A miscarriage is the loss of a baby before the 20th week of pregnancy
According to the March of Dimes, as many as 15% of all recognized pregnancies, and as many as 40% of all pregnancies end in miscarriage. The reason for the large difference between these two numbers is that many miscarried pregnancies go unnoticed because they occur before a woman realizes she was pregnant.
There are many old wives tales about the possible causes of miscarriage, including sex, excessive exercise, bad karma, and even misalignment of the astrological signs. Unfortunately, the truth is that the causes of many miscarriages are not known.
Most miscarriages occur in the first trimester (12 weeks) of pregnancy and are the result of chromosomal abnormalities in the developing embryo. These chromosomal abnormalities prevent the embryo from developing normally and the body spontaneously terminates the pregnancy. Other potential causes of miscarriages are infections, hormonal problems, reproductive tract abnormalities such as fibroids, or other health issues and illnesses affecting the mother.
The bad news is that there is nothing either a woman or her doctor can do to prevent an impending miscarriage. The good news is that most women who lose a child to miscarriage go on to have a healthy pregnancy in the future.
There are, however, certain risk factors.
If you have some of these risk factors, eliminating and modifying as many of them as possible may help reduce your risk of miscarriage. Before your next pregnancy, you may want to consider genetic testing and/or counseling.
The signs and symptoms of a miscarriage include:
If you are pregnant and experience any of these symptoms, contact your doctor immediately.
Certain medical problems may increase your risk for miscarriage. Testing of the mother, the father, or the fetus can reveal the cause of the miscarriages in up to 70% of couples. However, even if you have had repeated miscarriages, you may still be able to complete a healthy pregnancy.
If the reason for your repeated miscarriages is a weak cervix, you may be able to undergo a cerclage. This is a procedure in which a stitch is made around the cervix to help keep it closed throughout the pregnancy.
If you have a chronic disease, such as diabetes, keeping the condition under control will also increase your chances of having a healthy pregnancy.
If you have thrombophilia, taking a blood thinner may help reduce the risk of miscarriages.
Progestin may be another therapy that can help reduce the risk of miscarriage in women with a history of recurrent miscarriages.
If you have repeated miscarriages, ask your doctor for a complete medical evaluation to determine the cause.
If you have experienced a miscarriage or the loss of a child for any reason, it is important for you to understand that grief is a very individual experience. There is no right or wrong way to grieve. However, it is also a process made up of several stages, and while you may skip or repeat certain phases, it is helpful to understand what they are.
The phases of grief:
The loss of a child, at any age, for any reason, is likely the most tragic and difficult loss any family can face. In addition to the physical loss, there is an emotional loss, and the loss of all the promise that life contained. Recovering from the loss is a slow process. But with support and time, you can heal.
The American Congress of Obstetricians and Gynecologists
US Office on Women's Health
Women's Health Matters
Christiansen OB, Nybo Anderson AM, Bosch E, et al. Evidence-based investigations and treatments of recurrent pregnancy loss. Fertil Steril. 2005;83(4):821-839.
Early pregnancy loss: Miscarriage and molar pregnancy. American Congress of Obstetricians and Gynecologists website. Available at: http://www.acog.org/~/media/For%20Patients/faq090.pdf?dmc=1&ts=20130725T1029548132. Accessed July 25, 2013.
Miscarriage. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated April 29, 2013. Accessed July 25, 2013.
Miscarriage. March of Dimes website. Available at: http://www.marchofdimes.com/baby/loss_miscarriage.html. Updated October 2008. Accessed July 25, 2013.
Recurrent pregnancy loss.EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated October 10, 2012. Accessed July 25, 2013.
Repeated miscarriage. American Congress of Obstetricians and Gynecologists website. Available at: http://www.acog.org/~/media/For%20Patients/faq100.pdf?dmc=1&ts=20130725T0945500212. Accessed July 25, 2013.
2/9/2012 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Lund M, Kamper-Jørgensen M, Nielsen HS, et al. Prognosis for live birth in women with recurrent miscarriage: what is the best measure of success? Obstet Gynecol. 2012;119(1):37-43.
Last reviewed July 2013 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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