Miscarriage: An Overview
A miscarriage can be a very overwhelming and upsetting experience for many people. Women often feel that it is their fault when they suffer a perinatal loss, especially if they have had multiple miscarriages. However, a pregnancy miscarriage is a very common experience among women.
What Is A Miscarriage?
Miscarriage, which is also known as a spontaneous abortion, is defined as a naturally occurring loss of a pregnancy before 20 weeks. After 20 weeks, it is referred to as a stillbirth.
How Common Is It?
Miscarriage rates estimate that as many as one in five pregnancies (or 20%) end in natural miscarriage. Some are even willing to put this number as high as 50% because so many early miscarriages happen before a woman even realizes she is pregnant.
Early pregnancy loss is most likely to occur in the first 12 weeks of pregnancy. In some cases, a woman may experience a missed miscarriage. This is when the fetus dies but the body does not expel the products of conception until some weeks later.
A dilation and curettage (D&C) is often needed to ensure that all the products of conception have been removed from the uterus. This will help to prevent infections and possibly lessen the extent of bleeding after a miscarriage, which can continue for seven to 10 days.
Causes of Miscarriages
The most common cause for miscarriage is a chromosomal defect with the fetus. It is believed that up to 70% of miscarriages are caused by this reason. This does not mean there is something wrong with the parents’ ability to produce a child. Rather, there was something wrong with that one particular egg or sperm that caused the embryo to not develop or implant properly.
Other causes of miscarriage include uterine or cervical problems (such as a misshapen uterus), infections, unusual hormonal levels, toxins in the environment, including exposure to industrial solvents, or a blighted ovum.
Because miscarriages are so common in the first trimester, health care providers usually don’t perform tests to determine the exact cause. Since miscarriages that occur during the second trimester are more likely to be caused by uterine problems, there is a greater chance that tests may be ordered. If a woman is experiencing recurrent miscarriage, that is two or more pregnancy losses, both she and her partner should be evaluated for any possible fertility problems.
Signs of Miscarriage
The most typical symptoms of a miscarriage are bleeding and abdominal cramping.
If you know you are pregnant and experience any type of vaginal bleeding during pregnancy, call your health care provider. This may be a sign of an early miscarriage. Be sure to mention whether the bleeding is accompanied by mild cramping or a backache. If you’re experiencing severe abdominal pain and/or heavy bleeding, contact your health care provider immediately. If they are not available, then go to your nearest hospital emergency room. While you may not be experiencing a miscarriage, it doesn’t hurt to be over cautious.
Women who are not aware that they are pregnant, but experience unusual bleeding or spotting and/or abdominal cramping should contact their health care provider. When signs of a miscarriage appear, even in those who do not think that they are pregnant, it is best to err on the side of caution and have it investigated.
There are several factors that are believed to increase the risk of miscarriage including:
- Maternal age (as maternal age increases, so does the risk of miscarriage)
- Poorly controlled diabetes or thyroid problems
- Chronic medical conditions like lupus
- High fever (100°F or higher)
- Multiple pregnancy
- Exposure to environmental toxins
- Use of an IUD during the time of conception
Although one cannot always prevent a miscarriage, you can help lessen your chances of miscarriage by following the advice commonly given to women trying to conceive. Eat a healthy diet and exercise regularly. Cut back on alcohol and cigarettes. And don’t forget to take folic acid before you get pregnant, as well during the first few weeks of your pregnancy.
Conceiving After Miscarriage
Pregnancy after miscarriage is usually not a problem. Women can become pregnant even before they have their first period after the miscarriage (which usually occurs four to six weeks after the miscarriage). However, while a woman may be physically ready to get pregnant again, she may not be prepared emotionally. It is recommended that a woman wait for one menstrual period after miscarriage before she tries to conceive again. Grieving after a miscarriage can take some time and it is important that you deal with your loss in your own way in your own time. Once you have properly dealt with your loss, you will feel better prepared to become pregnant again.
Revision date: June 18, 2011
Last revised: by Janet A. Staessen, MD, PhD