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A miscarriage, undoubtedly, is the most unfortunate event to take place during pregnancy and no mother should have to go through this turmoil. As per March of Dimes, “10-15 on 100 pregnancies can end in a miscarriage,” which, in terms of percentage, equals to 15% of pregnancies. Out of this number, most miscarriages happen in the first trimester, that is, before the 12th week of pregnancy; whereas, in the second trimester (between 13 and 19 weeks) miscarriages are as rare as in 1 to 5 in 100 (1 to 5 percent) pregnancies. Given the stats, since the probability is rather high, it only makes sense for expecting mothers to educate themselves about miscarriages in order to be sure than sorry.
Since all women, all bodies, and all pregnancies are different from others, the experiences of a woman through her pregnancy are also varied. As a pregnant woman, even the smallest of unusual events might make you want to believe the worst. However, by the end of this blog, we hope that you’d be better equipped with the knowledge that can get you through all such confusions.
What is a miscarriage ?
A miscarriage, generally understood by all as the uneventful death of a baby in the womb, as per Wikipedia, is defined as “a spontaneous abortion and pregnancy loss, the natural death of an embryo or fetus before it is able to survive independently.” A miscarriage is referred to as a miscarriage only if the death of the baby happens before the 21st week of pregnancy. After the 20th week, the death is referred to as a stillbirth.
In a miscarriage, in layman’s terms, the embryo is spontaneously and unexpectedly discharged from the uterus, before 20 weeks of pregnancy. The most common symptom of a miscarriage is heavy vaginal bleeding and period-like abdominal cramps.
Signs and symptoms of a miscarriage ?
Though the symptoms of a miscarriage vary greatly from woman to woman, the most common signs and symptoms of a miscarriage include :
- Abnormal, intense pain in the lower back and/or abdomen region
- Heavy vaginal bleeding, perhaps, with the appearance of clots and tissues
- Light bleeding lasting for more than three days in a row
- Sudden dying down of other pregnancy symptoms like nausea, food aversion, or tender breasts
Is light bleeding during pregnancy okay ?
Oftentimes, women experiencing light bleeding or spotting during pregnancy tend to get alarmed and might imagine the worst- a miscarriage- for themselves. However, it should be known that light spotting during pregnancy might not be a reason for serious concern and might not be indicative of a miscarriage. If you have a reason to believe that the spotting is not as normal as it is supposed to be, it’s best to check in with your doctor and rule out any uneventful possibilities.
What causes a miscarriage ?
The reason for a miscarriage varies from woman to woman, from situation to situation, and from trimester to trimester. As discussed, most miscarriages happen during the first trimester. Here are the trimester-wise possible causes of a miscarriage –
1. Miscarriages in the First Trimester: Causes and Symptoms
- Most miscarriages that happen before the first 13 weeks of pregnancy are usually unavoidable and a result of chromosomal abnormality in the DNA. Hence, dear mamma, please do not beat yourself up if you happen to suffer from a miscarriage in the first 13 weeks of your pregnancy.
- Other possible reasons for a miscarriage in this time frame could be hormonal abnormalities, poor maternal health, failure of the implantation of the egg to the uterine lining, an underlying health issue, or even exposure to toxic environments.
- As per science daily, age also plays a role when it comes to miscarriages. The lowest miscarriages are found to be in women between ages 25-29 (10%), only to increase to a whopping 53% for women above 45 years of age. Such an occurrence can be associated with poor egg quality causing egg chromosomal abnormalities with increasing age.
The most common symptoms of a miscarriage happening in the first trimester include-
- Immense, abnormal, unbearable, piercing back pain
- White-pink colored mucus discharge from the vagina
- Pelvic contractions
- Painful diarrhea accompanied by abdominal pain
- Brown or bright red bleeding with/without cramps
- A sudden dismissal of pregnancy-related symptoms including nausea, breast tenderness, and heartburns
Having said that, it should also be kept in mind that some women might not experience any symptoms or experience anything unusual even after having suffered a miscarriage. If you happen to feel even the slightest of discomforts or have even the tiniest of reasons to believe that you have suffered from a miscarriage, do not double-question, listen to your gut, and reach out to your doctor immediately.
2. Miscarriages in the Second Trimester: Causes and Symptoms
A pregnancy miscarriage in the second trimester, that is, after the 20th week of pregnancy, is not called a miscarriage and is instead referred to as ‘stillbirth.’ Though a highly uncommon occurrence, the causes of a miscarriage after the 20th week of pregnancy or a ‘stillbirth’ include-
- Chromosomal abnormalities
- Cervical insufficiencies
- Drug/ substance use
- A possible infection in the mother’s body
3. Miscarriages in the Third Trimester: Causes and Symptoms
As discussed, the loss of an embryo in the third trimester is referred to as a stillbirth and is not a miscarriage. The causes of stillbirth in the third trimester remain the same as those of the second trimester and the symptoms include-
- Abnormal loss of blood via the vagina
- Heavy cramping in the vaginal area
- Reduced or stopped baby movements
If you happen to be experiencing any of these symptoms, please do not delay and speak to your doctor immediately. Also, it should be noted that doing a daily kick count in your third trimester can help greatly determine a baby’s health as you would be able to identify a decreased baby movement.
interlink The Guide To Understand A Baby’s Movement: Fetal Movement and Kick Counts once published on website
What happens in a mother’s body after a miscarriage ?
Typically, miscarriages are diagnosed by having a look at multiple factors like hCG (pregnancy hormone) levels, the status of the cervix (it should be closed during pregnancy), an ultrasound to examine the gestational sac, and by listening to a fetal heartbeat.
Once a complete miscarriage is diagnosed, most women happen to expel all content of the uterus, including the fetus, placenta, and the extrauterine lining naturally, a process that can take as long as two weeks. For some women, in some cases, when some parts of the pregnancy are retained by the uterus and not fully expelled, medicines might be prescribed by the doctor to help the body clear out the uterus. This is necessary because a woman’s body cannot function normally and cannot recover unless the uterus is emptied. In rarer cases yet, if medications do not help, the doctor might also advise a specific surgery called dilation and curettage, or D&C to artificially empty the uterus.
What are the factors that increase the risk of miscarriages ?
Apart from the trimester-wise causes of a miscarriage, here are some other factors that increase the chances of a miscarriage in women-
- Irregular Vitamin Levels
While lack or deficiency of vitamin D and vitamin B12 can increase a woman’s risk of miscarrying, high levels of vitamin A can also be dangerous during pregnancy. Maintaining a normal vitamin level is necessary for a healthy pregnancy, also why doctors recommend prenatal vitamins and regular vitamin tests
- Abnormal weight
Overweight (women with a BMI of 30 or higher), as well as underweight (women with a BMI of 18 or under), are at high risk of miscarriage
- Untreated thyroid imbalances ( hypothyroidism as well as hyperthyroidism) even if it was in the past
- Substance use (prolonged use/abuse of alcohol, drugs, and smoking)
- Sexually Transmitted Diseases
- Chronic diseases like kidney disease, autoimmune diseases, polycystic ovary syndrome (PCOS), and diabetes
- Non-recommended usage of over-the-counter medicines (never pop a pill without prior consultation with your doctor during pregnancy)
- Exposure to toxins like lead, mercury, organic solvents, and ionizing radiations
- Uterine fibroids
A commonly diagnosed tumor in women as they age, uterine fibroids, increase the chances of a miscarriage, especially if they are around the uterus or tend to grow in correspondence with increasing pregnancy hormones.
It is advised to always make sure that you discuss all pre-existing or formerly existing health conditions with your doctors as soon as you learn about your pregnancy to avoid a mishap.
Pregnancy After A Miscarriage: Can I Conceive Again After a Miscarriage ?
Usually, most women who have had a miscarriage do end up conceiving again and giving birth to a healthy baby! Quoting from the website of the American College of Obstetricians and Gynecologists (ACOG), “even after two or more consecutive losses, around 65 percent of women go on to carry their next pregnancy to term.”
Typically, reasons for recurring miscarriages (two or three miscarriages) need medical intervention and to be intensively diagnosed to find the probable cause. Some reasons for recurring miscarriages include-
- An autoimmune disease in the mother’s body
Such a disease causes the mother’s immune system to misunderstand the embryo and instead of protecting it, the immune system tends to attack the embryo. An autoimmune disease is again a thyroid problem.
- Apart from an autoimmune disease, mothers might also be tested for blood-clotting disorders and for chromosomal abnormalities. It should be noted that a blood clotting disorder can occur when a woman’s body begins to produce antibodies that attack their own tissues, resulting in blood clots that clog the maternal blood vessels. This clogging, thereby, causes insufficient food supply to the placenta.
As a final takeaway, we understand how emotionally taxing a miscarriage. However, please never beat yourself up and do not blame yourself or your partner as most miscarriages are unavoidable.
You might also be wondering, having read all this information, “how do I avoid a miscarriage?” To quote ourselves again, unless a specific potential cause or an underlying disease is pre-determined in your body, there is not much that can be done to avoid a miscarriage.
However, the following are the most recommended tips and advice to avoid the chances of a miscarriage-
- Always, in detail, explain and discuss any formerly existing health conditions to the doctor before planning a conception
- Keep a check on your weight and try to keep it in a healthy range
- Take prenatal vitamins
- Curb the use of substances including alcohol, cigarettes, and drugs
- Never pop an over-the-counter pill unless recommended by the doctor
All said and done, if you are a woman who has gone through a miscarriage, please ensure that you don’t close yourself and punish yourself for the loss. Always remember, a miscarriage is unfortunate but in most cases it also is unavoidable. Share your feelings, speak to your partner, express yourself to your friends or even a professional if required, and take some time off to recover from the loss.
It is never the end of the world and your friends, licensed therapists, your family, your partner, and even us at Parenthood Bliss are always available to extend a listening ear- we will get through this together!