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Miscarriage: Misconceptions, causes and signs of miscarriage


What is a miscarriage?

Miscarriages are more common than you might think - they affect around 15% of pregnancies (about 20-25% of women), yet they remain a taboo subject.

A miscarriage is a spontaneous abortion, often occurring when the embryo or foetus has a genetic abnormality or when it can't implant itself in the uterus. The majority of miscarriages happen before the first month and a half of pregnancy.

And while many women have experienced a miscarriage, a lot of women can feel isolated and alone because talking about it publically can be very painful.

Misconceptions about miscarriages

General Practitioner Dr Ian Campbell, talked us through some common miscarriage misconceptions...

FALSE: "Miscarriages are genetic"
It's time to debunk this myth, miscarriages are not genetic.Therefore, if your mother suffered miscarriages, it doesn't necessarily mean you're going to go through the same thing.

FALSE:"Tiredness and stress can cause a miscarriage"
Again, this is false! The effects of tiredness and stress in miscarriage haven’t been proven.

Nevertheless, there are risk factors: certain extreme work conditions (carrying heavy loads, inhaling products, exposure to lead...), long journeys, vigorous sports or tobacco and alcohol consumption increase the risks of miscarriage.

Drugs, caffeine and some medication can also, in certain cases, provoke miscarriages.

If in doubt, it's advisable to lead a balanced lifestyle - physically, emotionally and mentally.

FALSE: "Miscarriages only affect a small number of women"
One in four experience a miscarriage in early pregnancy - this amounts to about 20% of women in the UK.  The risk of miscarriage also increases with age: during a late pregnancy (after the age of 40), there is a greater risk of the embryo being genetically malformed.

FALSE: "All miscarriages are the same"
There is a distinction between non-recurrent and recurrent miscarriages (when there are at least 3 successive spontaneous abortions).

The latter affects less than 1% of women. Statistics show that when a woman has had a spontaneous miscarriage, the risk of a miscarriage during her next pregnancy is slightly increased.

 

Causes of miscarriages

A miscarriage can have multiple causes:
 
First pregnancy
Miscarriages are more likely during a first pregnancy: the uterus isn't completely ready yet but it's not a cause for concern: the following pregnancy has every chance of success.
 
Genetic accident
This represents 90% of early spontaneous miscarriages. When the foetus has a genetic abnormality (trisomy, monosomy, etc), the woman's body rejects the embryo, as if it were a "foreign" body. There is no reason for the following pregnancy to be affected.

Male factor
The quality of the man's sperm can sometimes be the cause of recurrent miscarriages. Get a sperm test to be sure.

Hormonal imbalance
If successive miscarriages occur after seven or eight weeks of pregnancy, hormones could be the reason. This can be cured wth a prescription of progesterone until the 12th week of pregnancy, before the placenta takes over.
 
Uterine (womb) abnormality
Miscarriages can also be caused by a deformity of the uterus or cervix. Sometimes, under pressure from the uterus, the woman's cervix opens and the foetus passes out.

If the mother of the pregnant woman was prescribed Diethylstilboestrol (DES), one doesn't need to look much further: this synthetic form of oestrogen, designed to prevent miscarriages, is often the cause of miscarriages.

For those who haven't been exposed to DES, a weak cervix can be treated with cervical stitching (cerclage), whereby stitches are placed in the uterus to keep the cervix closed during pregnancy.
 
Infection
Certain infections or sexually transmitted diseases may cause miscarriages but nothing is certain... 
 
Lifestyle
Once again, nothing is proven: just try to live a balanced lifestyle. Don't lose sight of the fact that, in the majority of cases, miscarriages are often due to external factors, and the large majority of miscarriages have no explanation.

Signs of a miscarriage

The signs of a miscarriage differ according to the length of pregnancy but there are some good indicators to be aware of:

Bleeding

This is the main warning sign of a miscarriage. Bleeding may vary, it might start, then stop, before starting again. If you're bleeding constantly, you should go to hospital as quickly as possible. After you experience bleeding, you should have a thorough examination and lie down as much as possible.

Pain and bleeding
Pain isn't really a sign of miscarriage in itself. However, if pelvic pain is accompanied by cramps, diarrhoea, vomiting or period-like pain, it could be the start of a miscarriage.

If the pain isn't accompanied by bleeding, it's not worth going to hospital: the doctors can't do anything to stop a miscarriage.

The only emergency available is when bleeding is constant and abundant: you'll most likely have to have a D&C procedure (dilation and curettage).
 
Disappearance of pregnancy symptoms
If the signs of pregnancy (swollen breasts, etc) disappear, it could also indicate a miscarriage.

It's often during the ultrasound scan that the end of a pregnancy can be detected. A 'dead egg' can stay in place for 4 to 10 weeks.

After a miscarriage

Having a miscarriage is a difficult time to get through, it can bring about feelings of guilt, failure, grief, suffering or even depression.

A miscarriage is often experienced as a bereavement. Yet, the mother can often do nothing about this natural event: remind yourself of that fact if you're coming to terms with a miscarriage.

Don't try to find a guilty partner (yourself, your doctor, stress) and above all, don't suffer in silence. Certain therapies - acupuncture, psychotherapy, massage - can help you.

Don't bottle things up, express how you're feeling and talk about your experience as much as possible: on the sofeminine forum, for example, you will find lots of women who have gone through the same experience.

It really does help to be able to talk about how you're feeling.


Trying again?

When you feel ready to try and get pregnant again, the best possible preparation is giving yourself a break. Try to stop worrying that miscarriage will happen again.

Even though it's possible to minimise the risks of a spontaneous abortion, nothing and nobody can prevent a miscarriage.

There is no miracle remedy - Try to stay relaxed and keep in mind that the chances of you having a miscarriage are minimal.

If you've just suffered a miscarriage, it's recommended that you wait two or three cycles before trying again for a baby: even though you could fall pregnant in the cycle following the miscarriage, it's better to wait for your body and mind to recover from the previous pregnancy.

Latest… 25/10/2014
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