Miscarriage, or early pregnancy loss, is defined as a pregnancy that ends on its own within the first 20 weeks of gestation. One of the most common forms of miscarriage is called a “missed miscarriage”. This relates to the fact that it is often discovered early in pregnancy without any obvious symptoms of loss. Other times, bleeding and cramping in early pregnancy can be a sign that a miscarriage is impending.
In addition to the physical trauma of miscarriage, the emotional pain can be challenging to cope with. The normal responses to pregnancy loss are varied and unique to each woman, and some common reactions include:
Shock
Feeling numb
Sadness and crying
A sense of loss
Feeling ‘empty’
Depression
Anger
Guilt
Feelings of failure
Feeling isolated and lonely
Taking little interest in everyday life
Finding it difficult to concentrate
Feeling tired all the time
Sleeping too much or too little
Having no interest in sex
Talking about the miscarriage all the time… or finding it too painful to discuss at all
Finding it painful to see pregnant women, babies or anything to do with motherhood
Acceptance – a feeling that ‘these things happen’
It may help some women to talk about their feelings with their partner, family or friends. Often, women find that others whom they know have also experienced pregnancy loss and it can be helpful to share experiences. It is not unusual to find that others may say the wrong things, even if they mean well. Some will avoid talking about miscarriage altogether. It can be very helpful to receive grief counseling from a professional and this can be coordinated through our office at Golden Gate.
Causes of miscarriage
Miscarriage is common, affecting up to one in every four pregnancies, and the cause is often not discoverable. It may help to know that it is extremely unlikely that anything a woman did– or failed to do– caused her miscarriage. Further, once a miscarriage starts it is almost impossible to stop.
Some known causes of miscarriage include:
- Genetic abnormalities can affect the baby’s development, and result in its inability to survive. This is the cause of more than half of early miscarriages.
- Hormonal irregularities can make it harder for women to get pregnant, and when they do get pregnant there is an increased chance of miscarriage.
- Blood-clotting problems in the vessels that supply the placenta with blood can lead to miscarriage.
- Minor infections like coughs and colds are harmless. However, some illnesses and infections that result in very high fevers may cause miscarriage.
Some anatomical issues can also increase risk for miscarriage:
- A weakened cervix (the bottom of the uterus) may start to open too early and cause a miscarriage
- If your uterus has an irregular shape, the placenta may not implant properly and lead to miscarriage
- Large fibroids (harmless growths in the uterus) can lead to miscarriage in later pregnancy.
- Ectopic pregnancy is when the fertilized egg starts to grow in the wrong place, usually one of the fallopian tubes.
- Molar pregnancy is a rare problem that can happen when an abnormally fertilized egg starts to grow in the uterus. The cells that should become the placenta grow too quickly and there is not normal development of the embryo.
Treatment
The main goal of treatment during or after a miscarriage is to prevent hemorrhaging and/or infection. The earlier a miscarriage occurs, the more likely it is that a woman’s body will expel all of the pregnancy tissue by itself and will not require a medical procedure to complete it. If the body does not expel all of the tissue, the most common procedure performed to stop bleeding and prevent infection is a dilation and curettage, known as a D&C. There are also medications that can assist the body in expelling the remaining tissue from a miscarriage.
Looking to the future
Depending on the nature of the miscarriage, it may be recommended that a woman undergo special testing in an attempt to find the cause. In general, it is recommended that she wait until after the first normal menstrual cycle to attempt another pregnancy. It may be advised to wait longer if there have been particular problems or test results are pending. After one miscarriage, most women go on to have a normal pregnancy. Even after several miscarriages, there is still a good chance of having a normal pregnancy.
Some women find that being pregnant again soon helps them to recover from miscarriage. Others need more time. If waiting is a better choice, talk to your doctor about contraceptive choices and optimal timing.
Adapted From the Following References:
https://www.miscarriageassociation.org.uk/wp-content/uploads/2016/10/Your-Miscarriage.pdf
