A miscarriage is the loss of a pregnancy that happens during the first 23 weeks.
The commonest time for a miscarriage to occur during a pregnancy is during the first trimester – before 12 weeks of gestation. The commonest cause of a miscarriage during this time is genetic anomalies in the fetus which are not compatible with life.
While one-off miscarriages are common, consecutive miscarriages are relatively rare, and only affect 1% of all couples. This usually refers to a sequence of three or more miscarriages in a row.
While medical treatment should always be sought during/after a miscarriage, it is especially important to do so if you suspect an ectopic pregnancy, which refers to the development of the pregnancy outside the uterus. It is a potentially life-threatening emergency. While it may be difficult to know without a scan if a pregnancy is ectopic, the bleeding and abdominal pain are usually much more severe, and may often times be accompanied by fainting spells and headache.
MISCONCEPTIONS ABOUT MISCARRIAGE
There are a number of widely held assumptions about the possible causes of miscarriages. For example, maternal stress is often believed to be a cause. However, there is no evidence to support such claims.
An increased risk of miscarriage is also not linked to:
a mother’s emotional state during pregnancy, such as being stressed or depressed,
having a shock or fright during pregnancy,
exercise during pregnancy (but discuss what type of exercise is suitable for you during pregnancy with your GP or midwife),
lifting or straining during pregnancy,
working during pregnancy, and
having sex during pregnancy.
SIGNS AND SYMPTOMS
Bleeding from the vagina is the most common symptom. The amount of bleeding may vary from light spotting to heavy bleeding.
Abdominal cramps often accompany the bleeding.
Sudden disappearance of other symptoms of pregnancy such as breast tenderness and nausea may also disappear.
WHAT HAPPENS NEXT WHEN YOU MISCARRY
Your treatment plan depends on whether you have had a complete or incomplete miscarriage (whether there is any foetal tissue left in your womb).
If you have had a complete miscarriage, no further medical treatment is required.
If you have had an incomplete miscarriage, it will be necessary to remove the foetal tissue as there is a risk that it could become infected. This can be done in three ways:
surgical treatment, where minor surgery is used to remove the tissue,
medical treatment, where medication is used to remove the tissue, or
expectant treatment, where you wait for the tissue to pass naturally out of your womb.
All three treatments are equally effective in preventing infection.
Medical and expectant treatments sometimes fail to remove all the fetal tissue or can cause other complications. This means that there is a slightly higher risk that you will need further unplanned surgery.
DEALING WITH EMOTIONS FOLLOWING A MISCARRIAGE
Having a miscarriage can be very difficult. It is often perceived by couple as loss of a family member, especially if it happens later on in the pregnancy. The emotional impact can usually take longer to heal than the physical impact. Allowing yourself to grieve the loss can help you come to accept it over time.