The journey of pregnancy, with its exciting highs and potentially heartbreaking lows is a profound and intricate process. Nestled within this ancient dance of life lies a bleak reality: miscarriage.

While the science of reproduction has made remarkable strides, the mystery shrouding pregnancy loss continues to cast a shadow upon expecting parents. Complex factors are involved in a successful pregnancy, many of which remain beyond the control of the pregnant person.

Both parents feel the emotional burden of miscarriage, however women must get proper medical treatment to deal with the physical fallout of pregnancy loss.

With over 85% of women going on to a successful pregnancy, proper medical and self-care will help you heal.

Why Does Miscarriage Happen?

There are many reasons why a miscarriage happens, most of which are totally out of your control.

In many cases, your doctor may not be able to tell you why the miscarriage happened, but in other cases such as recurring miscarriages, it is important to find out if there are any underlying reasons.

  1. Chromosomal abnormalities: Around 50% of miscarriages are due to genetic problems in the developing fetus and can come from either the mother or the father.
  2. Parental age: Advanced parental age is associated with a higher risk of miscarriage, because as women and men get older, the chances of chromosomal abnormalities in sperm and eggs increase.
  3. Hormonal imbalances: Imbalances in hormones can lead to the embryo not implanting or not remaining implanted in the uterus.
  4. Uterine abnormalities: Abnormalities in the uterus such as fibroids or polyps can interfere with embryo implantation and development.
  5. Problems with the placenta. Potential contributing factors include a history of diabetes, maternal age of 35+, previous placental, uterine, or umbilical cord problems, and high blood pressure. Lifestyle factors such as smoking, and cocaine use may increase the risk of placenta issues along with Injuries, such as from a car accident or physical abuse.
  6. Infections: Serious bacterial or viral infections can trigger miscarriages.
  7. Immunological factors: Autoimmune response to pregnancy is a significant cause of recurrent miscarriage. If autoimmune system-caused miscarriages go untreated the risk of miscarriage increases with each pregnancy. In this case, both parents should get thorough examination for reproductive health as repeat miscarriages can also be due to issues with sperm.
  8. Chronic health conditions: Certain chronic health conditions in the mother, such as uncontrolled diabetes, thyroid disorders, kidney disease or autoimmune diseases such as lupus can increase the risk of miscarriage.
  9. Lifestyle choices: Both parents should avoid all alcohol, tobacco, and drugs other than prescribed before pregnancy and while pregnant as they have been shown to increase chance of miscarriage.

Miscarriage Rates by Week

With each week that passes, risk of miscarriage decreases. See below for specifics.

Miscarriage rate by week

Miscarriage Symptoms

If you experience any or all of the miscarriage symptoms below while pregnant, it is crucial to head immediately to your healthcare provider or the emergency department.

Bleeding may start off as spotting and get heavier or appear as a gush of blood. The heaviest bleeding should generally be over within three to five hours from the time heavy bleeding begins. Lighter bleeding may stop and start over one to two weeks before miscarriage symptoms completely end.

Other miscarriage symptoms include:

  • Mild to severe back pain (often worse than normal menstrual cramps)
  • White-pink mucus coming from the vagina.
  • True contractions (very painful happening every 5-20 minutes)
  • Tissue with clot like material passing from the vagina.
  • A sudden decrease in signs of pregnancy

Treatments

While healing emotionally from a miscarriage will take time, medical treatment for miscarriage should be sought out right away. Treatment will vary based on the individual’s situation and the stage of the miscarriage.

One approach is Expectant Management, where the patient waits for the miscarriage to begin or resolve naturally without intervention.

This option is often chosen for early miscarriages when there are no complications. During Expectant Management, individuals can experience bleeding and cramping, like a heavy period, as the body expels the pregnancy tissue.

This process usually occurs at home, and healthcare providers may offer support and guidance to help manage pain and monitor the progress of the miscarriage.

Another treatment option is Medical Management, which involves the use of medications to induce the completion of the miscarriage. Typically, a 2-drug combination is administered, consisting of mifepristone followed by misoprostol.

Medical Management can be up to 92% effective in completing the miscarriage and is often used for pregnancies up to nine weeks’ gestation. Like Expectant Management, individuals may experience bleeding, cramping, and passing of tissue as the miscarriage progresses.

In cases where Expectant or Medical Management is not feasible or unsuccessful, Surgical Management may be recommended.

This involves a surgical procedure called dilation and curettage (D&C), typically performed in a hospital setting.  Approximately 1 in 4 women may require an emergency D&C due to excessive bleeding or other complications.

After the Miscarriage

Doctors are able to diagnose why a miscarriage happened in only about half of all cases. Regardless, it’s important to try to discover why it happened, particularly for multiple miscarriages. It is recommended that when miscarriages occur, especially multiple times, testing focuses on the father as well as the mother.

Miscarriage is as much a physical odyssey for women as it is emotional. Get the medical care you need and practice as much self-care as possible during this difficult time.

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