Miscarriage is a normal risk of pregnancy. How do you spot the signs and can you prevent it?
As soon as a woman gets pregnant, she has at least a 20% risk of having a miscarriage. Once we see the baby’s heart beating (around 6 and 1/2 weeks gestation), that risk goes down to 5% and once you get out of the first trimester (13 weeks gestation), that risk goes down to less than 1%.
What causes a miscarriage?
Essentially, a miscarriage is when an embryo or fetus stops growing and dies. It is also defined as any birth before 20 weeks of pregnancy. A miscarriage is the most common complication of early pregnancy and can occur for many reasons: genetic, chromosomal or uterine abnormalities; problems with the umbilical cord or placenta; reproductive tract infections; polycystic disease; multiple foetuses; high blood pressure; maternal age; uncontrolled diabetes; and heavy smoking.
Many women who miscarry subsequently go on to have normal, full-term pregnancies. If you have three consecutive miscarriages, further medical investigation may be required to determine a specific cause.
What are the signs of a miscarriage?
The first signs of miscarriage are usually spotting or bleeding with or without cramping. An ultrasound of your uterus will confirm whether you have miscarried.
While bleeding can certainly occur in the first trimester and not lead to a miscarriage, any amount of bleeding is always worth getting assessed, if for no other reason than to give you the reassurance that your pregnancy is progressing normally.
If you are experiencing painful or unusual cramping, or have a fever, call your health care provider immediately. Depending on how far your pregnancy progressed, you may need medical help to remove tissue from your uterus to prevent infection or stop the bleeding.
How do I prevent a miscarriage?
Unfortunately, there is nothing we can do, no drug we can offer, to prevent a miscarriage from happening. And other than taking control of your health and not smoking, there is also very little you can do - bed rest does not prevent miscarriage. And activities such as exercise and sexual intercourse do not increase the risk of miscarriage. (Of course, it’s always wise to take things easy and curtail overly strenuous activities once you are pregnant, at the very least you won’t blame yourself needlessly should you miscarry).
How do I cope?
Many couples blame themselves for a miscarriage. Losing a baby at any stage of pregnancy is difficult and everyone deals with the loss in his or her own way. Yes, there will be anger, guilt and, of course, sadness. Family and friends or colleagues may not know what to say or say completely inappropriate things. People are often uncomfortable talking about death – especially when it involves a baby. You may find it helpful to speak with a local support group, a member of the clergy or other women who have experienced the same kind of loss. Most hospitals have information packages they can provide you with.
You might also find these resources useful to help you through this difficult time:
- Centre for Reproductive Loss
- Pregnancy and Infant Loss Network (PAIL network)
- Bereaved Families of Ontario
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