A spontaneous abortion, more commonly known as a miscarriage, is quite common in pregnancy, yet regardless of that simple truth, it remains a challenging and emotionally complex experience for women to navigate.
Miscarriage is defined as pregnancy loss prior to 20 weeks. If the pregnancy lasts beyond 20 weeks but is unsuccessful, it is termed stillbirth.
Anyone can have a miscarriage. The most often quoted numbers are that 10 to 20 percent of all pregnancies end in miscarriage. Now with new pregnancy tests and ultrasound, pregnancy can be diagnosed before the first missed period. When the miscarriage rate includes those fetuses lost before missing a period, the miscarriage rate increases up to 40 percent.
Miscarriage before there is a beating heart is common and is usually a chromosomal mutation which doesn’t support life. These are not preventable. However, once the heart is beating, several conditions can lead to a miscarriage.
Risk Factors for Miscarriage
Activities like sexual intercourse and/or exercise have been believed to contribute to miscarriage, but there is no scientific evidence to suggest this.
The following factors are considered possible contributors to miscarriage:
- Alcohol and/or drug abuse
- Exposure to harmful chemicals or radiation
- Smoking
- Body trauma
- Uncontrolled or chronic conditions
- Complications with the cervix or uterus
- 2 or more miscarriages
The important point about repeated miscarriages is that they are preventable. If you have had more than two miscarriages, it’s time to look at the list of treatable conditions that are known to contribute to miscarriage in some women.
There are many bacterial infections that can cause miscarriage in some women, including Strep B. The current fashion is to leave Strep B untreated until delivery because one course of antibiotics may not successfully eradicate the organism. However, if the recurring infection is not treated until delivery, the organism can cause miscarriage before the mother reaches full term.
In addition, there are some clotting disorders which can cause miscarriages. If you have had two miscarriages, you should be checked for clotting disorders such as Factor V Leiden and methylenetetrahydrofolate reductase (MTFHR).
Signs of Miscarriage
There is cramping with miscarriage, often like a period, but sometimes more severe. Most of the time bleeding will be heavier than a period.
These are some of the common symptoms of a miscarriage:
- Severe abdominal cramps
- Heavy spotting
- Vaginal bleeding
- Discharge of tissue or fluid from your vagina
- Mild to severe back pain
- Weight loss
- Contractions
If you experience any symptoms or notice any sudden changes, you should call your doctor or midwife immediately.
The Important of Grieving
Emotionally, the events surrounding miscarriage are death and failure. This death is real and includes the five stages of grieving and guilt described by Elizabeth Keebler Ross’s landmark research in On Death and Dying. I consider grieving the most important part of recovery from a miscarriage.
Pregnancy After Miscarriage
One precaution: always remember after miscarriage getting pregnant again is often very easy. Some providers say wait for three months before getting pregnant again. I always suggest waiting for one regular period before getting pregnant again. It can then be determined with more accuracy when you are due. In addition, having a normal period signals you are done with the miscarriage.
Miscarriage is NOT your fault!
Miscarriage is traumatic for all pregnant women and their partners. If you have had, are having, or will have a miscarriage, remember this: Miscarriage is NOT your fault.