Finding out that you are expecting a precious little one is one of the most thrilling experiences that you will ever have. Almost immediately, you start to wonder if baby will be a boy or a girl, what he or she will look like, how the nursery should be decorated, the list goes on and on.
Along with all of the exciting experiences that come with being pregnant, expecting mothers have a long list of worries as well. One of the biggest concerns, especially in the early months, is whether or not a miscarriage will occur.
Out of all of the known pregnancies, fifteen to twenty percent end in miscarriage. Eighty five percent of those occur in the first trimester, these are considered early miscarriages.
Statistically, researchers and medical professionals believe that up to fifty percent of all pregnancies in the earliest stages, before most women are even aware that they are pregnant. Because of early detection home pregnancy tests, more women are aware of their miscarriages.
Whenever a miscarriage occurs, there is a loss to be grieved. Learning what can cause early miscarriage can help you through that process.
7 What is an Early Miscarriage?
An early miscarriage is a loss of pregnancy before twelve weeks gestation. Half of all pregnancies end in miscarriages, but only twenty five percent of women are aware that a miscarriage has occurred, due to the fact that most women wait a week or two after a missed period to take a pregnancy test.
A chemical pregnancy is a pregnancy that is miscarried before it is able to be detected by ultrasound. The name of this type of pregnancy comes from the fact that the only evidence of the pregnancy was the chemical reaction needed to get a positive pregnancy test.
In these early miscarriages, the egg is fertilized, and either fails to implant in the uterine wall, or implants , but fails to grow.
Until recently, the only women who were aware they had a chemical pregnancy were those who were working with a fertility specialist. Home pregnancy tests have developed technology that can detect a pregnancy five days before a missed period. Unfortunately, many women get a positive pregnancy test, only to realize that the pregnancy failed to develop.
Researchers have found that the following conditions can increase the likelihood of a chemical pregnancy:
- infection or STDs
- poor quality of the sperm or egg
- abnormal cell division
- untreated thyroid disease
- improper implantation, either inside or outside the uterus
- hormone imbalance
- luteal phase defect ( the body fails to produce progesterone at the proper time during the menstrual cycle)
6 Signs and Symptoms of a Chemical Pregnancy
Because the miscarriage occurs before five weeks of pregnancy, most women have no idea that a miscarriage has happened. Women may notice cramping or bleeding that resembles a period. Because all of this happens so close to the time of an expected period, most women take little notice of it.
Treatment and Prevention
If a chemical pregnancy is detected, there is no method of treatment. If a chemical pregnancy is diagnosed or suspected, it is important that hormone levels are monitored in order to rule out a tubal pregnancy or ectopic pregnancy.
There are generally no physical complications involved in a chemical pregnancy. Mental health treatment may be needed to address the emotional impact of the pregnancy loss. Pregnancy loss support groups can offer a great deal of support to a grieving family, as well.
If continued chemical pregnancies are an issue, the following treatment can help prevent them from occurring:
- surgery to repair any abnormalities in the reproductive system
- antibiotics to address any infections that are present
Before trying to conceive again, it is important to talk to your healthcare provider to ensure that your body is ready to carry a successful pregnancy.
5 Early Miscarriage
After five weeks gestation, a pregnancy is considered a successful pregnancy, or a clinical pregnancy, due to the fact that evidence of the pregnancy sac can be detected via ultrasound.
If a miscarriage occurs between five and twelve weeks gestation, it is considered an early miscarriage. Eighty percent of all miscarriages occur within the first twelve weeks of pregnancy.
Causes of Early Miscarriage
Seventy percent of all miscarriages that occur in the first twelve weeks of pregnancy are caused by a malfunction in baby’s genetic make up. SImply put, the mother’s chromosomes and the father’s chromosomes don’t fit together like they should.This doesn’t mean that there is anything wrong with the parents or that this will happen again.
Sometimes a woman’s body fails to produce progesterone in the quantity it is needed to maintain a healthy pregnancy. Since testing for this before pregnancy isn’t par for the course, this disorder is usually diagnosed after several miscarriages. Your healthcare provider can prescribe a plan of action that will increase your chances of a healthy pregnancy in the future, if this is the case.
Uterine infections, diabetes, heart disease, and thyroid disease can compromise blood flow to the uterus and cause a miscarriage, due to the fact that baby fails to get the oxygen it needs to sustain life.
If you suffer from any of these or any chronic illness, it is important that you consult with your healthcare provider prior to becoming pregnant to ensure that your illness is properly managed. Early prenatal care is a must to increase your chances of delivering a healthy baby.
Consuming alcohol or drugs during pregnancy can poison baby’s developing cells and contribute to miscarriage, along with a long list of birth defects. If you are trying to conceive, it is best to abstain from alcohol and drug use for the health and safety of your baby.
Caffeine consumption increases the risk of miscarriage when the mother consumes over 200 mg daily. Your healthcare provider can recommend an amount that is safe for you and baby. Needless to say, energy drinks of any kind are completely off limits.
4 Signs and Symptoms of an Early Miscarriage
If you are pregnant and experience any of the signs of early miscarriage, contact your health care provider immediately. Some of the signs and symptoms of an early miscarriage are:
- cramps, similar to menstrual cramps or more severe
- bleeding, this can be light or heavy
- passing clots or tissue
- change in pregnancy symptoms
What to Expect
A threatened miscarriage is scary, whether it’s your first pregnancy or your fifth. Contacting your healthcare provider at the first sign of symptoms is extremely important in order to rule out a tubal pregnancy, miscarriage of one or more babies in a multiple pregnancy, or other issues.
You can expect that your doctor will do either an internal or external ultrasound, depending on how far along you are in your pregnancy. He or she will look for a fetal heartbeat, analyze the pregnancy sac, and look for issues with the placenta. Ultrasound will also reveal an tubal pregnancy, or the loss of one baby in a set of multiple pregnancies. You will also be checked for irregularities in your reproductive organs that could contribute to miscarriage.
You will also have a pelvic exam to look for changes in the cervix that would indicate a miscarriage.
You will also have bloodwork done to gauge the levels of pregnancy hormone in your blood and determine how severe your blood loss has been. Your blood type will also be determined and if you are rh negative, you will need an injection to prevent issues with incompatible blood types in your next pregnancy.
Many doctors order bed rest, or abstinence from any and all sexual activity in an effort to stop a threatened miscarriage. You may also be required to cut back on work and household activities.
The main goal of the treatment is to prevent infection and hemorrhaging.
If you are filling more than one sanitary napkin per hour, you need to contact your health care provider. This is an indicator that, most likely, the miscarriage has progressed.
Generally, a woman’s body will completely expel both the baby and the pregnancy contents on its own. Sometimes a woman retains pieces of tissue, this is called an incomplete miscarriage and action needs to be taken to prevent infection or hemorrhage.
3 Dilation and Curtilage
Generally, a dilation and curtilage will be performed to ensure that no tissue is retained, Before this is done, you can request an ultrasound to ensure that baby is no longer viable, if you haven’t had one already.
A dilation and curtilage, or D and C, requires the cervix to be dilated so that leftover pregnancy tissue can be removed. Because this is a painful process, the patient is usually under general anesthesia when this occurs. In addition to scraping the lining of the uterus, suction may be necessary to ensure that the entire pregnancy has been removed.
Sometimes, a prescription drug is used to help the body expel the pregnancy. Again, you can request an ultrasound to confirm baby's lack of viability if one has not already been performed.
Some healthcare providers will give a woman’s body time to expel the pregnancy on its own. You will need to be closely monitored to ensure that you don’t hemorrhage or develop infection during this process.
You will be prescribed medications to prevent hemorrhage, antibiotics to prevent infections, and pain medications as necessary.
If you are rh negative, you will need to receive an injection to prevent further pregnancy issues.
Contact your health care provider immediately if you have chills or a fever as this can indicate the presence of an infection.
You should also report excessive clotting or bleeding that is beyond what your healthcare provider told you that you can expect, or any other unusual symptoms that cause concern. It's always better to be safe than sorry.
You will need to follow up with your healthcare provider as he or she requests to monitor your physical and emotional condition.
If you had a D and C, you will be checked for a complication, known as Asherman’s Syndrome. This scarring on the cervix happens in roughly seventeen percent of women who have had a dilation and curtilage. Generally, the scar tissue is easily removed and doesn’t affect fertility.
2 Physical and Emotional Recovery
No matter how early on a pregnancy is lost, it is difficult to bear. Grieving the loss of your baby is a normal, and very necessary, part of healing.
Just as every person is different, everyone grieves differently. There are stages of grief that all people go through. As a parent who has lost a child, you may find yourself going through the steps over and over as the time comes to remember different dates that remind you of baby. This is perfectly normal.
The stages of grief are:
- Shock and/or denial - This first stage is actually your brain’s defense mechanism to help you deal with loss.
- Guilt and blame- As you begin to process the loss of your baby, you may begin to look for someone to blame. Whether it’s God, your doctor, your spouse, or yourself, this is a perfectly normal response. You may also resent people around you who are pregnant or have children and wonder why this happened to you and not them.
- Depression- You may find yourself slipping into depression. Some signs of this are: crying, mood swings, loss of appetite or turning to food for comfort, insomnia, and have the inability to function. While depression is normal, you need to contact your health care provider if you are unable to function, or feel like harming yourself or others.
- Acceptance- You are finally able to get on with everyday life. This doesn’t mean that you forget your baby, but the loss doesn’t consume your life anymore.
Finding a mental health care provider to help you sort out your emotions may be a good idea. Others find solace in counsel with clergy.
There are also various support groups, both online and in real life, that can offer support and encouragement from those who have been there.
The best thing for your emotional health is to not isolate yourself from friends, family, and loved ones.
1 Conceiving Again
For each couple, deciding when to conceive again is an individual matter. You need to be sure that you are not only physically ready for a pregnancy, but emotionally as well.
Talk to your healthcare provider before you make the decision to try to conceive to ensure the best outcome possible for your new pregnancy. Your healthcare provider may order tests in order to determine whether or not an underlying issue is responsible for your miscarriage.
You may also be referred to a specialist if your healthcare provider discovers genetic or physiological reasons for your miscarriage.
Before you conceive again, you should do the following to make sure you are physically and emotionally ready for pregnancy:
- Make sure you are in top condition before conceiving. This means eating healthy and getting enough rest. Visit your healthcare provider to make sure that any preexisting conditions that you may have are under control.
- Take a prenatal vitamin. Taking a prenatal vitamin with folic acid can help reduce the chances of chromosomal incompatibilities in future pregnancies and ensure that your body is properly nourished.
- Reduce stress.
- Wait six months to conceive, if possible. Most healthcare providers recommend that couple wait six months before trying to conceive to allow for physical and emotional healing.
Although common, early miscarriage has a profound effect on the lives of baby’s parents and family. Give yourselves time to grieve and heal, both emotionally and physically. Be patient and love each other.
Celebrate and acknowledge the time that you had with baby, however brief, all life is precious and deserves to be honored.