The Long Answer: A Researcher’s Perspective on the Lack of Miscarriage Studies

“Please tell me why there is so little information on this? Why is no one studying this?” My friend asked, frustrated and aggravated by the lack of answers after the third pregnancy loss.

“There are people doing it, but it’s far too few and it’s not that easy. It’s not just one thing.” I said.

“What do you mean?”

I’ve had this conversation several times now with different people. If you are reading this blog, chances are you’ve had a version of this conversation, too—either with a loved one, a doctor, or in the quiet of your own mind while searching for answers.

Someone will inevitably ask why they never hear of miscarriage research the same way we hear studies about wine or coffee on your health. I always give them the option of the short answer or the long answer.

Today, you’re getting the long answer. The long answer isn’t an excuse for why science is failing grieving families. It’s an explanation of the massive hurdles we need to tear down, and a look at how we can actively start fighting back. (Because spoiler alert: I'm currently running a study to change this, and if you've been through this, I'm going to need your help by the time you reach the end of this page). 

The Hidden Complexity of Tracking Loss

Though miscarriage is not an uncommon phenomenon, it is a very  complex health experience to research.

Even in circumstances that are “ideal” for researchers, it is mostly retrospective, so research studies on things like establishing causality or potential exposures are difficult. Furthermore, depending on how you define the start of pregnancy, many miscarriages go unnoticed by people who experience them, sometimes mistaking them as a heavy period.

Because we can’t observe it as you might breaking your arm or transplanting an organ, rates of blastocyst implantation failure are impossible to collect precisely with our current technology. It is also possible that a person may test positive on a home pregnancy test and negative on a clinical test.

Why the “Gold Standard” of Research Takes So Long

There are two types of data that researchers use: primary, where researchers collect the data themselves, or secondary, where someone else does that work and other researchers may use and analyze it. Secondary data are ideal for a lot of researchers because collecting data is hard work and requires a lot of time, money, infrastructure, and energy.

Regarding primary studies, to understand things like miscarriage rates over time, the “gold standard” type of study is a pre-conception, prospective cohort where you take a group of people attempting to become pregnant and follow them through to the end of the pregnancy, be it ending in a loss or live birth.

The problem with these studies is that they are often longitudinal, ranging from nine months to decades, which means several major things: 

• The Timeline: The length of time means there is a long time before you get results. 
• The Participant Drop-Out Rate: The length of time is also something that typically works against you in that for every additional step you ask people to do, the likelihood of participants no longer participating in your study increases, meaning you have to keep it going longer to be able to conduct the analyses you need.
• The Peer-Review Crawl: When you finally can put it together, the nature of peer-reviewed publications also takes time. It takes time to find people to review your work, make recommendations, make changes to the article, continue the cycle of re-review until it gets accepted or rejected. If rejected, you have to submit to another journal and continue the cycle. If accepted, then it can be a couple months after acceptance before the work is published in full.
• The Staggering Cost: Cohort studies are expensive to conduct. You need to consider compensation for participants, but also wages and training for yourself and your staff over the length of the study, equipment and overhead (i.e., analytical/data collection software subscriptions, access to EHR, etc.), recruitment, administration, and other factors over the life of the study.

In some other studies scientists may use Randomized Control Trials to prove cause and effect. This may look like giving half a group a real drug and half a placebo. In miscarriage research, this is impossible to do; we can never ethically expose a pregnant person to something dangerous just to see if it causes a loss. 

Finally, the last type of study design is the cross-sectional study. Though these studies are often cheaper and easier to conduct as they only reflect one point in time, they can only establish an association, not causality. Another issue with cross-sectional studies is that they may rely on self-report data which may be subject to things like how well a person recalls details.

The Funding Crisis facing Miscarriage Research

Researchers, regardless of whether they are in academia, non-profits, think tanks, or industry, rely heavily on grant money. While grant money can come from a variety of sources, the most important grant a health researcher can get is a R01. R01 grants come from the National Institutes of Health (NIH) that often have significant funding attached for multiple years. It is also worth noting that for many public health researchers, any promotions often require receiving one of these grants.

These grants tend to be incredibly competitive in good conditions. In the current climate, many grants have been terminated, cancelled, or frozen in addition to reducing the number of available grants and making it even tougher. In 2022, there were 220 active projects investigating miscarriage. In this current 2026 fiscal year, that number has plummeted to just 89—a staggering 59% drop in just two years. 

When a scientist's or researcher’s career and livelihood depend on winning these hyper-competitive grants, many are forced to pivot away from miscarriage research entirely because the system stops prioritizing it. 

How You Can Help Us Change the Path Forward

All of this to say: there isn’t just one reason we don’t have enough miscarriage research. It’s a political, financial, and scientific uphill battle. But if we can send someone to the moon, we can absolutely do better for families experiencing loss.

I am refusing to let this gap stand. I am currently conducting dissertation research to understand how full-time workers in the US navigate workplace leave after a miscarriage. By sharing your story, you can help us build the data needed to demand better workplace protections and policy changes.

Are you eligible to help?

• Do you live and work full-time in the US?
• Have you experienced a miscarriage while employed within the last two years?

If you want to ensure the next person has a clearer, more supported path than the one you walked, please consider taking our brief screening survey.