Given that one in four pregnancies ends in miscarriage, it's surprising that we hear so little about it. Most miscarriages typically happen within the first 12 weeks of pregnancy

British pop singer Lily Allen, 25, suffered a miscarriage this past weekend. She was 6 months pregnant. Allen is best known for her hit songs Smile and The Fear as well as her cheeky personality, drunken binges, and disdain for other celebrities. Yet, in spite of her personality quirks the tabloids and the public love her. She’s cute and stylish and possibly the least fake female celebrity I've seen in a long time.

She’s belligerent in public, she smokes, she drinks excessively, she struggles with her weight and she suffers with bouts of depression.  Not your typical girly-girl celebrity.  But most of that changed when Allen found out she was pregnant.  Suddenly there was talk of marriage to her boyfriend Sam Cooper, ending her singing career, and settling down to raise a family.  Sadly, despite all of the positive changes in her life she still lost the baby she so desperately wanted.   

On October 30th, the day she miscarried, Allen was to perform at an AIDS benefit hosted by Elton John.  At the last minute she pulled out of the performance.  Allen sent an apology to the legendary pianist citing “unforeseen circumstances”.  At the time of the event she was actually in the hospital fighting to save her baby’s life.  At one point she tweeted to her 2.4 million Twitter followers, “Say a little prayer.”  The next morning Allen’s publicist announced, “It is with great sadness that we have to confirm that Lily Allen and Sam Cooper have lost their baby.  Doctors tried desperately to save him, but in the end they were unsuccessful. The couple asks that their privacy be respected and that they be left alone at this deeply distressing time.  No further comment will be made.”  It was also announced that Allen had been suffering from a serious viral infection and earlier in the week she'd begun having stomach cramps.   

The sadness of this loss is compounded by the fact that this is her second miscarriage in two years.  Allen’s first miscarriage was in 2008 - she was 4 months pregnant.  Losing that baby devastated her.  She often talks about the depression that followed and led to a three week stay at  a psychiatric hospital. “I was really depressed because of the miscarriage and I’d kind of lost the plot a bit.  It was quite a nasty time.  I didn't even start beginning to deal with it until the baby's due date. Then it just hit me like a house collapsing.  The week before the due date, all I wanted to do was talk about my baby but I also felt I shouldn't.  I lost it.” Allen says the depression from the first miscarriage still haunts her and although she sees a therapist regularly she is still plagued by negative thoughts and high levels of anxiety.   

That seems to be a common theme among women who have miscarriages.  They often feel shame, increased anxiety, isolation, anger and guilt. When a family member or friend dies there is a community of people to share your grief with.  You have a funeral; you tell stories about that person, you reminisce.  People expect you to be sad, or angry and grieve outwardly. Miscarriage, on the other hand, is an entirely different private kind of grief.   

With the loss of a pregnancy, people feel sorry for you at first, but they move on and stop asking about it. For them, the baby wasn't an actual person that they bonded with or had experiences with.  However, as a mother to be, you've been visualizing your new baby since the day you saw those two little lines on the stick. You may have already named the baby and readied a room.  You may have had your first ultrasound and saw the heart beating.  And then it’s over.  You leave the hospital with an empty womb and empty arms. You’re forced to move on but the grief is always there just buried deep inside.  You may shed a tear around what would have been the due date and again on the anniversary of the loss.  But no one else remembers or they’re too afraid to mention it.   

There are nearly 6 million pregnancies in the U.S. every year and up to 25% end in miscarriage. Most miscarriages typically happen within the first 12 weeks of pregnancy - many times before a woman is even aware that she is pregnant.  Only 2% occur after the 12-week point.  The most common causes of miscarriage are chromosomal abnormalities, infections, bleeding, advanced maternal age, and lifestyle – smoking, drinking, poor nutrition, etc. 

Signs and symptoms to watch for if you are pregnant: vaginal bleeding - may be light spotting or very heavy.  Abdominal pains and cramping - may occur on only one side, both sides, or in the middle. The pain can also be in your lower back and genitals.  Or, you may notice the sudden loss of pregnancy symptoms such as nausea and breast tenderness.  If you experience any of these you should call you doctor right away. 

Given that one in four pregnancies ends in miscarriage, it's surprising that we hear so little about it.  There should be no shame or guilt in miscarriage.  If you’ve had a miscarriage and you're feeling overwhelmed by your feelings of sadness call your doctor.  They can put you in touch with a therapist or support group who can help.   

As for Lily Allen, she is still in the hospital recovering and tweeted a message to her many well-wishers, "Thank you for all your kind messages. I'm still very sick but the messages are helping me to be stronger. Thank you x x." 

Stacy Matson, a health enthusiast from Southern California, regularly blogs on Celebrity Health for A Healthier World, as well as contributing to the Best of the Best.