What is a miscarriage?
A miscarriage, or spontaneous abortion, is an event that results in the loss of a fetus before 20 weeks of pregnancy. It typically happens during the first trimester, or first three months, of the pregnancy.
Miscarriages can happen for a variety of medical reasons, many of which aren’t within a person’s control. But knowing the risk factors, signs, and causes can help you to better understand the event and get any support or treatment you may need.
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:
- heavy spotting
- vaginal bleeding
- discharge of tissue or fluid from your vagina
- severe abdominal pain or cramping
- mild to severe back 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.
While there are some things that increase the risk of miscarriage, generally it isn’t a result of something that you did or didn’t do. If you’re having difficulty maintaining pregnancy, your doctor may check for some known causes of miscarriage.
During pregnancy, your body supplies hormones and nutrients to your developing fetus. This helps your fetus grow. Most first trimester miscarriages happen because the fetus doesn’t develop normally. There are different factors that can cause this.
Genetic or chromosome issues
Chromosomes hold genes. In a developing fetus, one set of chromosomes is contributed by the mother and another by the father.
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: Both sets of chromosomes come from the father, no fetal development occurs.
- Partial molar pregnancy: The mother’s chromosomes remain, but the father has also provided two sets of chromosomes.
Errors can also occur randomly when the cells of the embryo divide, or due to a damaged egg or sperm cell. Problems with the placenta can also lead to a miscarriage.
Underlying conditions and lifestyle habits
Various underlying health conditions and lifestyle habits may also interfere with the development of a fetus. 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 fetus development include:
- poor diet, or malnutrition
- drug and alcohol use
- advanced maternal age
- untreated thyroid disease
- issues with hormones
- uncontrolled diabetes
- problems with the cervix
- abnormally shaped uterus
- severe high blood pressure
- food poisoning
- certain medications
Always check with your doctor before taking any medications to be sure a drug is safe to use during pregnancy.
Miscarriage or period?
Many times, a miscarriage can happen before you even know that you’re pregnant. Additionally, as with your menstrual period, some of the symptoms of a miscarriage involve bleeding and cramping.
So how can you tell if you’re having a period or a miscarriage?
When trying to distinguish between a period and a miscarriage, there are several factors to consider:
- Symptoms: Severe or worsening back or abdominal pain as well as passing fluids and large clots could indicate a miscarriage.
- Time: A miscarriage very early in pregnancy can be mistaken for a period. However, this is less likely after eight weeks into a pregnancy.
- Duration of symptoms: The symptoms of a miscarriage typically get worse and last longer than a period.
If you’re experiencing heavy bleeding or believe that you’re having a miscarriage, you should contact your doctor. Read on to learn more about distinguishing between a period and a miscarriage.
Miscarriage rate by week
Most miscarriages happen within the first trimester (first 12 weeks) of pregnancy. The earliest weeks of pregnancy are when a woman is at the highest risk of a miscarriage. However, once pregnancy reaches 6 weeks, this risk drops.
From weeks 13 to 20 of pregnancy, the risk of miscarriage drops further. However, it’s important to keep in mind that miscarriage risk doesn’t change much after this, as complications can arise at any point in a pregnancy. Discover further details about miscarriage rate by week.
The early loss of a pregnancy is common. According to the American College of Obstetricians and Gynecologists (ACOG), it occurs in 10 percent of known pregnancies.
Sometimes the cause of a miscarriage will remain unknown. However, the Mayo Clinic estimates that about 50 percent of miscarriages are due to chromosome issues.
The risk of miscarriage definitely increases with age. According to the Mayo Clinic, the risk of miscarriage is 20 percent at age 35. It increased to 40 percent at age 40 and rises further to 80 percent at age 45.
A miscarriage doesn’t mean that you won’t go on to have a baby. According to the Cleveland Clinic, 87 percent of women who have had a miscarriage will go on to carry a baby to full term. Approximately only 1 percent of women have three or more miscarriages.
Most miscarriages are due to natural and unpreventable causes. However, certain risk factors can increase your chances of having a miscarriage. These include:
- body trauma
- exposure to harmful chemicals or radiation
- drug use
- alcohol abuse
- excessive caffeine consumption
- two or more consecutive miscarriages
- being underweight or overweight
- chronic, uncontrolled conditions, like diabetes
- problems with the uterus or cervix
Being older can also affect your risk for miscarriage. Women who are over 35 years old have a higher risk of miscarriage than women who are younger. This risk only increases in the following years.
Having one miscarriage doesn’t increase your risk for having other miscarriages. In fact, most women will go on to carry a baby full term. Repeated miscarriages are actually quite rare.
There are many different types of miscarriage. Depending on your symptoms and the stage of your pregnancy, your doctor will diagnose your condition as one of the following:
- Complete miscarriage: All pregnancy tissues have been expelled from your body.
- Incomplete miscarriage: You’ve passed some tissue or placental material, but some still remains in your body.
- Missed miscarriage: The embryo dies without your knowledge, and you don’t deliver it.
- Threatened miscarriage: Bleeding and cramps point to a possible upcoming miscarriage.
- Inevitable miscarriage: The presence of bleeding, cramping, and cervical dilation indicates that a miscarriage is inevitable.
- Septic miscarriage: An infection has occurred within your uterus.
Not all miscarriages can be prevented. However, you can take steps to help maintain a healthy pregnancy. Here are a few recommendations:
- Get regular prenatal care throughout your pregnancy.
- Avoid alcohol, drugs, and smoking while pregnant.
- 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.
Remember that having a miscarriage doesn’t mean you won’t conceive again in the future. Most women who miscarry have healthy pregnancies later. Get additional information about ways to prevent miscarriage.
Miscarriage with twins
Twins typically happen when two eggs are fertilized instead of one. They can also happen when one fertilized egg splits into two separate embryos.
Naturally, there are additional considerations when a woman is pregnant with twins. Having multiple babies in the womb can affect growth and development. Women who are pregnant with twins or other multiples may be more likely to have complications such as preterm birth, preeclampsia, or miscarriage.
Additionally, a type of miscarriage called vanishing twin syndrome can affect some who are pregnant with twins. Vanishing twin syndrome occurs when only one fetus can be detected in a woman who was previously determined to be pregnant with twins.
In many cases, the vanished twin is reabsorbed into the placenta. Sometimes this happens so early in the pregnancy that you didn’t even know you were pregnant with twins. Find out more about the phenomena of vanishing twin syndrome.
The treatment that you receive for a miscarriage can depend on the type of miscarriage that you’ve had. If there’s no pregnancy tissue left in your body (complete miscarriage), no treatment is required.
If there’s still some tissue present in your body, there are a few different treatment options:
- expectant management, which is where you wait for the remaining tissue to pass naturally out of your body
- medical management, which involves taking medications to help you pass the rest of the remaining tissue
- surgical management, which involves having any remaining tissue surgically removed
The risk of complications from any of these treatment options is very small, so you can work with your doctor to determine which one is best for you.
Your body’s recovery will depend on how far along your pregnancy was before the miscarriage. After a miscarriage, you might experience symptoms such as spotting and abdominal discomfort.
While pregnancy hormones might last in the blood for a couple months after a miscarriage, you should start having normal periods again in four to six weeks. Avoid having sex or using tampons for at least two weeks after having a miscarriage.
Support after a miscarriage
It’s normal to experience a wide range of emotions after a miscarriage. You may also experience symptoms such as trouble sleeping, low energy, and frequent crying.
Take your time to grieve for your loss, and ask for support when you need it. You may also want to consider the following:
- Reach out for help if you’re overwhelmed. Your family and friends may not understand how you’re feeling, so let them know how they can help.
- Store any baby memorabilia, maternity clothing, and baby items until you’re ready to see them again.
- Engage in a symbolic gesture that may help with remembrance. Some women plant a tree or wear a special piece of jewelry.
- Seek counseling from a therapist. Grief counselors can help you cope with feelings of depression, loss, or guilt.
- Join an in-person or online support group to talk with others who have been through the same situation.
Getting pregnant again
Following a miscarriage, it’s a good idea to wait until you’re both physically and emotionally ready before trying to conceive again. You may want to ask your doctor for guidance or to help you develop a conception plan before you try to get pregnant again.
A miscarriage is typically only a one-time occurrence. However, if you’ve had two or more consecutive miscarriages, your doctor will recommend testing to detect what may have caused your previous miscarriages. These may include:
- blood tests to detect hormone imbalances
- chromosome tests, using blood or tissue samples
- pelvic and uterine exams
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