This is the VOA Special English Health Report.

A miscarriage is the natural loss of a pregnancy before the twentieth week. This happens to as many as twenty percent of known pregnancies.

Experts say many pregnancies end before a woman even knows she was pregnant.

Miscarriages are usually caused by chromosome problems that prevent the baby from developing. The online medical encyclopedia MedlinePlus says these problems are usually unrelated to the genes of either parent.

But whatever the reason, the loss of a pregnancy can be heartbreaking. And sometimes the advice that follows can be painful, too.