Miscarriage: How To Deal and Prevent It From Happening

Miscarriage, a heartbreaking event for many, is a loss that affects millions of women and their partners worldwide. Experiencing it can be one of the most emotionally challenging events in a person’s life.

It’s a loss that’s often overlooked by society, yet deeply felt by those who endure it. Despite its prevalence, the topic remains surrounded by stigma and misconceptions.

In this article, we’ll explore the topic of miscarriage in detail, offering insights into its causes, symptoms, treatments, and emotional effects, whether you’re someone who has experienced it first-hand or seeking to understand and support a loved one, this guide aims to provide clarity and support.

Understanding Miscarriage

What is Miscarriage?

it is medically known as spontaneous abortion, refers to the loss of a pregnancy before the 20th week, happening in approximately 10-20% of recognized pregnancies.

It can occur due to various factors, including genetic abnormalities, hormonal imbalances, or uterine issues. Understanding the process of miscarriage and its potential causes is essential for individuals navigating this challenging experience.

What Causes Miscarriage?

Understanding the causes of miscarriage can provide some clarity, although in many cases, the exact cause remains unknown.

Some common factors that may contribute to it include:

Chromosomal abnormalities

Most miscarriages occur due to genetic abnormalities in the embryo, making it unable to develop properly.

Anembryonic pregnancy: This occurs when either an embryo fails to develop or when it forms but gets reabsorbed into the body. The embryo comprises the cells that typically grow into an unborn baby, also known as a fetus.

Intrauterine fetal demise: In this situation, an embryo begins to form and then stops developing, it dies before any signs of pregnancy loss manifest.

Molar pregnancy and partial molar pregnancy: In cases of molar pregnancy, fetal development doesn’t occur, typically when both sets of chromosomes originate from the sperm. This condition is associated with irregular placental growth, “the pregnancy-associated organ responsible for providing oxygen and nutrients to the fetus.”

In partial molar pregnancies, some fetal development may occur, but the fetus cannot survive. This situation arises when there’s an additional set of chromosomes, known as “triploidy”. The additional set is often contributed by the sperm but can also be contributed by the egg

Both molar and partial molar pregnancies are unable to progress due to their potential to cause severe health complications. In some cases, these pregnancies are associated with placental changes that can lead to cancer in the pregnant individual.

Other chromosome abnormalities: include anencephaly, a neural tube defect; trisomies, which can lead to conditions like Down syndrome; renal agenesis, a kidney defect; and hydrops, a form of thalassemia.

Maternal health conditions

In some cases, having certain health conditions may cause miscarriage, including:

Uterus or cervix problems, such as the Septate uterus, Asherman syndrome, Fibroids and polyps or scars from surgery on the uterus, or Cervical insufficiency (also called incompetent cervix).
Infections, such as Cytomegalovirus, sexually transmitted infections (STIs), Listeriosis, or Parvovirus B19.
Certain medicines, like isotretinoin (Accutane).
Uncontrolled diabetes.
Hormonal problems.
Obesity.
Thyroid disease.
Severe malnutrition.

What Are The Types of Miscarriage?

There are different types of miscarriage, each with its own characteristics and implications. Knowing the distinctions between these types can aid in diagnosis and management.

Threatened Miscarriage: This occurs when there is vaginal bleeding and pelvic cramping, but the cervix remains closed, indicating the possibility of miscarriage.
Inevitable Miscarriage: Characterized by bleeding and cramping with an open cervix, and the possibility of leaking amniotic fluid, indicating that miscarriage is likely to occur.
Incomplete Miscarriage: This happens when not all the pregnancy tissue is expelled from your body. you may experience symptoms including bleeding, cramping, and other signs typical of miscarriage.
Complete Miscarriage: You lost the pregnancy, and your uterus is now empty. You’ve had bleeding and passed fetal tissue. Your healthcare provider can confirm a complete miscarriage with an ultrasound.
Recurrent miscarriage: It is the loss of two pregnancies in a row, and affects approximately 1% of couples.

What does NOT cause miscarriage?

Activities like these typically prevent miscarriage:

1-Exercise, provided you are in good health. However, it’s advisable to consult your pregnancy care team beforehand and avoid activities with a risk of injury, such as contact sports.

2-Arguments.

3-Use of birth control pills before getting pregnant.

4-Sex.

5-Working, unless exposed to high levels of harmful chemicals or radiation. If concerned about workplace risks, consult a healthcare professional.

It’s common for people who have experienced a miscarriage to blame themselves, attributing it to falls, intense scares, or other factors. However, miscarriages mostly occur due to random events that are beyond anyone’s control.

Signs and Symptoms of Miscarriage

Recognizing the signs of miscarriage is crucial for seeking medical attention promptly. Common symptoms include:

Vaginal bleeding
Light spotting or heavy bleeding, often accompanied by cramping, can indicate a miscarriage.
Abdominal pain
Persistent abdominal cramps, similar to menstrual cramps, may occur during a miscarriage.
Passing tissue or clots
Passing tissue or clots from the vagina is a sign that the miscarriage is progressing.
Loss of pregnancy symptoms
A sudden decrease in pregnancy symptoms, such as breast tenderness or nausea, can signal a miscarriage.
Back Pain and Fever

Risk Factors of Miscarriage

Certain factors may increase the likelihood of experiencing a miscarriage, understanding these risk factors can empower individuals to make informed choices regarding their prenatal care. These factors include:

Age: As you get older, the likelihood of experiencing a miscarriage increases compared to a younger person. Specifically, at age 35, the risk stands at approximately 20%. By age 40, this risk escalates to approximately 33% to 40%, and by age 45, it reaches a range of 57% to 80%.

Weight: being underweight or overweight is associated with a higher risk of miscarriage.

Chronic health conditions: Such as uncontrolled diabetes or thyroid disorders

Certain medications: Certain studies indicate that nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, diclofenac, and naproxen, might elevate the risk. NSAIDs are medications utilized for relieving pain and inflammation. Additionally, isotretinoin, a medication for acne treatment, has been associated with miscarriage and fetal abnormalities.

Smoking and alcohol: Smoking, heavy caffeine or alcohol consumption, and the use of illegal drugs like cocaine increase the risk of miscarriage compared to non-smokers.

Stress: Both brief, intense periods of stress and prolonged stress can elevate the likelihood of miscarriage.

Previous miscarriages: If you’ve had one or more miscarriages before, you’re more likely to experience pregnancy loss again.

Uterine or cervical problems: Some uterine conditions or weak cervical tissues, known as incompetent cervix, can increase the risk of a miscarriage.

Getting pregnant while using an intrauterine device (IUD): Intrauterine devices (IUDs) are contraceptive devices inserted into the uterus to prevent pregnancy. However, in rare cases, individuals may become pregnant while using an IUD.

Management and Treatment of Miscarriage

If you have experienced a miscarriage, it’s essential to ensure that all fetal tissue is removed from your uterus to prevent potential complications like infection or excessive bleeding.

If the miscarriage is complete and your body expels all the fetal tissue, no further intervention is usually necessary. Your healthcare provider will perform an ultrasound to confirm that your uterus is clear of any remaining tissue.

However, if your body does not expel all the tissue naturally or if there’s no bleeding, your healthcare provider may suggest medication or surgery to remove the remaining tissue.

1. Nonsurgical treatment

For non-surgical treatment, your provider may recommend waiting to see if the miscarriage completes on its own, especially in cases of missed miscarriage. (Waiting for a miscarriage to start can take several days).

If it’s not safe to wait for the tissue to pass naturally or if you prefer to remove it as soon as possible, they might suggest medication to help your uterus expel the tissue. These options are typically suitable for miscarriages before 10 weeks of pregnancy.

If a miscarriage is suspected but not confirmed, bed rest and observation in the hospital might be advised until the bleeding subsides. In some cases, if the cervix is dilated, they might diagnose you with an incompetent cervix, and a procedure called (cervical cerclage) may be performed to close the cervix.

2. Surgical treatment

In cases where surgical intervention is necessary, your provider may perform a dilation and curettage (D&C) or dilation and evacuation (D&E) procedure, particularly if there’s heavy bleeding or incomplete miscarriage. Surgery might also be necessary if your pregnancy has progressed beyond 10 weeks.

These surgeries involve dilating the cervix and gently removing any remaining pregnancy-related tissue from the uterus under anesthesia in a hospital setting.

What tests should you have after repeat miscarriages?

If you had more than three miscarriages in a row, known as “repeated miscarriage”, then tests might be necessary. These tests include:

1-Chromosome tests

Both you and your partner can undergo blood tests, such as karyotyping, to screen for chromosome abnormalities. Karyotyping can assess the number and integrity of chromosomes. If tissue from the miscarriage is accessible, your healthcare provider can conduct tests to detect chromosomal conditions.

2-Hormone tests

You can undergo blood tests to assess hormone levels for any abnormalities. Additionally, your healthcare provider may recommend an endometrial biopsy, a procedure that involves removing a small piece of the uterine lining. This biopsy helps evaluate the timing of your menstrual cycle and hormone levels.

3-Blood tests

You might undergo a blood test to screen for autoimmune or hormonal conditions that could be contributing to miscarriages.

4-Looking at the uterus

You may undergo an ultrasound, a hysteroscopy (where a specialized scope is inserted through the cervix to examine the uterus), hysterosalpingography (an X-ray of the uterus), or other relevant tests.

How can I prevent another miscarriage?

Preventing a miscarriage is typically beyond control. If you experience one, it’s important to understand that it’s not your fault. Prioritizing your well-being is key. Here are some examples of how to take care of yourself:

1-Attend all your prenatal care appointments.

2-Maintain a healthy weight for your body.

3-Avoid risk factors such as alcohol consumption and smoking.

4-Take prenatal vitamins as advised.

5-Incorporate regular exercise and a nutritious diet into your routine.

Coping Strategies and Emotional Support

Navigating Grief

Experiencing a miscarriage often triggers a range of emotions, including grief, sadness, anger, and guilt. It’s essential to acknowledge and process these feelings, allowing oneself to grieve in a healthy and supportive environment.

Seeking Support

Whether through friends, family, support groups, or professional counseling, seeking support is crucial in coping with miscarriage. Sharing experiences and emotions with others who understand can provide comfort and validation.

Self-Care Practices

Engaging in self-care activities such as journaling, meditation, gentle exercise, or creative expression can help alleviate stress and promote emotional healing during the grieving process.

Honoring the Loss

Many individuals find solace in honoring the memory of their lost pregnancy through rituals, ceremonies, or memorialization activities. This can provide a sense of closure and acknowledgment of the profound impact of the loss.

Planning for the Future

While grieving is essential, it’s also crucial to look towards the future with hope and resilience. For those who desire to try again, discussing fertility options and planning for future pregnancies with healthcare providers can offer reassurance and support.

Finding Meaning and Purpose:

Exploring ways to find meaning and purpose amidst loss can be a transformative aspect of the healing journey. Whether through advocacy, volunteering, or creative pursuits, channeling grief into positive outlets can foster healing and growth.

Supporting Loved Ones Through Miscarriage

Empathy and Understanding

For friends and family members supporting someone through miscarriage, offering empathy, and understanding is paramount. Listening without judgment, validating emotions, and being present in their grief can make a significant difference.

Practical Support

Offering practical assistance such as meal delivery, household chores, or childcare can alleviate some of the burdens during this challenging time, allowing the grieving individual to focus on self-care and healing.

Educating Others

Breaking the silence surrounding miscarriage and educating others about its prevalence and impact can help reduce stigma and provide greater support to those who are grieving.

Checking-In Regularly

Consistently checking in on loved ones who have experienced miscarriages, even months or years later, demonstrates ongoing support and validation of their grief journey.

Encouraging Professional Help

Encouraging loved ones to seek professional help if needed and offering to accompany them to counseling sessions or support groups can provide additional support and encouragement.

Remember, you are not alone, and there is support available to help you navigate this challenging time.

What you need to know…

Miscarriage is a significant and often devastating experience that affects millions of individuals and couples worldwide, a deeply personal journey that requires patience, self-compassion, and support. By understanding the complexities of miscarriage, embracing coping strategies, and offering empathy and support to others, we can help reduce stigma and provide better support to those who have experienced this loss.

Remember, you are not alone in this journey, and healing takes time and compassion.

FAQs (Frequently Asked Questions)

Q: Can stress cause a miscarriage?

A: Stress alone is unlikely to cause a miscarriage, but chronic stress may contribute to certain pregnancy complications. It’s essential to manage stress levels for overall well-being during pregnancy.

Q: Is miscarriage hereditary?

A: While there may be genetic factors that influence miscarriage risk, it’s not typically considered hereditary in the same way as certain medical conditions. However, individuals with a family history of miscarriage may have a slightly higher risk.

Q: How soon after a miscarriage can you try again?

A: It’s generally recommended to wait until after one menstrual cycle following a miscarriage before trying to conceive again. However, individual circumstances may vary, and it’s essential to discuss timing with a healthcare provider.

Q: What are the chances of having a miscarriage?

A: The likelihood of miscarriage varies depending on various factors, including maternal age, health status, and previous pregnancy history. On average, the risk of miscarriage is estimated to be around 10-20%.

Q: Can miscarriage be prevented?

A: While not all miscarriages can be prevented, maintaining a healthy lifestyle and addressing any underlying health conditions can help reduce the risk.

Q: What are the psychological effects of miscarriage?

A: Miscarriage can lead to a range of emotions, including grief, guilt, anxiety, and depression. Seeking support from loved ones or a mental health professional can be beneficial in coping with these emotions.

Q: How long does it take to recover from a miscarriage?

A: The physical recovery from a miscarriage typically takes a few weeks, but the emotional healing process may take much longer. It’s essential to allow oneself time to grieve and seek support as needed.