Miscarriage

Miscarriage

Losing a baby

A SAD AND DIFFICULT EXPERIENCE

Miscarriage is an extremely sad and difficult experience to deal with. To add to the difficulty is the pressing problem of explaining to friends and family that a new baby will not be coming any time soon. If you have a pregnancy loss, you are entitled to whatever feelings you have, whether they are mild or intense, mixed or very clear. Some women feel like they're in shock, or depressed and guilty. They may feel that way for many weeks or months. If you are told that you're "overreacting" or "exaggerating your feelings," know that this is not true.

On the other hand, some women feel sad for a few days at the most and that's all. Don't feel bad if you don't feel bad, and you don't have to believe those who say you are "repressing" or "denying your feelings." Your feelings will vary depending on many factors. Another factor in pregnancy grief is how far advanced the pregnancy was. Were you six weeks pregnant, or did you go through labor and give birth to a perfectly formed baby who tragically died? Often, but not always, the intensity of feeling increases the bigger the baby is.

Be aware that your body "grieves," too. It suddenly has to adjust hormonal levels and make other bodily changes. The further along you are, the more adjustments your body has to make. This "body grief" affects a woman who has an abortion, too. Breasts leak and other body changes occur.

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CAUSES AND PREVENTION

About half of the miscarriages that occur are caused by genetic abnormalities, which may be hereditary or spontaneous, in the father's sperm or the mother's egg. The other half are caused by a variety of known and unknown factors, including infection (mumps, for instance, in the first trimester increases the risk for miscarriage) and exposure to environmental and workplace hazards. Pesticides, the effects of Agent Orange (dioxin) experienced by some Vietnam Veterans, tap water near industrial sites, and using a video display terminal more than 20 hours a week.

Other factors behind miscarriage are hormonal irregularities; uterine abnormalities; radiation; and drugs, whether over-the-counter, or prescription.

Severe malnutrition can cause a miscarriage, as can an elevated blood sugar level in women with diabetes. If dietary problems are the culprit, then an improved diet sometimes helps prevent miscarriage. Induced ovulation with fertility drugs sometimes result in miscarriages, as does in vitro fertilisation. Two prenatal tests, amniocentesis and chorionic villi, are also associated with a slight risk of miscarriages.

To prevent miscarriage, some women are treated with progesterone, a hormone which is needed for implantation in the uterus. Research is mixed on the effectiveness of this, and researchers believe it should only be done if tests show that the body produces too little of that hormone in the early weeks of pregnancy.

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STEPS TO HELP AVOID MISCARRIAGE


Sensible steps taken from Miscarriage - What every woman needs to know, Professor Lesley Regan, 2001, Orion Books, London

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TYPES OF MISSCARRIAGE


A miscarriage occurs if you lose your baby before it is capable of sustaining life - normally considered to be before about 24 weeks. Most miscarriages happen in the first 10 weeks of pregnancy; in fact at least 30% of all conceptions end this way.

Not all miscarriages happen in the same way- there are several terms to define what takes place: "threatened", "missed," and "inevitable." In the first trimester, if there is bleeding but no pain, and the foetus stays alive and healthy so that the pregnancy continues to term, this is called a threatened miscarriage. You may have what is called a missed miscarrige if the foetus dies, but stays in the womb and is either expelled later or is removed by an operation. An inevitable miscarriage is the term used when there is bleeding and pain, the cervix opens and the foetus is expelled from the womb. If the miscarriage leaves small fragments of the placenta or blood clots in your womb, this is known as incomplete miscarriage.

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WARNING SIGNS

Vaginal bleeding with period-like cramps can be a sign that you are about to have a miscarriage. Bleeding at any stage of pregnancy, with or without pain, should always be taken seriously; seek medical advice immediately.

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TREATMENT AFTER MISCARRIAGE

Yes, you will probably have an ultrasound scan to see what has happened. You will not need treatment if the scan shows that your womb is clear. If the womb is not entirely empty, known as an incomplete miscarriage, you may need a procedure called an ERPC to clear your womb. If your womb is not treated in this way, an infection could develop which may affect your chances of future pregnancy. You will have a general anaesthetic and a short stay in hospital for this procedure.

 

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