Miscarriage is a heartbreaking experience that affects many women and their partners. Losing a pregnancy can be incredibly difficult to deal with – both emotionally and physically. This article aims to provide some understanding of the problem, resources, and a message of hope during this challenging time.
What is a Miscarriage?
A miscarriage is the spontaneous loss of a pregnancy before 20 weeks. It’s a surprisingly common occurrence, affecting roughly 1 in 4 pregnancies.
What Causes a Miscarriage?
Most miscarriages happen due to chromosomal abnormalities in the developing embryo. This is often beyond anyone’s control, and not related to what the expectant mother did or didn’t do.
Some factors listed below may increase the risk of a miscarriage :
- Uncontrolled chronic health conditions like diabetes, hypertension or thyroid disorders
- Inadvertent use of medicines that are unsafe to use during pregnancy
- Uncontrolled infections, trauma or travel in early stages of pregnancy
- Unhealthy weight, smoking and alcohol consumption
- Exposure to radiation or chemicals that may cause miscarriages
Symptoms of Miscarriage:
Symptoms can vary from person to person. Broadly the symptoms include:
- Vaginal bleeding
- Cramping or abdominal pain
- Passage of tissue
- Loss of pregnancy symptoms like nausea
- Sometimes, there may be no symptoms at all, but it is discovered during an ultrasound scan
Types of Miscarriage: Understanding the Different Experiences
There are different types of miscarriages, each with its own characteristics. Understanding these different types of miscarriages can help you make sense of your own situation and receive appropriate medical care. Here’s a breakdown of some common types:
Threatened Miscarriage:
This is when vaginal bleeding occurs in early pregnancy but the ultrasound shows an intact pregnancy and there’s a chance that the pregnancy can continue. This bleeding is often accompanied by mild cramping but the cervix remains closed. Early interventions like progesterone support and bedrest can be helpful.
Inevitable Miscarriage:
This is when the miscarriage has already begun and salvaging the pregnancy is not possible. Symptoms include heavier bleeding bleeding with passage of large clots or tissue and cramping. The doctor may offer ways to help complete it.
Complete Miscarriage:
This occurs when all pregnancy tissue has naturally passed from the uterus. Ultrasounds can confirm a complete miscarriage. Bleeding and cramping typically subside within a few days and any further treatment is usually not needed.
Incomplete Miscarriage:
In this case, some pregnancy tissue remains in the uterus in spite of heavy bleeding and cramping. Medical intervention with medication of procedures under anaesthesia may be needed to remove the remaining tissue.
Missed Miscarriage:
This happens when the embryo or fetus has died but hasn’t been expelled from the uterus. There are no obvious symptoms like bleeding or cramping. It is usually detected during an ultrasound which reveals an absence of a heartbeat and cessation of any further growth. Medical intervention might be needed to remove the products of conception in this case.
Biochemical Pregnancy:
This is an extremely early miscarriage where the pregnancy test is positive but bleeding begins even before the pregnancy can be detected on an ultrasound scan. This happens when the fertilized ovum fails to implant or stops growing soon after implantation. Treatment is usually not needed for this condition.
Blighted Ovum or Anembryonic Pregnancy
This is a specific type of miscarriage that occurs in the early stages of pregnancy. A fertilized egg implants itself in the lining of the uterus but the embryo either doesn’t form at all or stops developing very early. Despite this, the body still produces pregnancy hormones and you may continue to experience symptoms of early pregnancy. An ultrasound examination is typically used to diagnose a blighted ovum where an empty gestational sac with no developing embryo continues to remain visible over a period of two weeks. Unfortunately, there’s no treatment to save a blighted ovum pregnancy. The body will naturally expel the pregnancy tissue, which can happen through vaginal bleeding and cramping similar to a miscarriage. In some cases, medication or a minor surgical procedure might be needed to remove any remaining tissue.
Recurrent Miscarriage:
This is defined as having three or more consecutive miscarriages. Further testing with your doctor can be helpful in determining the cause.
Need more information or support on this topic? Dr. Daksha Bakre can help you.
What to Expect After a Miscarriage:
- Immediate Treatment: Your Doctor may recommend expectant management which essentially means allowing nature to take its course, or prescribe some medication or may recommend a surgical proedure called D&E under anaesthesia.
- Physical Recovery: Your body will naturally start to heal after a miscarriage. It may take a few days to a few weeks for bleeding and cramping to subside.
- Emotional Healing: Healing takes time. Be patient with yourself and allow yourself to grieve.
Coping with Loss:
The emotional impact of a miscarriage is real and valid, especially if you were excited about the pregnancy. Allow yourself to feel your grief, whether it’s sadness, anger, guilt, or a mix of emotions. Talking to a trusted friend, family member, therapist, or support group can be incredibly helpful. Remember that you are not alone. Miscarriage is a common experience, and there is support available to help you through this difficult time. Dr. Daksha Bakre and her team are always available for you, offering compassionate care and guidance.
Looking Forward:
It’s important to remember that having a miscarriage doesn’t necessarily mean you can’t have a healthy pregnancy in the future. Many women go on to have successful pregnancies after experiencing a miscarriage.
Frequently Asked Questions.
While severe or chronic stress is not healthy, it’s generally not a direct cause of miscarriage.
Bleeding in early pregnancy is estimated to happen in almost one in four pregnancies – many of which will result in a healthy baby. About a third of all women who have bleeding will go on to miscarry.
Moderate exercise and sexual intercourse are generally safe during pregnancy and do not cause miscarriage in healthy pregnancies.
Treatment of a miscarriage depends on the type of miscarriage and may involve expectant management (which means doing nothing and allowing nature to take its course), oral medication, or a surgical procedure called D&E under anaesthesia.
Wait for two normal menstrual cycles after a miscarriage before you try again. Make sure that you are both physically and emotionally ready before trying again.
It’s not always possible to definitively pinpoint whether a miscarriage was specifically caused by a “bad egg” (poor egg quality) or “bad sperm” (poor sperm quality). In most cases miscarriages are due to a random, non-recurrent chromosomal error in the embryo. However, if you’ve experienced recurrent miscarriages (two or more consecutive losses), your doctor will likely recommend investigations to find the potential underlying causes, which can include evaluating egg and sperm quality.
Focus on healthy lifestyle choices before and during pregnancy (e.g., maintaining a healthy weight, managing chronic conditions, avoiding smoking/alcohol/drugs). Folic acid supplementation from three months prior to conceiving may help. Meet your Doctor for a preconception check up. It is wise to remember that many miscarriages are unpreventable in spite of our best efforts.
References and further reading
https://www.nhs.uk/conditions/miscarriage/
https://americanpregnancy.org/getting-pregnant/pregnancy-loss/miscarriage-surviving-emotionally/
https://www.mayoclinic.org/diseases-conditions/pregnancy-loss-miscarriage/symptoms-causes
https://my.clevelandclinic.org/health/diseases/9688-miscarriage
https://www.marchofdimes.org/find-support/topics/miscarriage-loss-and-grief
Need more information or support on this topic? Dr. Daksha Bakre can help you.
Disclaimer
This article provides general information and is not a substitute for professional medical advice. Always consult your doctor to discuss your individual circumstances and the best course of action for you.