Miscarriage, although relatively common, is not a topic North American adults openly discuss. As a result, many couples who are starting a family or expecting a child do not understand it or know what to expect if it happens to them. This lack of knowledge can make the challenge of losing a child even more painful. Reducing the stigma associated with miscarriage by increasing awareness of it can make it easier for couples who have experienced a miscarriage. Here are twelve facts about miscarriage everyone should know to make coping with a miscarriage (or supporting someone who has) easier.
What Is A Miscarriage?
Miscarriage is the term used for a pregnancy loss within the first twenty weeks of gestation. The majority of miscarriages occur during the first thirteen weeks of pregnancy. A miscarriage can be an emotionally devastating experience and even come as a surprise if the couple did not know about the pregnancy. Miscarriages are the most common type of pregnancy loss; approximately ten to twenty-five percent of all recognized pregnancies end in miscarriage. Chemical pregnancies account for fifty to seventy-five percent of miscarriages. These occur when a pregnancy is lost shortly after implantation, resulting in bleeding around the time a woman would normally have her period. Thus, many women who experience chemical pregnancies may not even realize they conceived to begin with.
Signs Of Miscarriage
There are many physical signs of a miscarriage. For example, if the woman has moderate to heavy bleeding from the vagina, she may be having a miscarriage. Keep in mind, however, that twenty to thirty percent of women with healthy pregnancies experience some spotting and bleeding early on. There may also be pain in the lower abdomen that feels similar to menstrual cramps. If the cramps are severe, the body may be contracting and miscarrying an early pregnancy. Lower back pain is also a sign to watch for as is the absence of typical pregnancy symptoms, such as tender breasts and nausea, especially if they were present before. Couples should seek the advice of a medical practitioner if they believe they are experiencing a miscarriage.
Cause: Chromosome Development
It is difficult to pinpoint why miscarriages occur. However, the majority of miscarriages tend to be due to problems with chromosome development. Chromosomes are structures in the body that contain the DNA of the baby, including the genes that determine hair color, eye color, and health conditions. When there are too many or too few chromosomes, the baby may not develop normally. This is a chance outcome and is not based on something either partner has done. Most chromosomal abnormalities are caused by a damaged egg or sperm cell. There may also have been a problem with the zygote (the fertilized egg) as it proceeded through the cell division process.
Cause: Health Issues
Although less common than chromosomal abnormalities, health problems are another possible cause of miscarriage. Some common issues for women are hormone problems, such as polycystic ovarian syndrome (PCOS) or luteal-phase defects. Women with PCOS experience a higher risk of first-trimester miscarriage than women without PCOS do. Those who produce suboptimal levels of progesterone are also at an increased risk of miscarriage. In addition, untreated thyroid disease can make it challenging to conceive and maintain a pregnancy. Fortunately, doctors can diagnose thyroid dysfunction with blood tests and treat it accordingly. Uncontrolled diabetes can also lead to an increased risk of miscarriage. However, if doctors identify glucose intolerance before pregnancy, they can help couples take steps to mitigate the risk. In addition, women diagnosed with lupus are at a higher risk of miscarriage, although the condition is highly manageable.
Although most miscarriages are not caused by something either partner has done, some behavioral factors can increase the risk of miscarriage. Smoking, recreational drug use, and alcohol abuse all negatively affect health, which can increase the risk of miscarriage. Taking certain prescription or over-the-counter medications can also impair a woman's ability to maintain a pregnancy. As a result, experts recommend that women review their medications with a doctor when trying to get pregnant. In addition, certain foods, such as unpasteurized dairy products and raw or undercooked meats and eggs, can lead to food poisoning; this poses a risk to the fetus. Excessive caffeine intake and exposure to radiation or toxic substances have also been linked to miscarriage.
Chances Of Having A Miscarriage
For most women of childbearing age, the chances of having a miscarriage range from ten to twenty-five percent. However, for most healthy women, the average is about a fifteen to twenty percent chance. A woman’s age can affect the risk of miscarriage. Women under the age of thirty-five have about a fifteen percent chance of miscarrying whereas those between the ages of thirty-five to forty-five have a twenty to thirty-five percent chance. Once women reach the age of forty-five, their chances of miscarrying can be as high as fifty percent. This number varies based on other factors, such as overall health and whether it is the woman's first pregnancy. A woman who has previously miscarried has a twenty-five percent chance of having another miscarriage, which is only slightly higher than the risk of someone who has not miscarried before.
Types Of Miscarriage
There are several types of miscarriage women can experience. A threatened miscarriage is characterized by bleeding that is accompanied by cramping or low back pain. This bleeding is usually the result of implantation. When an inevitable or incomplete miscarriage takes place, there is abdominal or back pain along with bleeding and an open cervix. This is a result of dilation or effacement of the cervix. A complete miscarriage is when the embryo has been expelled from the uterus. In this case, bleeding and cramping subside quickly. A missed miscarriage is when there is an embryonic death without expulsion of the embryo. Signs of this type of miscarriage include the absence of pregnancy symptoms and no fetal heartbeat on an ultrasound. A recurrent miscarriage is characterized by three or more consecutive first-trimester miscarriages, which affects about one percent of couples.
If a woman begins to experience signs of a miscarriage, it is important to seek immediate medical attention to get a proper diagnosis. Doctors will ask when the bleeding started, how heavy it is, and whether or not there has been cramping. If there are pregnancy symptoms still present, such as nausea, let the doctor know. The presence of these symptoms could indicate a molar pregnancy, which may require a procedure to remove the abnormal tissue from the uterus. It is also important to report abdominal and pelvic pain, which could indicate an ectopic pregnancy. This condition occurs when the fertilized egg grows outside of the uterus. Note that these conditions are rare: only one in fifteen hundred pregnancies result in molar pregnancies and only one to two percent are ectopic pregnancies.
The primary goal of treating a miscarriage is to prevent maternal hemorrhaging and infection. The earlier the pregnancy, the more likely the body will expel the fetal tissue naturally without requiring medical intervention. This usually happens within two weeks after the miscarriage. If bleeding does not stop after two weeks, a doctor may prescribe medication to stimulate the uterus to release the rest of the tissue. Alternatively, if the body does not expel the tissue on its own, the most common medical procedure performed to stop bleeding and prevent infection is dilation and curettage (D&C). Couples should closely monitor bleeding at home as an increase in blood volume or the onset of chills and fever could indicate an infection.
Because most miscarriages are due to chromosomal abnormalities, there is not much couples can do to avoid them. However, there are steps women can take to create a healthy lifestyle before trying to conceive and during pregnancy. Achieve a healthy body-mass index by exercising regularly and eating nutritious foods. In addition, manage stress effectively, take prenatal vitamins or folic acid for a few months before trying to conceive, and limit alcohol and drug use. Once pregnant, continue to maintain a healthy diet and fitness regime. This is not the time to let the body go and eat for two because women need only five hundred extra calories during pregnancy. However, avoid trying new activities that may place stress on the body.
Recovering From A Miscarriage
Physical recovery from most miscarriages takes approximately one to two months. A period will often start again within four to six weeks. For the first couple of weeks after a miscarriage, avoid putting anything inside the vagina, including feminine hygiene products, and having sex. In comparison to the physical recovery, emotional healing after a miscarriage often takes much longer, especially if the couple was aware of the pregnancy. A woman can cycle through different feelings, such as anger, sadness, and grief. Her partner may also mourn the loss. It may be helpful to seek the help of a grief counselor to process feelings and lean on friends and family for support.
When To Try Again
Most women who have a miscarriage will go on to have successful pregnancies. After experiencing a miscarriage, talk to a doctor about how long to wait before trying again. Many doctors recommend waiting until the end of one to three menstrual cycles before trying again. However, it is also important for couples to wait until they feel emotionally ready. If there is a history of two or more miscarriages, speaking with a doctor about what may be causing the miscarriages can be helpful to figure out the best way to conceive and maintain a healthy pregnancy. Further testing may help to identify hormone problems, immune system issues, or problems with either parent’s chromosomes. An ultrasound can also help to detect uterine problems.