post-Pregnancy Loss

My clients benefit from a gentle, respectful approach to both the physical and emotional healing in the weeks and months after miscarriage.  Acupuncture is incredibly helpful in regulating menstruation and restoring hormonal balance and the herbs nourish, replenish and balance Qi and Blood.  Both calm and settle the Shen (mind) after the loss, and support any underlying causes.

Traditional Chinese Medicine works beautifully alongside conventional methods of ART like IVF, IUI, and can directly address issues like thin endometrium, luteal phase defect, PCOS and prepare for preconception.

Miscarriage is not always preventable, but many factors can be supported.  Early preparation for pregnancy with personalised care to build Jing and overall health in both partners is always the aim.  After pregnancy loss there is always hope in the healing process, you are not alone.