Miscarriage – What it is and how to cope with it if it happens to you
Approximately 15% of all detected pregnancies end in a miscarriage and most of them happen within the first 12 weeks of pregnancy. If you are in fertility treatment with either IVF or ICSI, the chances of miscarriage are higher – when in treatment the chances are about 15-30% of having a miscarriage. This may be because the average age of IVF patients is also higher.
What is a miscarriage?
A miscarriage means that the pregnancy ends within the 23rd week (22 weeks+6 days) of pregnancy.
A miscarriage is unexpected, unwanted and puts a brutal stop to something that could have been one of the happiest times of your life. For some, the experience of a miscarriage will follow them for the rest of their life. Some feel guilty after having a miscarriage, but it is also important to know that an early miscarriage is not something you could have had an impact on. It is natural selection since a large part of these pregnancies cannot lead to a healthy and living child.
It is important to remember that a miscarriage is quite common and happens to all types of women, it does not matter if you are a single mother by choice, lesbian parents or in a heterosexual relationship. You are not alone, and it can be a good idea to reach out to someone who may have had a similar experience or talk to family, friends, or your doctor. If you have suffered from multiple miscarriages, you can experience similar feelings to infertility. Therefore, we can recommend you to follow the link and read our blog post How to cope with infertility.
Causes that can lead to a miscarriage
- Chromosomal abnormalities or malformations: It is rare to find the exact cause of a miscarriage. We do know that a lot, about half, of the miscarriages that occurs before the 12th week of pregnancy, is caused by a chromosome defect or another developmental defect in the fetus, that makes the fetus unable to live in and outside the uterus.
- Age: The probability of chromosomal defects increases markedly with the woman’s age. Between the age of 20-30 the risk of a miscarriage is on its lowest. After the age of 35, the risk of a miscarriage increases markedly. For a 40-year-old woman, the risk of miscarriage is about 50%.
- Hormonal causes: Hormonal imbalance can also be one of the causes of miscarriages. This may, for example, be due to the "corpus luteum" that produces progesterone, which is a necessary hormone for the pregnancy to stay in place. Corpus luteum is a mass of cells that forms in the ovary and is responsible for the production of progesterone during the first weeks of pregnancy.
If the corpus luteum does not work optimally, or only produces a low amount of progesterone, it can lead to a miscarriage. Some patients in fertility treatment or patients who have experienced repeated miscarriages, will receive medicine that contains progesterone which helps the body "hold on to the pregnancy".
- Cell changes: If you have had treatment in your cervix for cell changes, it may increase the risk of miscarriage.
- Alcohol and smoking: If you drink alcohol or smoke during your early pregnancy the chance of having a miscarriage increases. Even 1 or 2 glasses of alcohol a week can increase the risk of a miscarriage. Read our blog on diet and pregnancy, to learn more about what to eat and what to avoid during pregnancy.
- Other diseases: Some chronic diseases can increase the risk of miscarriage. The chronic diseases could be: obesity, diabetes, low metabolism, kidney disease and lupus. Infectious diseases such as CMV, listeria and malaria can also lead to a miscarriage.
- Other advice: Avoid night work and heavy lifting (over 20 kg) during pregnancy, as these factors can enhance the risk of miscarriage.
The symptoms of miscarriage – and how to handle them
A miscarriage usually manifests itself in severe menstrual cramps and bleeding. If you experience this when pregnant, you should always consult a doctor or your midwife.
When arriving at the doctors or the hospital, a gynecological examination is performed to see if the cervix is open or closed. The doctor will assess the bleeding and possibly do an ultrasound scan to see whether it is a miscarriage or just bleeding during the early pregnancy. If a miscarriage has already begun, there is no treatment to prevent it. It usually happens without any complications, and you can take painkillers for the pain and cramps. In most cases the body handles the miscarriage itself, but in some cases, there may be tissue left in the uterus which must be removed medically. This is done under general anesthesia, where the doctor will remove all remaining tissue in the uterus.
After a miscarriage, the pregnancy hormone HCG may still be present in the blood for up to 8 weeks after. This means that a pregnancy test will still show positive even if you are no longer pregnant.
What is a missed abortion?
A missed abortion is another type of miscarriage in which the actual expulsion of the fetus has not taken place. This means that the fetus has passed away, but it remains inside the uterus for a while before it is expelled. This is ascertained by an ultrasound scan. Therefore, the deceased fetus must be removed from the uterus, which is done either with medical treatment or by having a scraping done.
Medical treatment will cause bleeding and severe menstrual cramps as the medication helps the uterus to contract and expel the fetus remaining tissue. It can extend over several days and after approximately a week you will be offered a control scan to check that all the tissue is expelled from the uterus. If there is still tissue left in the uterus, it is necessary with a scraping to remove the remains. A scraping takes place, as described above, under general anesthesia. You will receive painkillers for both procedures.
When can I get pregnant again after a miscarriage?
If you have had a miscarriage, future pregnancies will, in most cases, go well. After a miscarriage, you can get pregnant again during your next cycle, if you wish to do so. Some are best off waiting a cycle and others need to get started right away. The most important thing is, that you listen to yourself and do what you believe is the best for you.
My name is Julie, and I am a trained midwife working at Cryos Customer Care. I have been a midwife for 6 years and have experience from many different maternity wards, including a stay in Uganda. I provide Cryos’ blog with expert knowledge about fertility, pregnancy and birth. I hope to bring you a step closer to make your dream of having a baby come true.JulieCryos