Mending Miscarriage Heartache

You are excited about your pregnancy even though you are barely into your first trimester.  You are already stacking onesies for the baby. Later that night, you notice a spotting of blood. A couple of hours later, you have suffered a miscarriage.

Miscarriage is the loss of a pregnancy before 20 weeks gestation. Most miscarriages happen in the first trimester. Chromosomal abnormalities are the cause of miscarriages.

It is the unexpected ending of a pregnancy within the first 20 weeks of gestation. It is important to remember it is beyond your control and you didn’t do anything wrong during your pregnancy.  

There are five kinds of miscarriage that you can have:

§  Missed miscarriage: You’ve lost a pregnancy that you didn’t know you had. You don’t have any symptoms but an ultrasound shows there is no fetal heartbeat.

§  Complete miscarriage: You’ve lost a pregnancy and your uterus is empty. You have had bleeding and passed some fetal tissue. Your health care provider can confirm a miscarriage with an ultrasound.

§  Recurrent miscarriage: Three consecutive miscarriages.

§  Threatened miscarriage: Your cervix is closed but you’re bleeding and have pelvic cramping. But the pregnancy continues without incident. Your health care provider may monitor you closely during the rest of your pregnancy.

§  Inevitable miscarriage: You are bleeding, cramping and your cervix has started to open (dilate). You may leak amniotic fluid. It is likely that you will have a complete miscarriage.

In most instances, you may be unaware that you are having a miscarriage. Some symptoms that are common with miscarriages are: bleeding that progresses from light to heavy (along with grayish tissue and blood clots); cramps and abdominal pain (much worse than menstrual cramps); low back pain that ranges from mild to severe; and a reduction in pregnancy symptoms.

It is estimated that more than 30 percent of pregnancies end in miscarriage. Most of those who miscarry end up with a healthy pregnancy later.

According to the Cleveland Clinic, chromosomal abnormalities are responsible for at least 50 percent of all miscarriages during the first trimester. Chromosomes are tiny structures inside the cells of your body that carry your genes. Genes determine a person’s physical attributes, such as your assigned sex, hair and eye color and blood type.

During fertilization, when the egg and sperm come together, two sets of chromosomes come together as well. If the egg or sperm has too few or more than normal, the fetus will have an abnormal amount. As the fertilized egg grows into a fetus, its cells will multiply and divide several times.

Most chromosome problems occur by chance. It is not known why this happens. Several factors may cause miscarriages including:

§  Infection.

§  Exposure to TORCH diseases (toxoplasmosis, rubella, cytomegalovirus, herpes and other agents).

§  Hormonal imbalances.

§  Improper implantation of fertilized egg in your uterine lining.

§  How old you are.

§  Uterine abnormalities.

§  Incompetent cervix (your cervix opens too early during pregnancy).

§  Lifestyle factors such as smoking, drinking alcohol or using recreational drugs.

§  Disorders of the immune system like lupus.

§  Severe kidney disease.

§  Congenital heart disease.

§  Diabetes that isn’t managed well.

§  Thyroid disease.

§  Radiation.

§  Certain medicines, such as the acne drug isotretinoin (Accutane).

§  Severe malnutrition.

There is no scientific proof that exercise, stress, sexual activity or prolonged use of birth control can cause miscarriages. Most miscarriages have nothing to do with anything you did or didn’t do.

No one’s miscarriage is alike. Some have painful cramping while others experience cramps similar to a menstrual period.

Miscarriages are diagnosed through ultrasound. The test checks for a fetal heartbeat and a yolk sac (one of the first fetal structures that your provider can see on an ultrasound).

Your physician may run a blood test to measure human chorionic gonadotropin (hCG), a hormone produced by the placenta. A low hCG may be indicative of a miscarriage. Your doctor may also do a pelvic exam to see whether your cervix has opened.

Once the loss of a pregnancy has occurred, the fetus must be removed in order to prevent complications such as an infection. If your uterus expels the fetus, no further treatment is needed. If the body hasn’t removed all the tissue on its own, your doctor may suggest medicine or surgery.

Once the miscarriage is complete, you may not insert anything in your vagina including tampons, sexual intercourse, fingers or sex toys. Your provider will schedule an appointment to check your progress.

It is important to grieve the loss of the pregnancy in your own way. Usually your provider will recommend that you have a normal menstrual period before trying to get pregnant again. A miscarriage doesn’t mean you can’t have children or that you will have another miscarriage.

Remember you shouldn’t blame yourself for what happened. You did nothing to cause it. It can’t be prevented. Surround yourself with supportive people including family and friends and if necessary, a support group of people who have been through this experience. Discuss with your doctor when it’s the best time to try to conceive again.