Miscarriage is often defined as a spontaneous loss of the fetus before the 20th week of pregnancy, and happens usually from naturally occurring events other than a medical or surgical abortion. Most pregnancy losses occur before the 12th week of pregnancy. According to Mayo Clinic, about 15 to 20 percent of known pregnancies result in miscarriages, and there may be times when a woman has a miscarriage without knowing that she is pregnant. Research has also shown that chemically or artificially induced pregnancies (such as in-vitro fertilization) have a higher rate of miscarriage than natural pregnancies.
Since miscarriages are not medically or surgically induced, what can cause them? There are several factors that contribute to and can increase the risk of a miscarriage:
- Infection during early stage of pregnancy
- Exposure to environmental toxins (such as heavy smog or chemical leaks)
- Hormonal disorders and/or thyroid abnormalities
- Abnormalities of the uterus
- Abnormalities in the cervix
- Lifestyle factors (smoking, alcohol, drug use, food choices, malnutrition, etc.)
- Immunological disorders
- Other pre-existing medical conditions of the mother, such as heart disease or diabetes
- Radiation exposure
- Abnormal chromosomes or genes
- Maternal age
- Psychological, emotional, or physical trauma
Sometimes, the cause of a miscarriage cannot be determined and remains unknown. There are women who may be genetically predisposed to recurring pregnancy loss, so it may be helpful to trace the family tree from both parents' sides to see if that is a hereditary trait.
Signs and Types
Most of the time, miscarriage is a process instead of a single event. There are several types of miscarriage your healthcare provider may refer to, each with its own set of signs:
- Threatened miscarriage: accompanied by uterine bleeding, cramping and backache.
- Incomplete miscarriage: abdominal and back pain accompanied with bleeding and an open cervix.
- Complete miscarriage: when the embryo or fetus has exited the uterus. It can be completed by an ultrasound or surgical curettage.
- Missed miscarriage: occurs during embryonic death. Often times, there are no signs or symptoms of miscarriage, and the loss of pregnancy would not be confirmed until the absence of fetal heart beats from an ultrasound.
- Recurrent miscarriage: defined by three or more consecutive, first trimester carriages.
- Blighted ovum: it is possible for a fertilized egg to attach to the uterus wall, but fail to have any fetal growth.
- Ectopic pregnancy: this happens when a fertilized egg implants itself outside of the uterus, usually in the fallopian tube. This is a serious condition and should be treated immediately to avoid further complications for the mother.
- Molar pregnancy: this is due to a genetic error during fertilization, which leads to abnormal tissue growth in the uterus.
Signs and symptoms of a miscarriage may include:
- Vaginal spotting or bleeding (color can range from pink, to red, to brown)
- Tissue or fluid passing from the vagina
- Cramps, abdominal pain, or back pain
If you are pregnant and are experiencing these symptoms, be sure to call your healthcare provider or obstetrics doctor immediately.
While there is little that can be done about genetically-related miscarriages, there are still steps a woman can take to minimize all other potential risks for pregnancy loss. Here are some suggestions:
- Adopt a healthy, nutritious diet
- Stress management
- Keep a healthy weight
- Take care of any pre-existing medical conditions
- Take folic acid and/or prenatal vitamins
- Quit smoking
- Stop excessive alcohol intake
- Speak to your doctor about fertility testing and tips to prepare for pregnancy
During the pregnancy, be sure to:
- Stay out of second hand smoke areas
- Avoid or limit exposure to toxic environments, such as fumes, chemical leaks, or radiation
- Limit caffeine intake
- Avoid heavy-duty contact sports
- Protect the abdomen area
- Adopt a pregnancy-healthy diet
When a woman experiences a miscarriage, the main goal of the healthcare provider is to prevent infections, stop bleeding, and expel all tissues to ensure the mother's health. Depending on the type and stage of miscarriage, there are different types of treatment, ranging from simply taking medication to surgery. It is important to monitor and manage the pregnancy loss as directed by the doctor after confirmation.
After a miscarriage, emotional and psychological healing may take more time than physical healing. Do not be afraid to reach out to your loved ones or a hotline for support, and heal at your own pace. If you are feeling symptoms of depression or extreme psychological distress, be sure to contact your doctor for further steps of management. When you are ready to get pregnant again, consult a fertility specialist or your healthcare provider to even better prepare against miscarriage in the future.