Miscarriage

As many as one in four pregnancies end in miscarriage. Find out more about the causes, symptoms, risks, and treatment for miscarriage for women in New Zealand today.

What is a miscarriage?

A miscarriage refers to a pregnancy which ends spontaneously before 20 weeks. The medical term for a miscarriage is ‘spontaneous abortion’. The term abortion has become associated with ending a pregnancy through termination of pregnancy, but in actual fact means ” loss of the pregnancy “.

One in four pregnancies will miscarry and the majority of those miscarriages occur in the first trimester (up till 12 weeks), often around the time that a period would have been due.

What causes miscarriage?

Usually no cause is found for the miscarriage and it is assumed that abnormal pregnancies often end this way:

• There may have been a problem at conception
• There may have been a problem with implantation of the embryo in the womb
• There may have been a problem with the placental development
• Lifestyle factors, such as cigarette smoking, alcohol, drugs and stress are also causal factors for miscarriage.

How will I know I am losing my baby?

Often prior to the miscarriage the woman will be aware that the pregnancy does not feel right. Early signs and symptoms are:

• Reduced nausea and other symptoms of pregnancy
• Spotting or light bleeding
• Mild lower abdominal pain.

Often these symptoms of a ‘threatened miscarriage’ will settle and the pregnancy will continue as normal.

Otherwise the pain may become stronger and the bleeding heavier. Blood clots and/or pregnancy tissue (of a whitish grey appearance) may be passed  – and accordingly the pregnancy may end.

The stronger pain and heavier bleeding may also be accompanied by nausea and feeling faint. If you are at home, then ask an adult to come and be with you and contact your doctor for advice. Do not drive if you suspect you are having a miscarriage as the pain could become severe while you are driving, putting you at risk of an accident.

If and when the pregnancy tissue has been passed, the cramps and the bleeding usually settles down. In most cases the baby and placenta will come away with the blood loss. If the miscarriage is early in the pregnancy it may be difficult to see the baby. The placenta will look like a blood clot or raw liver. Occasionally the baby and placenta are kept for a post mortem to investigate repeated miscarriage or late miscarriage. In most cases, however, this does not happen.

Usually there is very little that can be done to prevent a miscarriage. If a woman is experiencing threatened miscarriage her doctor will usually recommend rest to give the pregnancy its best chance of continuing. Miscarriage is usually inevitable one way or the other, but physical rest and contact with your doctor will help you to know that you are doing everything you can to help your pregnancy to continue.

After a miscarriage women are advised to take some time off work and get help with other children for a few days to enable her to rest and physically recover. Avoid sexual intercourse until the bleeding has settled, in order to prevent infection. If there is any doubt as to whether anything is left inside your womb, or uterus, then your doctor will observe your recovery carefully. Occasionally women need an operation if part of the baby or placenta remains and is causing bleeding or infection. This is known as having retained products of conception and the operation is commonly known as a D&C – Dilatation and Curettage.

What are the risks following a miscarriage?

The majority of women recover physically very quickly after a miscarriage. After about 7 days duration the bleeding will begin to settle and any pain will have subsided.

Occasionally women experience problems after a miscarriage. These could be caused by retained products, whereby part of the growing baby or placenta did not come away during the miscarriage. This can cause continued bleeding or infection. Infection would usually be painful, cause a smelly vaginal discharge and a high temperature. Contact your doctor if you suspect that your recovery is not normal as antibiotics would need to be prescribed to treat the infection.

If you wish to try again for a baby many doctors will advise waiting until your next menstrual period occurs. This enables your body to heal and regular ovulation to resume. It also gives you a date of your last menstrual period from which to date your pregnancy.

After a miscarriage

Most families experience grief following a miscarriage, for the baby that never was. From the first moment of pregnancy families are imagining what their new baby will be like, whether it will be a boy or a girl and what their characteristics will be. This bond is often formed very early in the pregnancy and the loss of a baby is hard, no matter how long or short the pregnancy may have been.

In addition, if this is a repeat miscarriage it may be associated with anxiety that a normal pregnancy prove to be difficult.

As miscarriage is common there is often a lack of appreciation of how devastating it can be for some couples. Others may feel philosophical about the miscarriage; others may feel guilt or relief. There is no right reaction as each individual and whanau will have their own feelings about the loss of the baby. If possible find a close relative or friend who can let you express how you are feeling, openly and honestly. Talk to your partner and share the feelings that you have.

It is important to ensure that you feel ready to move on from your loss before trying again for another baby, otherwise the grief from the miscarriage may lead to postnatal depression after the birth of a subsequent baby. There are miscarriage support groups which many women and men find extremely helpful in learning to express their grief and move on.

Useful articles and websites

For information on Bleeding in Pregnancy visit our Kiwi Families article

To find out more about New Zealand’s support group visit our article on Miscarriage Support

To understand about Ectopic Pregnancy, click here.