Miscarriage Demystified

Feb 01, 2012 25 Comments by

Pregnancy losses are common and usually unavoidable. The good news is that most women go on to have healthy babies.

miscarriage

miscarriage

For many women, the instant exultation that a positive pregnancy test evokes is slowly replaced with a nagging fear: What if something goes wrong? What if I lose the baby? While a certain number of pregnancies do, sadly, end in miscarriage, it’s reassuring to know that the majority of pregnancies result in healthy babies. And even if a woman does suffer a loss, she’s very likely to have a healthy pregnancy in future.

If you experience a miscarriage, you may feel very alone. The fact is, you actually have plenty of company:Studies reveal that anywhere from 10 percent to 25 percent of recognized pregnancies end in miscarriage. But many woman keep miscarriage secret, even from close friends and family members, often because they feel guilty or ashamed. Those emotions are unwarranted.

“The routine miscarriage many women haave are due to pure bad luck,” says Henry Lerner, M.D., an OB-GYN at Newton- Wellesley Hospital in Newton, Mass., and an assistant clinical professor in obstetrics and gynecology at Harvard Medical School. “Since they’re random, they’re not likely to occur the next time around.” In fact, for the majority of women who have a miscarriage, the chances of a successful next pregnancy are 80 percent, Lerner adds.

Many women fear that exercising, falling, lifting heavy objects or the like can trigger a miscarriage, but the chances of that happening are slim. “unless you are a smoker, illicit-drug user or heavy drinker, there’s very little you can do to cause a miscarriage,” notes Lerner. “Even a typical car accident or fall won’t cause one.” However, a Swedish study found that pregnant women who are exposed to secondhand smokes were 67 percent more likely to miscarry than those who weren’t exposed.

Certain health conditions also predispose some women to miscarriages. Thyroid problems, diabetes, genital-tract infections, and being either underweight or obese can all pose some degree of risk. that’s why it’s important to try to get such conditions under control before you conceive. And though many women believe stress can cause a miscarriage, scant research supports this.”I know of no firm evidence linking stress to miscarriage,” Lerner says.

Some infections, such as listeriosis (most often caused by eating undercooked meat or unpasteurized dairy products) and toxoplasmosis (usually caused by eating raw or undercooked meat or by contact with cat feces), can also cause pregnancy loss, but luckily these are rare.

That said, here’s an in-depth look at why most miscarriages happen, along with news about the latest research into the causes and the treatments being offered.

When Chromosomes Are The Problem

The main causes of miscarriage fall into two broad categories: problems with the embryo or fetus and problems within the mother. More than 50 percent result from the first-what experts refer to as chromosomal errors.

“When the chromosomes of the eggs and those of the sperm fuses to form an embryo, they usually pair up correctly,” explains Lerner, who is also the author of Miscarriage: Why it Happens and How Best to Reduce Your Risks (Perseus). “But sometimes they get scrambled. Since chromosomes are the blueprint for development, if they’re paired incorrectly, the embryo stops developing and dies.”

These errors can be so significant that pregnancy per se never occurs-the fertilized egg may begin to divide and grow but fails to implant itself i the uterus. In fact, it’s estimated that as many as half of clinical pregnancies-those in which fertilization takes place-never make it to the point that a woman would have a positive pregnancy test.

“The great majority of genetically abnormal embryos don’t implant, and of the few that do, most miscarry early on says William P. Hummel, M.D., a productive endocrinologist specializing in miscarriage and infertility at San Diego Fertility Center. “The body recognizes a problem and takes care of it before a woman even knows she’s pregnant.” Most miscarriages happen within the first 12 weeks. “Once you pass the eight-to-12 week mark and we see the fetus’s heartbeat by ultrasound, you have a 98 percent chance of having a full term, healthy baby,” Hummel adds.

The Role Of Age

Closely tied to the incidence of chromosomal abnormalities in pregnancy is a woman’s age. “The likelihood of miscarriage increases exponentially as a woman gets older,”says Lesley Regan, M.D., director of the Recurrent Miscarriage Service at St.Mary’s Hospital in London and a clinical professor in the Division of Surgery, Oncology, Reproductive Biology and Anesthetics at Imperial College of London.

According to Hummel, a woman age 35 or younger has a 15 percent chance of miscarriage; as she nears 39, her chances are 20 percent. Risk increases to 30 percent at age 40 and to nearly 40 percent if she is 42 or older.
“At birth, a woman has all the eggs she’ll ever have,” Lerner explains. “The older she gets, the more time there is for her eggs to be damaged by such environmental insults as noxious chemicals, gases and heavy metals. This inevitable DNA deterioration over time could make the eggs’ instructions for growth unreadable.” Scientists now suspect that the father’s age-particularly if he iss older than 40-may also be a factor in miscarriage, although a much smaller one than the mother’s.

Anatomical Abnormalities

The second most common cause of early losses are abnormalities in a woman’s body-most often her uterus, according to Hummel. “At least 30 percent of all miscarriages are due to anatomical factors within the uterus,” he explains. “Of these, fibroids are the biggest problem.”

Hummel points out that although these noncancerous tumors are extremely common in women of reproductive age, not all contribute to miscarriage. “The key is its location and size,” he says. The closer a fibroid is to the center of the uterus, where a fertilized egg is likely to implant, the more likely it is to cause a miscarriage; as for size, any fibroid larger than 5 centimeters (about 2 inches) can be problematic. Surgery to remove the fibroid is often extremely effective in reducing a woman’s risk of miscarriage without hampering her ability to conceive or carry a pregnancy to term, Hummel adds.

If You Think You’re Miscarrying

Unfortunately, there’s nothing you can do to stop a miscarriage once it starts. Nor should you want to, as the majority of losses are due to serious problems with the embryo or fetus.

The hallmarks of a miscarriage include heavy bleeding and cramping, as opposed to normal spotting, which occurs frequently in early pregnancy. This lighter spotting can be caused by implantation of the fertilized egg or by the developing placenta “digging”
its roots into the wall and blood vessels of the uterus. “But half of the time, bleeding does indicate a miscarriage,” says Henry Lerner, M.D. “It’s a result of the fetus having died and the tissue starting to disintegrate. By the time start bleeding, it’s already done- it usually takes seven to 10 days to see any bleeding.”

If you think you might be miscarrying, call your doctor or midwife. If you have in fact miscarried, she will want to make sure your body has completely expelled the tissue. If it hasn’t, you may need a procedure called a D&C to remove it.


Managing A Complicated Pregnancy, Staying Healthy

25 Responses to “Miscarriage Demystified”

  1. getting pregnant after miscarriage says:

    For the reason that the admin of this site is working, no hesitation very quickly it will be famous, due to its quality contents.

  2. topsoil Hockessin says:

    Simply a smiling visitant here to share the love (:, btw great design and style .

    • Edelbert says:

      Hi Kate,You eepsesrxd your feelings with great honesty and that’s all others need to identify with you, whether they have had a miscarriage or not. As it happens, I had 4 as well, so perhaps I understand slightly more than some, what it means to know that you will survive; that you’ll be “okay,” even when okay means numbing out the raw pain and getting on with things. I do believe that what you and the other members of the IF community are doing by blogging so prolifically and honestly, is keeping constant attention on the issue of infertility and recurrent miscarriage. That, in turn, is accellerating progress in fertility medicine, because what women, 20 – 40 or so years old, talk about, and spend their money on, is what government think tanks, research facilities, hospitals and pharmaceutical companies listen to. We put pressure on them to come up with answers and solutions. Someday, I hope that unexplained infertility will be a thing of the past.In the meantime, you are a woman of great strength, wisdom and humour. You and Adam are a family unto yourselves, which will hopefully expand to include a child. It’s a great thing that you can be a voice in the dark for other women who suffer infertility and pregnancy loss; just remember to reach out on your dark days and let someone else (including me) be there for you. Lisa (yourgreatlife)

  3. topsoil Hockessin says:

    I truly appreciate this post. I’ve been looking everywhere for this! Thank goodness I found it on Bing. You’ve made my day! Thank you again!

    • Jeremy says:

      Kate, I fololw your blog (quietly) and as I read this post I am happy that I can walk out of my office and across the street to hug you. Some of your fololwers here cannot and I see that they want to… so soon I will walk over and deliver a hug that so many here cannot. I feel rather privileged to know you in person; but today I want to thank you for reminding me how much I was moved to tears to see my son’s early in utero heartbeats. That was 21 years ago and I had forgotten how much that moment meant to me and his father. Some of us who have been winners at ovarian roulette need to remember those moments and not take our good fortune for granted. Lately I have been feeling weary of motherhood…but not after this post. You do many of us good in many ways KV. I am heading to the next room to hug my son and tonight I will say an earnest prayer that the universe give you, Adam and all the women (and their partners) the moments of awe and inspiration that our children bring into our lives. For this I truly pray… see you for that hug soon. TR

  4. topsoil Hockessin says:

    You have brought up a very excellent details , thanks for the post. “The great object is, that every man be armed. … Every one who is able may have a gun.” by Patrick Henry.

    • Mark says:

      I know how you feel. I had a mairircsage and 2 months later i found out i was pregnant again. I know until you hit that 12 week mark you are going to be anxious, try maybe taking a warm bath with some lavender scented bath gel before you go to bed to relax your body and maybe it will help you sleep better. When you wake up from one of those dreams, just take a few deep breaths, and i know it sounds kinda wierd but i used to touch my tummy (well the lil bump that was there) alot just to remind myself that i was blessed enough to get pregnant again and it would make me wonder what this baby would look like, what gender, what name i would give and eventually my anxious feeling would go away. I really hope this helps

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    • Brennen says:

      I also had an epticoc pregnancy and yet I got pregnant again within like 9 months! And I was on the Ortho Evra patch at the time. Not saying I never wanted to have kids, but I usually go to school full-time (except for this past Spring semester 2009 where I dropped to part-time) and I’m trying to get my Degree A.S.A.P. cuz I am an older non-traditional student, so time is $ $ $ $ .I never had anything but the methotrexate shot. NO surgery whatsoever, fortunately for me.I have never had any STD’s. However, for myself what most likely caused my Ectopic pregnancy was the fact I have had endometriosis symptoms since age 15 (which may eventually render me infertile). This condition causes me to vomit every period unless I take an OC or some stronger meds. It also causes severe dymennorhea.This pregnancy (technically my 2nd, but my first child, and also come to think of it, I had no morning sickness the FIRST pregnancy either, lol and I was nearly 8 weeks along when it ended) I have had no morning sickness (unless you count mild and rare nausea) and that was awesome for a woman whose periods can cause her to throw up at the smell of bacon and other odors, without medication to control it. This time, except for some unexplained bleeding for nearly 2 weeks during my 2nd or 3rd month, which could be because at time I was walking miles and miles each week (I thought, OH boy, another epticoc?) I was have been doing great and have had no unexplained bleeding since early trimester.I just had a 3rd trimester check-up today and have gained 22 lbs so far. (4 during first trimester, and 5 lbs a month each month beginning at 20 weeks, believe it or not ). Baby is always active and kicking up a storm. He was boxing in his nearly-15-week ULtrasound, lol. Incidentally, I do absolutely no routine exercise this pregnancy since my bedrest for light bleeding. I do get exercise but it’s not a routine and it’s very much just around the house not planned. (I know, not exactly super-healthy , but I feel like I don’t want to overdo after the bleeding and I have a wonderful OB Team of Doctors and Nurses and Staff support so if I need to step it up, I can and will!)Timing is everything. Be in a committed relationship. My husband and I are due to have a boy in a few months. The less stress the body is under the better for your maintaining and keeping a healthy pregnancy.Any questions message me.

    • Rayyan says:

      I had 2 mraasriicges before I ever had any children. It was really hard to get through, but I managed. About a year later I found out I was pregnant with my son Derek, and was really worried about having a miscarriage again. I just took things easy and one day at a time, and now he is going to be 5 years old. Following that I had 2 more children and everything went great. And the after that I went through a divorce, and my current fiance and I went through another 2 mraasriicges. The doctor ran tests and found no reason as to why I have had so many mraasriicges. I was told to wait at least 3 months before trying again. We kinda gave up at that time, and strangely enough 3 months later we were pregnant again. We had a beautiful healthy baby girl. Now I am pregnant with baby #5, another girl, and things are going well (though I am gettin fixed after this lol 5 kids is enough).

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  8. Reshad says:

    While it is more pvaerlent in women who have had, or been around others who have had miscarriages, I think it is quite normal for us all to be scarred of tragedy. I think that fear of losing the little one is part of the maternal process, you are beginning to truly love this little baby and feeling its bond grow inside you. The fear of something happening to your child does not go away even if they are grown and on their own. I just focus on each day. I had losses of my own and then a difficult pregnancy so I made up my mind to savor every move the baby made and every ultrasound picture I got. My son is almost two and healthy and I still soak up his every move like a sponge. I think if we looked at like in general this way we would all be happier. I hold him to dear to my heart for as long as I am blessed with him. Relax, you are becoming a mother, sweetheart! ENJOY IT! Was this answer helpful?

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