By Marya Burgess
Producer, BBC Radio 4's The Miscarriage
An estimated one in five pregnancies end in a miscarriage.
Losing a baby can be traumatic
But the proportion is far higher, possibly as high as 50% if early pregnancy losses before clinical tests are included.
Despite being so common, miscarriages are rarely talked about and society tends to neglect the impact, but the psychological effects on both parents can be devastating.
"When any woman is pregnant with a wanted pregnancy then right from the very beginning, not only are they pregnant but they are also moving into parenthood," said Jane Ogden, Professor of Health Psychology at the University of Surrey.
She has studied the psychological effects on a group of women who have miscarried, and it seems it is all about looking into the future.
"They are imagining how that child will grow up and what their future is going to be.
"And so when you experience loss, you don't just experience the loss of a foetus, you experience the loss of all that future which you have created for yourself as a mother.
"But I think also just not knowing why it's happened is very unsettling for people."
Miscarriage triggers clinical depression in 30% of women. And when the experience is repeated the risk of depressive illness is increased.
Roxanna suffered her first miscarriage in 1995. In the last 10 years she has had 10 more.
Nigel Martyn tried to appear strong for his wife
"After having a miscarriage, I actually lose myself as well," she said.
"I shout at my husband. Something happens to me."
Roxanna said it has taken her weeks to get over a miscarriage and that each loss is worse than the one before.
She and her husband still hope one day to have a child.
Professor Pam Geller, from Drexel University in Philadelphia, has done some of the most comprehensive studies on the aftermath of miscarriage.
Prospective parents often say they won't let themselves believe they are having a baby until after the 12 week scan; so it would be logical that a miscarriage before then would be easier to deal with.
But Pam has found that the impact of miscarriage is the same, whether it is early or late.
Impact on fathers
"Preparing for parenthood happens even earlier now than in the past because of technology.
"Women and their partners can see ultrascan pictures of the foetus, they can see a heartbeat very early.
"We have home pregnancy tests so women know very soon that they are pregnant. So the attachment begins very early."
The impact on prospective fathers tends to go unrecognised.
Dr Martin Johnson, at the University of Newcastle in Australia, has made it his mission to change this.
"Men can get caught in what we call a double bind where if they show too much emotional response, that's quite often seen as being a negative response by other family members - you are not supporting your partner, you are being too self indulgent.
"And then if they don't show an emotional response, they are seen as being uncaring by their partner."
Amanda and Nigel Martyn, the former England goalkeeper, now have two children, but suffered four miscarriages.
Nigel was so successful at appearing strong and supportive that Amanda was driven to ask whether he felt anything.
"I can remember myself saying to him; 'It's your baby as well, you should be upset.'
"I was bouncing a lot of anger, hurt, everything off Nigel and rightfully he was there, taking it all.
"And then in the background I was shouting well you aren't crying. Well obviously he did but it was away from me."
Jane Ogden has defined three stages in which women experience a miscarriage: first comes turmoil, including the physical trauma of miscarriage; even those whose pregnancies are unwanted are shocked by this.
Then there is a period of adjustment, where people wonder why it has happened to them.
At this stage many search for meaning, for a reason for the miscarriage and they find it very difficult if they can't find a medical explanation. In the third stage there is a decline in sadness.
She said: "Some people actually manage to turn the miscarriage into a learning experience something which is positive for them.
"Out of a miscarriage you have learnt something about who you are, how you manage a difficult negative event in your life and being able to see that you have come though the other end as somebody who is in control of their life."
But for Roxanna and many women the pain will never go away.
"Every time when you go outside and see people with their prams and babies and baby clothes, I think how easy it is for them and how hard it is for me," she said.
"My first baby which I lost at five-and-a-half months, the due date for that was 14 August. That would have been 10 years of age.
"That same year my husband's brother's wife, she had a baby, she had a little boy.
"And now he is 10 years of age. When I look at him, I think my child, my first child would have been 10 years of age."
The Miscarriage is on Radio 4 on Monday 18 June at 1100BST and will be available for seven days afterwards at Radio 4's Listen again page.
The programme will also be available as the "Radio 4 Choice" podcast from Friday 23 June for seven days. For instructions see the Radio 4 podcast guide.