A miscarriage, or spontaneous abortion, refers to the loss of a pregnancy before the 20th week. It is a relatively common occurrence, with many women experiencing one in their lifetime. Miscarriages can happen for various reasons, including chromosomal abnormalities, hormonal imbalances, uterine issues, or infections. Some lifestyle factors, such as smoking, excessive alcohol consumption, or extreme stress, can also contribute to the risk. Symptoms of a miscarriage may include vaginal bleeding, cramping, and the passage of tissue. It’s important to seek medical care if any of these symptoms occur. While a miscarriage can be emotionally challenging, many women go on to have healthy pregnancies in the future. Counseling and support groups can help individuals cope with the emotional impact of a miscarriage.
What Is a Miscarriage?
A miscarriage is the loss of a pregnancy before the embryo or fetus is developed enough to survive outside the womb. This can sometimes happen even before a woman knows she’s pregnant. Unfortunately, miscarriages are fairly common and usually occur within the first 12 weeks of pregnancy. A very small number of pregnancy losses after 20 weeks are called stillbirths.
What Happens During a Miscarriage?
Some women may experience an extra heavy menstrual flow without realizing it’s a miscarriage, especially if they weren’t aware of the pregnancy. Others might have symptoms like cramping, spotting, heavy bleeding, abdominal or pelvic pain, weakness, or back pain. However, spotting isn’t always a sign of miscarriage—many women experience spotting early in pregnancy and still go on to have a healthy baby. If you notice any of these symptoms, it’s important to consult your doctor.
What Is Stillbirth?
A stillbirth refers to the death of a baby after the 20th week of pregnancy, occurring either before or during labor. Sometimes referred to as intrauterine fetal death, stillbirth can have risk factors like smoking, obesity, placental issues, prolonged pregnancy, or infections. However, many stillbirths occur without a known cause. The most common sign is decreased fetal movement. If this occurs, contact your doctor immediately. They may use an ultrasound or fetal non-stress test to check the baby’s heartbeat and movements.
Why Do Miscarriages Happen?
The most common cause of miscarriage is a chromosomal problem that prevents the fetus from developing normally. Other potential causes include:
- Imbalanced hormone levels, such as thyroid hormone
- Uncontrolled maternal diabetes
- Exposure to environmental hazards like radiation or toxins
- Certain infections
- Uterine abnormalities
- Incompetent cervix, which opens too early in pregnancy
- Certain medications, such as the acne drug Accutane
Miscarriage risk is also higher in women who smoke, drink alcohol, or use illegal drugs.
What Happens After a Miscarriage?
If a miscarriage occurs, the doctor will perform a pelvic exam and ultrasound to confirm it. If the uterus is clear of fetal tissue, or if the pregnancy was in its early stages, further treatment may not be necessary. If tissue remains in the uterus, the doctor may use medication to help expel it or perform a procedure like:
- Dilation and Curettage (D&C): Scraping the uterine lining
- Dilation and Extraction (D&E): Using suction to remove tissue
These procedures may cause bleeding or cramping afterward. If a baby dies later in pregnancy, labor may be induced to deliver the baby. The doctor may examine the baby and placenta to find the cause of death if it’s still unknown.
Women who experience multiple miscarriages may be tested for genetic, anatomical, or hormonal factors that could contribute to the losses.
Can Miscarriages Be Prevented?
In most cases, miscarriages can’t be prevented because they are usually caused by chromosomal abnormalities. However, certain lifestyle choices like smoking and drinking can increase the risk. Good prenatal care can support a healthy pregnancy. If you’re pregnant:
- Eat a balanced diet with plenty of folic acid and calcium
- Take prenatal vitamins daily
- Exercise regularly with your doctor’s approval
- Maintain a healthy weight
- Avoid drugs, alcohol, and foods that may carry listeriosis
- Limit caffeine
- Quit smoking
- Discuss any medications with your doctor
- Avoid activities that could cause abdominal trauma
- Stay up to date on vaccinations
- Attend all prenatal appointments and discuss any concerns with your doctor
- Contact your doctor immediately if you have fever, illness, decreased fetal movement, bleeding, or cramping
Trying Again After a Miscarriage
If you’ve had a miscarriage, take time to grieve and heal both physically and emotionally. Some health care providers suggest waiting at least one menstrual cycle before trying to conceive again. To help cope with this difficult time:
- Join a Support Group: Ask your doctor about support groups for women trying again after a loss.
- Seek Encouragement: Hearing success stories from women who have had a healthy pregnancy after miscarriage can be uplifting.
During future pregnancies, it may help to:
- Be Proactive: Learn about your pregnancy and discuss options and outcomes with your doctor.
- Monitor Baby’s Movements: Once you can feel fetal movements (usually between 18 and 22 weeks), keep track of them. If movements decrease, try eating something sugary and lying on your side. You should feel at least 10 movements in 2 hours. If not, contact your doctor immediately.
- Stay Positive: Focus on a hopeful outcome for your pregnancy.
No two pregnancies are the same, so try not to dwell on similarities with a previous pregnancy loss. Stay positive and take care of yourself throughout this journey.