The first thing most women do
is wonder if they could have prevented the miscarriage
or go searching for reasons on why it happened. Self-blame
and sometimes denial accompanies the feeling of loss
making it hard for many to move on. The truth about
pregnancy loss or miscarriage is in over 50% of cases
it is not preventable. Because in most situations
of miscarriage the doctor is unable to provide explanations
as to why it happened, most women tend to feel their
loss is being taken lightly.
It is NOT your Fault
About 50% of miscarriages lie in the obscure area
in which doctors are not able to specify, the most
common being problems with the chromosomes of the
fetus. Chromosomal problems occur randomly; if there
is a problem with the number of chromosomes or the
structure of a chromosome then a miscarriage is most
likely. Daily activities or events such as work, sex,
stress, exercise, morning sickness etc do not contribute
to the occurrence of miscarriage. When a miscarriage
happens it is wise to view it as an act of nature
because in most cases the abnormality is severe enough
to be incompatible with life. (Harsh but true)
When miscarriage is confirmed either by ultrasound
or by clinical assessment, the next step is to check
on remnant tissues in the uterus; this would need
to be expelled. Miscarriage is considered complete
if all the tissue has been passed and no further treatment
is required. In situations where some tissues remain
a D & C will be recommended.
Follow up care with your doctor is necessary to check
on ensuing problems, if any (usually 6 weeks post
the procedure). A three month wait is mostly suggested
to allow the physical and emotional healing, and for
the regular period cycle to resume. Statistics indicate
that 90% of women go on to conceive after suffering
a miscarriage, although about 15-20% face the possibility
of a miscarriage reoccurrence. It is advisable to
see your doctor right away when you become pregnant
A Word on Recurrent Miscarriages
Recurrent miscarriage is hard on the woman both physically
and emotionally. Unfortunately evaluation is only
performed after having undergone 2 or more miscarriages
in a row. As mentioned about half of recurrent miscarriage
cases have no underlying causes. For the rest, the
cause can be pinned on medical conditions, hormonal
problems, chromosomal problems, lifestyle issues or
abnormalities of the uterus.
You on your part should work with your doctor by providing
details on your history, any medical condition you
may have developed and experiences during your past
pregnancies. In repeat miscarriages, tests are often
conducted to check on possible causes. Some conditions
are treatable so the chance of having a successful
pregnancy greatly improves the next time round.
Your doctor may suggest a complete physical check
and this may include many diagnostic tests (blood
tests and/or pelvic ultrasound) to understand the
cause and possibly provide the treatment. It is important
to understand and accept that despite careful investigations
doctors may not be in the position to provide the
cause of recurrent miscarriage nor guarantee the outcome
of the next pregnancy when it happens. Here is a checklist
of the possible tests in brief:
Actions to REDUCE the chance
of Early Pregnancy Loss
||Blood work is
done to check for progesterone level, thyroid
function, diabetes, certain viruses, blood-clotting
disorders and other immune disorders
||You, your partner
and the miscarriage tissue will be tested for
the presence of abnormal chromosomes. The placenta
and embryo will be assessed through karyotyping
although it is not always possible to get a
||Your pelvic anatomy can
be evaluated for possible problems using ultrasonic
||Swabs from the vagina and
the uterus will be sent to the lab to test for
infection, especially if you miscarried in the
4-6 month period.
||A device resembling a narrow
telescope will be inserted into the uterus to
view the insides of the cavity and check for
||This involves the use of
ultrasound where sterile water is injected into
the uterus for better viewing and evaluation
of the uterine cavity.
You have a right to be hopeful despite having suffered
a miscarriage or recurrent miscarriage by incorporating
certain positive actions as those outlined below:
• Before attempting pregnancy, schedule a complete
medical checkup. Use this opportunity to discuss risk
factors and causes of past pregnancy loss (es).
• A healthy lifestyle is elementary to a healthy
pregnancy: a healthy food regime, staying away from
alcohol, nicotine, unprescribed medications and illegal
drugs, working towards a stress-free life, and incorporating
some regular exercise helps.
• Be vigilant about your prenatal vitamins,
especially folic acid and all other medications that
have been prescribed by your doctor for any prevailing
• The physical health of both parents can influence
future pregnancies. It is known that sperm
abnormalities increase the risk of miscarriage. Therefore
not only women but even their partners should work
at staying fit and healthy in the interim period.
A 3-month wait is also important as this time-frame
allows for sperm replenishment; quality sperm will
replace any damaged sperm, if present.
• Plan your pregnancy. Keep a close watch on
your menstrual cycle and gain a better perspective
of your ovulation.
• See your doctor at the earliest if you suspect
you are pregnant for an early diagnosis. An early
scan determines the viability of pregnancy and offers
assurance, where necessary. Remind your doctor on
past loss (es) and share your concerns and queries.
Ensure your well-being and pregnancy is being monitored.
The Final Word
Don't give up.
If having a baby means
a lot to you and you have the financial and other
necessary resources, then take your time if you have
to but don't give up. Remember that you have a good
chance for a successful pregnancy following a pregnancy
loss even if the cause of the previous loss cannot
be established, even if this is your 5th miscarriage
because many women who have persisted after disappointments
have been rewarded for their tenacity. Your future
pregnancy will surely demand special care, supervision
and sometimes medication.
Don't rush into things.
time and try for another baby when you feel ready.
You may need 3 months, 6 months or more than that
but the truth is different intervals are appropriate
for different women. Statistics also show that women
who miscarried early in pregnancy were as likely to
have a successful pregnancy as those who waited longer.