Understanding Miscarriages:
What is a Miscarriage?
A miscarriage is a pregnancy loss before 20 weeks (or 5 months) of pregnancy. Another name for miscarriage is “spontaneous abortion.
Factors Contributing to Miscarriages:
Most couples spend time wondering WHY they had a miscarriage so I’m going to spend a good bit of time discussing several causes of miscarriages.
Genetics:
Nearly 50+% of all early pregnancy losses are related to genetic abnormalities that would not have allowed the baby to live. To determine this, the tissue from the miscarriage would need to be sent to a genetics lab through your hospital.
Structural issues:
Fibroids and polys in the living of the uterus can lead to issues with blood supply to the baby vs difficulty fully planting on the living of the uterus
Infection:
This is not as common as the others, but it’s certainly a cause. Sometimes moms can have a uterine infection that leads to a miscarriage. For this to be the cause the infection is typically severe, like PID (pelvic inflammatory disease). PID is from an untreated sexually transmitted infection, like gonorrhea or chlamydia.
Another type of infection is called chorioamnionitis, or infections in the sac that the baby lives inside. This could be related to sexually transmitted infections or other abnormal bacteria. You’ll usually see this cause in the second trimester. There’s some data on use of probiotics to help your body have normal bacteria to prevent this and preterm deliveries (delivery after 20 weeks/5 months).
Blood clotting disorders:
After a person has had 2-3 early miscarriages, we begin to test for things like lupus and other blood clotting disorders. Usually taking a blood thinner (Lovenox) or baby aspirin from the moment you have a positive pregnancy test is what helps here.
Cervical insufficiency:
Cervical insufficiency or incompetence is related to issues with a “weak” cervix, meaning it starts to dilate too early and you basically go into “labor” far too soon for the baby to survive. This is usually seen in the second trimester. If this has happened to you, ask about a cervical cerclage (a procedure where you have a stitch placed in the cervix to help keep it strong and closed)
As sad as miscarriages are, I have to inform you that with all the searching of the reason why a miscarriage is a part of your fertility story, many times, there are no causes found.
Also, I must mention that miscarriages are NOT causes by working, exercising and doing your daily activities. Many times, I hear patients say, "I should have sat down" or that their families told them that. That concept is misleading. Daily activities, including exercise does not contribute to miscarriages.
Impact of Miscarriage on Families:
A loss is a loss. Four weeks or 40 weeks at terms... It is a loss. Pregnancy losses hurt and can be detrimental to the mental state of a person, especially if it was a desired pregnancy. They can also be detrimental to a relationship. Here are a few tips to help individuals and couples heal from a pregnancy loss:
-Take time to process the loss. If this means you need to take 1-2 weeks off work to cry, sit alone, think, be angry, do it.
-Consider grief counseling. Being able to talk through your feelings creates healing for the soul!
-No blaming. Too many times we hear families and partners blame the mother. No one is at fault for a miscarriage. Remember, "sitting down" doesn't prevent a miscarriage.
-Take a few periods before attempting pregnancy again. In the meantime, work on getting your health in check (blood pressures, blood sugars, stress, etc). Also take prenatal vitamins.
All in all, pregnancy losses are difficult to navigate and every individual will process it differently. Take time to heal the way you need to heal and block out others who are not contributing to your healing process.
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