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Miscarriage
What is Miscarriage?
A miscarriage is a spontaneous loss of pregnancy before the 20th week of gestation. Miscarriages occur in the early stages of pregnancy, most frequently (99%) during the first trimester, before 20 weeks’ gestation. Miscarriage occurs much more commonly than most people realize. About a third to half of all pregnancies end in miscarriage before a woman misses a menstrual period, many occurring before a woman even knows she is pregnant. About 10-20% of people who know they are pregnant will miscarry.
Potential Factors that May Cause Miscarriage
- Lifestyle factors (such as obesity, smoking, alcohol or drugs)
- Age – as a woman’s age increases, sadly, so does the chances of a miscarriage While not a cause of miscarriage, maternal age is a great risk factor for miscarriages. Studies have shows that the risk of miscarriage is 12% to 15% for women in their 20s, while this rises to about 25% once women reach age 40. This is likely due to an increased incidence of chromosomal abnormalities in the eggs as women age.
- Abnormal uterus
- Hormonal disorders
- Medical conditions
- Infections
- Chromosomal abnormalities, either too many or too few chromosomes, that occur randomly in the egg or sperm.
- Anatomical obstructions in the uterus such as septum, fibroids, polyps, cysts, or endometritis, all of which can cause problems with vascularization or inflammation.
- Sperm DNA fragmentation, abnormal genetic material within the sperm, can also lead to miscarriage, although this topic is debated by experts.
Miscarriage and Coping with Loss
The most important thing to know when experiencing a miscarriage is that it is not your fault. While many things can cause a miscarriage, there is not always a way of knowing exactly the reason behind your loss. However, this does not mean that what you are going through is your fault or that you have done anything to deserve it.
The other important thing to know is that whatever you are feeling is completely normal and healthy. The ending of a pregnancy can be a terrible loss, and you or your partner may feel immense grief, depression, anxiety, guilt, or sometimes a complete shutdown of emotions.
Due to the changes your body is undergoing, you may also experience hormonal fluctuations that intensify these emotions. Allowing yourself to feel whatever emotions flow through you during this time is the first step toward healing. Trusting your partner and those close to you to support you is also important. Sharing and discussing your emotions can be a huge step toward healing.
You may also consider counselling or support groups to further explore what you are going through in a safe and supportive environment. Sharing with others who have had similar experiences can be very helpful for women grieving the loss of a pregnancy.
Types of Miscarriage
Missed Miscarriage: a fetus implants but fails to develop. The body does not expel the pregnancy tissue. You may continue to feel signs of pregnancy if the placenta still releases hormones, or you may notice the signs of pregnancy fade. Some women may experience some vaginal discharge and cramping, but many have no symptoms of miscarriage. Sometimes the body will dispel the fetal tissue, but other times, a D&C procedure is necessary. If you are experience
Threatened Miscarriage: vaginal bleeding that occurs during the first 20 weeks of pregnancy. This does not always end in a miscarriage — around half of threatened miscarriages result in a live birth. You may also experience lower back pain and abdominal cramps. If you experience any of the above symptoms and suspect you may be miscarrying, please contact your fertility specialist or obstetrician as soon as possible. Time is of the essence here, so please don’t hesitate to reach out.
Chemical Pregnancy/Chemical Miscarriage: a very early miscarriage that can occur before you even learn that you’re pregnant. An egg is fertilized, but is non-viable shortly after implantation, and is never visible on ultrasound. There may be no signs of a chemical pregnancy. Most women simply begin to bleed around the time of their next period, though their period may arrive a few days late or be slightly heavier.
Blighted Ovum/Anembryonic Pregnancy: a fertilized egg attaches to the uterine wall, but an embryo does not develop. This occurs very early in pregnancy, often before you even know you are pregnant. You may feel signs of pregnancy, but when your doctor performs an ultrasound, there will be an empty gestational sac, without a confirmed heartbeat. You may miscarry the pregnancy or schedule a dilation and curettage (D&C) procedure, in which the cervix is opened, and the pregnancy is gently curetted, or removed, from the uterus.
Miscarriage and Fertility
After you have grieved the loss of a pregnancy, you may wonder when you’ll be able to try for a baby again. While most women are able to do so after their next menstrual period, four to six weeks after miscarriage, this is not necessarily the case for every individual. The best thing to do is discuss this with your physician or fertility specialist, who is always here to help however they can.
When you are ready, it may be helpful to run a diagnostic test or further diagnostic workup after a miscarriage to determine whether there is a known cause for your condition.
Though your experience is very difficult, it is possible to become pregnant again and have a healthy baby.