miscarriage

by Jenny Vaughan

miscarriage | help and info

You're pregnant. Maybe you've been trying for a while, and it's happened at last. Or it was unplanned – but, all the same, you're thrilled. You're just getting used to the idea, excited, surprised, perhaps a little apprehensive...

© stockbyte

And then it all goes wrong. You miscarry. There's no baby, no motherhood and some painful questions to answer.

You want to know so much. What went wrong? Why? Can I have another child? Will I ever feel happy again?

Not everyone responds in the same way to a miscarriage, and there is no 'right' or 'wrong' way to feel. But for most, there is a need to grieve, and a need for information.

what is a miscarriage?

A miscarriage is a pregnancy that ends before the baby can survive outside the womb – that is, before 'viability'.

Sadly, miscarriage is relatively common – something that is unlikely to be much comfort to anyone who has had one. Yet it is true that around 15% of clinically recognised pregnancies end this way, and a quarter of all women will miscarry at some time in their lives. Younger women have about a 5% chance of losing a baby, rising to 25% among over-40s.

early/late miscarriage and ectopic pregnancy

A miscarriage may be 'early' (during the first 13 weeks of pregnancy), or 'late'. The vast majority are early – only around 1% are late.

Rarely, a pregnancy is ectopic, forming outside the womb, typically in a fallopian tube. This is life-threatening to mother and baby, and must be terminated.

symptoms

The symptoms that an early miscarriage has taken place vary widely – from pain and bleeding (which may not necessarily mean the end) to no more than a feeling that something is wrong. Late miscarriage is usually painful – with 'breaking waters', contractions similar to labour, and heavy blood loss.

what to do

If you think you are miscarrying, go to the Accident & Emergency department of your local hospital at once.

Once an early miscarriage has started, it is inevitable, but you may need medical treatment to ensure your own health. In some cases in late pregnancy, there are treatments that can prevent the loss of the baby if miscarriage threatens.

why does it happen?

Many women find it hard to accept that their miscarriage was not, somehow, their 'fault'. Yet they are almost always, quite simply, bad luck. Most early miscarriages are 'sporadic' – one-off events, often the result of a chance abnormality in the developing baby's genetic make-up, making it unable to survive.

Though understandable, looking for something to blame is not helpful. Once an early miscarriage has happened, the tissues from the developing baby are nearly always lost, and without these, there is no way the cause can be found.

By contrast, the causes of a late miscarriage are usually investigated, and a treatable problem (such as a weak cervix) may be identifiable.

Recurrent (three or more) miscarriages may indicate an underlying problem needing specialist help. London's Recurrent Miscarriage Clinic, to which patients can be referred by their GPs, is a major centre offering such help.

things that don't cause miscarriage

It is unlikely that any of the following cause miscarriage:

• 'overdoing things'
• having sex
• constipation
• having had a termination
• having taken prescription drugs, including the contraceptive pill
• long-distance travel
• working at a computer.

the emotional impact

There are as many reactions to miscarriage as there are women who miscarry. A sense of loss, irrational guilt and deep depression are all common. Help is available (see help and info). This includes counselling services offered in many doctors' surgeries, private counselling (which can be expensive) and support groups such as those offered by the Miscarriage Association.

another try

Anyone planning pregnancy can take precautions against infections or other threats to the health of the mother and the developing baby. These include:

• having been inoculated against rubella (German measles) before conception
• taking folic acid supplements
• not smoking
• avoiding excess alcohol
• avoiding contact with cat faeces, rare meat, and unpasteurised dairy products
• avoiding all risks of food poisoning.

Look after yourself while you are pregnant – and don't be shy about asking others at home and at work to do their best to support you. Get all the rest you want – it seems that 'tender loving care' can do a lot to raise the chances of a successful pregnancy.

(March 2002, resources updated June 2005)

Read on for details of relevant organisations, websites and reading.