What is miscarriage?

Losing a baby before 20 weeks of pregnancy is called a miscarriage.  It can be a very tough time to go through and, with around one in five pregnancies ending in miscarriage it sadly happens relatively frequently.  The likelihood of miscarriage also increases slightly with age.  Although some women experience a late miscarriage, the majority happen within the first 13 weeks of pregnancy or first trimester, and in fact 90% occur within the first eight weeks of pregnancy.


What causes miscarriage?

The first thing to recognise is that miscarriage is usually a natural process. The whole process from conception through early gestation is complex.  If anything about the pregnancy is abnormal then the developing fetus may not be viable and a miscarriage will occur.  For example, often an isolated miscarriage is a single event due to chromosomal error in the egg or the sperm.  If a woman endures three consecutive miscarriages, the miscarriages are considered recurring. A woman suffering recurring miscarriages may undergo medical tests to try and discover any underlying conditions that may be causing her to miscarry. 


How to reduce the risk of miscarriage

There are a few things you can do to reduce the risk of having a miscarriage. Giving up smoking is one of the most important, as is maintaining a healthy diet, plus cutting out caffeine and alcohol.

You may be at higher risk of miscarriage if you have diabetes, kidney disease, thyroid disease, lupus, an abnormality of your uterus or a history of miscarriage.  If this is the case it’s a good idea to consider having your pregnancy closely monitored by an obstetrician or your GP.


Signs of miscarriage

Some of the signs that you might be miscarrying often depend on how long you have been pregnant. Prior to six weeks of pregnancy the only sign may be bleeding that looks like a heavy period. Miscarriage later in the first trimester at six to eight weeks will include cramping as well as bleeding. You should contact your fertility or pregnancy care provider immediately if you are experiencing signs of miscarriage.  Often an ultrasound can be carried out to see whether or not your pregnancy is proceeding normally or if you have miscarried.

Some women will have little or no sign that their pregnancy is no longer continuing. This type of miscarriage is referred to as a ‘missed miscarriage’.  Often it is only at first ultrasound that the miscarriage is confirmed.


What happens next?

Women should then discuss with their Doctor whether to have an operation to remove any remnants of the pregnancy - this is called a D & C (dilation and curettage) - or whether to allow time to miscarry naturally.

Women who choose to wait for a natural miscarriage after being diagnosed with a pregnancy loss often wonder how long it will take for the bleeding to start if it hasn’t already. Overall 70% of women who chose natural miscarriage miscarry within 14 days of diagnosis. However it is OK to change your mind at any time and choose D & C, or your doctor may recommend this method.


Emotional impact

Suffering a miscarriage can be very traumatic. Not only is it taxing on you physically, but emotionally, the healing process can take much longer.

As with any loss it is normal for people to feel grief after a miscarriage. It is important to remember that entering a grieving period after a significant loss is a perfectly normal emotion.  On the other hand, some people cope more easily, and some people may suffer upset at a later date.

Miscarriage can make men nervous to talk to their partners. They can be upset about the pregnancy loss, but they can also be grieving for their partner.  After a miscarriage a couple’s relationship may become significantly strained.  Seeking out counselling can help you work through your grief as well as improve the communication between you and your partner.

Friends and family can also be a good source of support.  Miscarriage occurs so frequently that a family member or friend may also have experience of this and together you may find support.

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