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What is a miscarriage?
A miscarriage is an event that results in the loss of a fetus during early pregnancy. It’s also called a spontaneous abortion. It typically happens during the first trimester, or first three months, of the pregnancy. According to the American Pregnancy Association (APA), 10 to 25 percent of all clinically recognized pregnancies end in miscarriage.
The cause of a miscarriage varies from person to person. Often the cause is unknown. Miscarriages that occur after three months, or between 14 to 26 weeks, are usually due to an underlying health condition in the mother.
Read on to learn the signs, types, symptoms, and risk factors of a miscarriage.
Signs and symptoms of a miscarriage
The symptoms of a miscarriage vary, depending on your stage of pregnancy. In some cases, it happens so quickly that you may not even know you’re pregnant before you miscarry.
Here are some of the symptoms of a miscarriage:
mild to severe back pain
expulsion of tissue with clots from your vagina
severe abdominal pain
Call your doctor right away if you experience any of these symptoms during your pregnancy. It’s also possible to have these symptoms without experiencing a miscarriage. But your doctor will want to conduct tests to make sure that everything is fine.
Types of miscarriage
There are many different types of miscarriage. Depending on the cause of your miscarriage and stage of your pregnancy, your doctor will classify your condition as a:
blighted ovum, where a fertilized egg implants into your uterine wall, but fetal development never begins
complete miscarriage, where the products of conception are expelled from your body
incomplete miscarriage, where the membranes are ruptured, and your cervix is dilated or thinned
missed miscarriage, where the embryo dies without your knowledge, and you don’t deliver it
recurrent miscarriage, where you’ve had three or more consecutive first-trimester miscarriages
ectopic miscarriage, where an egg implants somewhere other than your uterus, usually in your fallopian tubes
threatened miscarriage, where bleeding and cramps point to a possible upcoming miscarriage
Causes of miscarriage
During pregnancy, your body supplies hormones and nutrients to your developing fetus. This helps your fetus develop normally during your pregnancy. Most first trimester miscarriages happen because the fetus doesn’t develop normally. There are different factors that can cause this.
Genetic or chromosome issues
About 50 percent of miscarriages are due to chromosome issues. Errors occur randomly when the cells of the embryo divide, or are due to a damaged egg or sperm cell. Problems with the placenta can also lead to a miscarriage.
Examples of these chromosome abnormalities include:
intrauterine fetal demise: The embryo forms but stops developing before you see or feel symptoms of pregnancy loss.
blighted ovum: No embryo forms at all.
molar pregnancy: Molar pregnancies are rare. There is usually an abnormal placenta growth, but since both sets of chromosomes come from the father, no fetal development occurs.
partial molar pregnancy: This happens when the mother’s chromosomes remains, but the father has also provided two sets of chromosomes. This causes placenta abnormalities and an abnormal fetus.
External health conditions
External health conditions, lifestyle habits, and underlying conditions may also interfere with the fetus’ development, especially in the second trimester. Exercise and sexual intercourse do not cause miscarriages. Working won’t affect the fetus either unless you’re exposed to harmful chemicals or radiation.
Conditions that can interfere with a fetus’ development include:
poor diet, or malnutrition
drug and alcohol use
advanced maternal age
untreated thyroid disease
problems with the cervix
abnormally shaped womb
severe high blood pressure
Always check with your doctor before taking any medications to be sure a drug is safe to use during pregnancy.
Most miscarriages are due to natural and unpreventable causes. However, certain risk factors can increase your chances of having a miscarriage. These include:
excessive caffeine consumption
being underweight or overweight
chronic, uncontrolled conditions, like diabetes
Being at an older age can also affect your risk for miscarriages.
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Having one miscarriage doesn’t increase your risk for having other miscarriages. Only one in 100 women experience three or more miscarriages in a row. Over 60 percent of these women also go on to carry a baby to full-term.
Not all miscarriages can be prevented, but having a miscarriage doesn’t mean you won’t conceive again in the future. According to the Mayo Clinic, only a small number of women have two or more miscarriages. Most women who miscarry have healthy pregnancies later.
Some recommendations for a healthy pregnancy include:
Avoid alcohol, drugs, and smoking while pregnant.
Engage in light regular exercise to improve fetal health.
Maintain a healthy weight before and during pregnancy.
Avoid infections. Wash your hands thoroughly and stay away from people who are already sick.
Limit the amount of caffeine to no more than 200 milligrams per day.
Take prenatal vitamins to help ensure that you and your developing fetus get enough nutrients.
Eat a healthy, well-balanced diet with lots of fruits and vegetables.
Recovering from a miscarriage
Your body’s recovery will depend on how far along your pregnancy was before the miscarriage. After a miscarriage, you might experience the following symptoms:
vaginal bleeding like a menstrual period or spotting
lower abdominal pain or cramps
discomfort or engorgement in the breasts
While pregnancy hormones might last in the blood for a couple months after a miscarriage, you should start having normal periods again in three to six weeks. You can resume your normal activities as soon as you feel ready to do so. Listen to your body. It’s important that you give yourself time to heal physically and emotionally.
It’s normal to experience a range of emotions after a miscarriage. You may also experience the following symptoms:
loss of appetite
These symptoms may become serious and get worse without treatment.
You may also want to consider the following:
Reach out for help if you are overwhelmed. Your family and friends may not understand how you’re feeling, so let them know how they can help. Even helping with housework, cooking, or child care may be helpful.
Read literature about miscarriage and bereavement.
Store away any baby memorabilia, maternity clothing, and baby items until you are ready to see them again may help with your recovery.
Take your time to grieve for your loss, but also remember that support is all around you. You can also seek counseling from a therapist. Grief counselors can help you cope with feelings of depression, loss, or guilt. Online support forums and chat rooms can be helpful for women who want to talk about their miscarriage with others who have been through the same situation.
Getting pregnant again
You may want to ask your doctor to help you develop a conception plan before you try to get pregnant again. Being as healthy as possible can help you prepare for a pregnancy and lower your risk of another miscarriage.
Your doctor will likely recommend tests to detect any problems that may have caused your previous miscarriage. These may include:
blood tests to detect hormone imbalances
chromosome tests, using blood or tissue samples
pelvic and uterine exams
Your doctor may recommend that you wait several months before getting pregnant again. Depending on your health, your doctor may also require periodic testing throughout your pregnancy.
Remember that most miscarriages are out of your control. Healing doesn’t mean you have to forget about what happened. A symbolic gesture may also help with the experience. Some women plant a tree, or wear a special piece of jewelry.
Is There a Link Between Endometriosis and Miscarriage?
Endometriosis is a fairly common condition in women of childbearing age. It occurs when endometrial tissue builds up outside of the uterus. That means the tissue can’t be expelled through the vagina during a period. Endometriosis may affect fertility in some women.
Once pregnant, symptoms of endometriosis may be temporarily alleviated. They tend to return once the pregnancy is complete.
It was previously thought that once a woman with endometriosis became pregnant, the condition wouldn’t affect her pregnancy. However, some recent studies have shown a strong link between endometriosis and miscarriage, though the reason for this link isn’t yet understood. A miscarriage is classified as a pregnancy loss that occurs before 20 weeks of gestation.
What does the research say?
Two large studies recently looked at the relationship between endometriosis and miscarriage. Both studies found endometriosis to be a risk factor for miscarriage. One found a significantly increased risk of previous miscarriage for women with endometriosis. The other cites that the increased risk of miscarriage for women with endometriosis is almost 80 percent. These studies were carried out in 2016 and 2017.
Neither study notes any similarities in the miscarriages, but it’s widely agreed that more research is needed in this area.
Other risk factors
There are some other things that could increase the risk of miscarriage. Being 35 years of age or older is one risk that affects both males and females.
For females only, additional risks include:
three or more previous miscarriages
polycystic ovary syndrome
particular viral or bacterial infections during pregnancy
abnormalities in the structure of the uterus
exposure to certain medicines or chemicals during pregnancy
smoking or using alcohol or cocaine during pregnancy
excessive intake of caffeine during pregnancy
Many women wonder if they’ve done something wrong following a miscarriage. Most miscarriages occur because the fertilized egg in the uterus isn’t developing normally, not because of anything they did. Miscarriages aren’t caused by exercise, stress, or sex.