In just an instant, what some women wait their entire lives for can disappear.
Defined as the loss of a fetus before 20 weeks of pregnancy, miscarriage affects at least 15 to 25 percent of recognized pregnancies, according to WebMD. When factoring in instances where a woman doesn’t yet know she’s pregnant, that number may be as much as 50 percent. [pullquote align=”center”]This little life that was inside of me had died, and I didn’t know why.[/pullquote] If you’ve ever experienced a miscarriage, you know that along with the heartache and devastation that comes with it, so do questions—and sometimes, judgment. And although miscarriages are hardly taboo, there’s still much about them that is shrouded in secrecy. Here, we take a look at what causes miscarriages, if preventing them is possible, and what to do after one occurs.
Miscarriage Causes: Is anyone at fault?
Unfortunately, miscarriages can happen to any woman at any time during her pregnancy. Doctors aren’t always able to determine the reasons why a miscarriage occurs; in fact, they aren’t even sure of all the possible causes for the tragic event. They do know, however, that the most common cause for miscarriage is unpreventable. [pullquote align=”center”]In the first trimester of pregnancy, miscarriage is not caused by factors under the mother’s control.[/pullquote] “The most common cause of miscarriage is a chromosomal abnormality, meaning the baby has too few or too many chromosomes to develop normally,” says Melissa Kirven, MD, of Akron General Obstetrics and Gynecology. “The most common chromosomal abnormality is Trisomy 21, also known as Down Syndrome. Although many babies with Down Syndrome grow up to be healthy adults, it is a risk factor for pregnancy loss.” Other frequent miscarriage causes are not as widely known. “Less common causes, which women may be less familiar with, are abnormalities of the uterus, such as abnormally-shaped uteri and uterine fibroids,” says Kirven. “Other causes include thyroid disease, diabetes, and auto-immune diseases. There are also some less common blood clotting disorders that can be associated with miscarriage, as well.” Miscarriages can also occur because of the mother and father’s age, the bacteria Listeria, substance use, and trauma. The highest risk of miscarriage occurs during the first thirteen weeks of pregnancy, also known as the first trimester. Fortunately, the risk of miscarriage goes down as the pregnancy progresses. Second trimester miscarriages, which take place between 13 and 19 weeks gestation, only affect 1 to 5 out of 100 pregnancies.
Prevention: Is it possible?
Unfortunately, there’s not much a pregnant woman can do to prevent the vast majority of miscarriages. “In the first trimester of pregnancy, miscarriage is not caused by factors under the mother’s control,” says Kirven. You can, however, take action to avoid the other known miscarriage contributors. “All women who are pregnant or who are planning to become pregnant should not smoke, should eat healthy and exercise, and should take a vitamin containing folic acid to reduce their risk of miscarriage,” shares Kirven. Mothers-to-be should also avoid using illicit substances, manage their stress, and keep their weight within healthy limits.
Feelings of Blame
It’s safe to say that the majority of pregnant women want to carry their babies to full-term. When this doesn’t happen, others are sometimes quick to assign blame for why the pregnancy didn’t work out—including, as we’ve said, the mother herself. According to a survey published in the Obstetrics & Gynecology journal, 41 percent of women (out of 1,084 surveyed) felt they had done something wrong to cause the miscarriage, and 28 percent had felt ashamed. The truth is, there’s not much a woman can do to cause a miscarriage, Sindhu Srinivas, MD, assistant professor of obstetrics and gynecology at the University of Pennsylvania told Parents. As mentioned, most are caused by genetic abnormalities. This hasn’t prevented an abundance of myths and rumors regarding the cause of miscarriages from circulating, however. Sex, moderate exercise, and working are some of the most popular myths as to why miscarriage occurs, says Kirven. Getting sick in the first trimester, any previous abortions, and prior pregnancy loss are also rumored to cause miscarriage. Fortunately, it isn’t thought that any of these things will cause a miscarriage. However, it’s always a good idea to check with your obstetrician if you aren’t sure if what you’re doing is safe.
What to Do After the Miscarriage
The physical toll of a miscarriage can be significant: mild-to-severe back pain and cramping are common (a more comprehensive list of symptoms can be found here—though these symptoms don’t always mean miscarriage, you should consult your doctor). [pullquote align=”center”]Allow yourself to grieve.[/pullquote] A miscarriage is just as taxing emotionally, though, as it is physically. In fact, many would argue that it takes even more of a toll on your heart and mind than it does on your body. Whatever you believe, one thing is for certain: there’s no right way to handle a miscarriage. For instance, not everyone feels devastated after having one. A 28-year-old mother of a 3-year old boy who lives in Severna Park, Maryland, and who wished to remain anonymous, remembers eventually feeling relief when she discovered she had miscarried with her first child. “When I first found out, I was really sad. This little life that was inside of me had died, and I didn’t know why,” she recalls. “But it was also a horrible time in my life to become a young, first-time mother.” An unstable relationship, coupled with a less-than ideal living situation, made bringing a baby into the world a terrifying idea for her. However, she wanted to keep the pregnancy. “I didn’t want an abortion, but it also wasn’t the right time in my life to have a baby,” she said. The radiology technician says she was under a doctor’s care and was doing everything she was told to do during her pregnancy, including taking prenatal vitamins. Unfortunately, these preventative measures didn’t stop her from miscarrying at nine weeks along. “I was cramping and spotting, and since this was my first pregnancy, I immediately flipped out and went to the doctor,” she says. Once there, the staff was unable to locate a heartbeat. After she had time to process the miscarriage and discovered the relief she felt, she found support where she didn’t think she could: in her family. “I wasn’t sure how people would react if I told them I was relieved,” she says. “But everyone understood, even my relatives and friends I thought would think I was a bad person.” This isn’t the case for everyone, however. Some mothers experience depression, guilt, shame, anxiety, and anger. To make matters worse, the act of the miscarriage can take days to complete. So not only is the mother experiencing emotional grief, she’s also at the mercy of the body’s miscarriage process. Unfortunately, there isn’t a one-size-fits-all cure for enduring a miscarriage. It’s important, however, to do what feels right to you, even if you fear what others may think. “Allow yourself to grieve,” says Kirven. “Although it may be a loss early in pregnancy, to you and your family, it is still a significant loss. Others may not understand how much the loss of this baby means to you. Seek out the support of friends and family who will allow you to grieve in the way you want. It’s okay to talk about your baby.”
Should you try again?
The good news is this: there isn’t any evidence that suggests that having a miscarriage increases your chances of having another. In fact, the Mayo Clinic says that miscarriages are typically single occurrences: only 1 percent of women have more than one. You’ll need to tap into your emotions, however, before you get back on the wagon, says Kirven. “Know that there’s no ‘right’ time to try again,” she says. “Medically, it’s safe to attempt pregnancy as soon as you have a normal period. [But you] may or may not be emotionally ready.” Although the chances of a second miscarriage are slim, there is still that small, terrifying shot that things could go wrong. If you find yourself pregnant again, you may want to take a few steps to possibly lessen the blow should the unimaginable happen for a second time. The American Pregnancy Association recommends avoiding early preparation for the baby’s arrival. That is, consider holding off on purchasing the bulk of the items you’ll need until after your little one is born. You may also want to wait to plan your baby shower until after you have the baby. Preparing yourself for emotions you may not expect is also helpful. Feelings of sorrow from your first loss may reappear after you give birth. You may also feel hesitant to bond with this baby for fear that something will happen. Talk to your medical provider about any concerns you have regarding the pregnancy or birth. It may help you to feel better about your pregnancy and what it is to come. Miscarriage hits everyone in a different way. Ask those around you to remain flexible in the kind of support they give you, as your needs may change each day. And remember that whatever way you choose to handle the miscarriage is the right way for you.