Miscarriage
A miscarriage is a loss of pregnancy during the first 20 weeks. Miscarriage occurs in about half of all pregnancies, but only 10% of known pregnancies, and most occur in the first 13 weeks of pregnancy.
Often, a miscarriage is nature's way of ending a pregnancy in which the fetus is not growing as it should or would not have been able to survive. In many cases, there is no known cause for a miscarriage.
Genetic Causes
Most first-trimester miscarriages are caused by chromosomal errors that occur when the fetus is first forming. Chromosomes are tiny structures inside the center of each of the body's cells. Each chromosome carries many genes, which determine the traits of a person.
Most chromosome problems are not inherited, but happen by chance and are not likely to occur again in another pregnancy. In most cases, there is nothing wrong with the health of the female or male partner.
The Women's Health
The loss of a pregnancy, no matter how early, can result in feelings of loss and grief. Speak with your doctor if these feelings become overwhelming.
Preexisting health conditions can also cause you to miscarry. In many cases, your doctor can monitor these conditions and manage them so that your pregnancy can be successful. As always, talk with your doctor about any questions or concerns you have about your pregnancy.
Possible conditions that can cause a miscarriage include:
It's common for a pregnancy to miscarry so early that you don't even know you're pregnant.
- Infections that affect the uterus or the fetus
- Problems with your hormones
- Chronic diseases such as diabetes, especially if they are not controlled prior to pregnancy
- An abnormally shaped uterus
- An incompetent cervix
- Bleeding disorders.
There is no proof that working, exercising, having sex, use of birth control pills, most accidental falls, or morning sickness cause miscarriages.
Risk Factors
There are several risk factors that may increase your chances of a miscarriage. These include:
- Increasing age, especially age 35 and older
- A history of two or more miscarriages
- Nonprescription NSAID (such as ibuprofen or naproxen) use when you become pregnant or early in your pregnancy
- Alcohol or drug use during pregnancy
- Cigarette smoking during pregnancy
- Exposure to dangerous chemicals before or during pregnancy
- Heavy caffeine use during pregnancy
- Certain gynecological problems, such as uterine fibroids or other abnormalities of the uterus
- Disease or infection during pregnancy
- Physical trauma.
After the first 12 weeks of pregnancy, when a fetal heartbeat is seen on ultrasound, the risk of miscarriage drops significantly.
Ultrasound is a test that uses reflected sound waves to produce an image of the developing fetus. It does not use X-rays or other types of potentially harmful radiation.
Symptoms of Miscarriage
Common signs of a miscarriage include:
- Vaginal bleeding
- Abdominal or pelvic cramping or pain
- Lower back pain
- Tissue that passes from the vagina.
While most women who have vaginal spotting or bleeding during the early stages of their pregnancy have healthy babies, bleeding is the most common symptom of a miscarriage.
Diagnosing a Miscarriage
If you have any symptoms of a miscarriage, call your doctor right away. Often, your doctor will be able to diagnose a miscarriage from a pelvic exam. If not, your doctor may order blood tests or perform an ultrasound exam.
Treating a Miscarriage
There is no proven medical treatment to stop a miscarriage that has already started. While many miscarriages complete on their own, some require medical treatment. If tissue is left in your uterus after the miscarriage, your doctor may perform a dilation and curettage (D&C). In this procedure, the remaining tissue is gently removed from your uterus. Most D&Cs are performed in the doctor's office and require no hospital stay.
You should wait until you have had at least one normal menstrual period before attempting to become pregnant again.
Coping With The Loss
It is normal to go through a grieving process after a miscarriage, regardless of the length of your pregnancy. Guilt, anxiety, and sadness are common and normal reactions after a miscarriage. It is also normal to want to know why a miscarriage happened; however, in most cases, a miscarriage is a natural event that could not have been prevented.
Emotional healing is as vital as physical healing after a miscarriage. Grieving is normal and allows you to accept the painful loss of miscarriage and go on with your life. Counseling can help both you and your partner if you have trouble dealing with your feelings after a miscarriage.