Miscarriages are quite common things in most women’s life. It is estimated that 1 out of 4 pregnancies is going to get terminated by itself during the first trimester. There are also the cases of late miscarriages which is comparatively less common than those that happen early. This obviously does not mean that the woman won’t be able to deliver children ever and she has to be blamed for each miscarriage that happens. But the thing is, everyone deserves an explanation and a brief outlook so as to handle it carefully, if in case you or someone you know face it. I am going to explain about the causes, risk factors, nutrition, and all the essential parts in brief, since there are countless myths associated with miscarriages and educating oneself is necessary. First of all, we need to know why a miscarriage happens at the first place. So, here I begin!
Causes of Miscarriage
1. Immunologic Disorders – In some cases, the woman’s body’s immunity does not accept the newly fertilized fetus as its own, but as a foreign object, and as a result it (Antiphospholipid antibodies) attacks it till the pregnancy gets terminated. Biologically, the embryo is supposed to send signals that it isn’t foreign, but in rare cases, it fails.
2. Chromosomal Abnormalities – Nearly 60% of the total cases are due to chromosomal abnormalities or mismatched chromosomes. Chromosomes are the tiny structures inside the cells that are responsible to carry our genes. Each individual has 23 pairs and each set comes from both our parents. Sometimes due to specific errors these chromosomes aren’t properly aligned and so miscarriage occurs.
3. Uterine Abnormalities/Incompetent Cervixes – This issue contributes to 10% of the total cases. If someone has an abnormally shaped uterus, it either does not allow the pregnancy to happen at all or lets it terminated because of lack of required nourishment. The weak cervix also does not allow to let the fetus stay for longer months. Once the first trimester ends the fetus becomes larger and the cervix starts to bulge. The doctor usually detects the problem only if there are recurrent miscarriages (three or more), and to combat it a surgery is performed so that it could hold the fetus for full 9 months.
4. Bacterial Infections – In general, the bacteria, Mycoplasma hominis and Ureaplasma urealyticum, are known to be healthy and reside inside both male and female reproductive tracts. But in rare cases, these cause trouble like inflammation in the uterus lining, thereby obstructing the uterus to develop further. Unless a medical test procedure is being carried, it cannot be detected.
5. Polycystic Ovary Syndrome – In this case, the woman’s body has high levels of male hormone, testosterone, that is responsible for irregular ovulation and menstruation. Other than causing conception troubles and miscarriages, it also causes insulin resistance to even those women who are not suffering from diabetes. This ultimately causes the prevention of endometrial lining from maturing properly. Only prescribed medications can treat this.
6. Lifestyle Habits and Work Environments – Smokers have the risk twice as compared to non-smokers because the nicotine does not get filtered and the fetus is at harm. Drinking more than two units of alcohol a day also raises the risk of termination. Women who work in farms, dental offices, hospital labs and operating rooms also are greater risk at getting a miscarriage, due to unknown reasons.
What is blighted Ovum?
Blighted Ovum, also known as anembryonic pregnancy, is a fertilized egg which attaches itself normally to the uterine wall initially but does not proceed further to develop into an embryo. This means that the pregnancy happened through cell development but not enough being an embryo that sustains further. It usually happens during the first trimester because of chromosomal abnormalities, abnormal cell division or poor quality sperm, even before the woman realizes that she is pregnant. The woman’s body senses itself and does not allow the further development.
In the case of Blighted Ovum, the placenta continues to grow and supports itself without an unborn child for a while and the pregnancy hormones too continue to rise, resulting into pregnancy symptoms, and making a woman believe that she is pregnant for sure. Only an ultrasound test confirms that what it is by showing an empty womb or gestational sac. The woman might face minor bleeding. The doctor recommends to terminate whatever is left inside because there is absolutely no chance of the embryo’s development. If the woman does not abort it, it will eventually result into a miscarriage. Early termination saves a lot of complications since a female’s body is capable to pass the tissue on its own, else one might need to go through a surgical procedure if it is too late. The earlier, the better!
When the doctor advises to abort?
The doctor closely monitors the health of the mother as well as of the unborn child. If he finds out the the mother is not healthy enough to carry the entire phase of pregnancy, he suggests to quit. It isn’t just nutritional deficiency since it could be coped up using supplementations. It is more than that which is life threatening and the mother is likely risking her own life. Certain medical conditions that are untreatable and cause greater health troubles than a healthy woman are – Autoimmune disorders, HIV, AIDS, others kinds of STD, heart disease, severe diabetes, and cancer.
There is a test known as Amniotic Fluid Test (AFT) which can recognize the potential threats the fetus is going to get after getting welcomed into this world. The risks it can detect are – Muscular Dystrophy, Down Syndrome, Trisomy 18, Cystic Fibrosis, Spina Bifida, Sickle Cell Disease, Tay-Sachs, and Anencephaly.
If your doctor recommends you to abort the child, it is still your decision to go for it. There are cases of delivering healthy babies, despite of the early possible detection of physical and/or mental health ailment the child might develop. You may also go for getting yourself tested at different clinics so as to confirm the risks.
Does abortion leads to future miscarriages?
There is no statistical evidence that supports that this statement is one hundred percent true. Some studies suggest that if a woman gets pregnant for the first time she should not go for the elective abortion because it could lead to several miscarriages in a row. An elective abortion, if done several times, elevates the risk of miscarriages. But this does not mean that the woman is not going to go through the entire phase of pregnancy and deliver a healthy child ever. There is a difference between increased risk and a definite pattern. Other than the doctor’s own recommendation, there are still several factors that result into taking such step, which is usually lack of finances, inability of mother to take care of the child because of her own unstable physical and/or mental health condition, and pregnancy that happened as a result of rape, dysfunctional relationship, or similar causes.
Signs and symptoms of a miscarriage
So, what are the signs and symptoms of a miscarriage? Everyone needs to know, although, those who have experienced it know exactly how it is but it differs from individual to individual.
1. Bleeding – The bleeding happens at the birth canal that could be light or heavy, irregular or consistent. The bleeding is sometimes misinterpreted as a miscarriage but it may not necessarily true, since during the first trimester this might occur even if there is a healthy pregnancy. If the bleeding is followed by pains and cramps then one must take note and immediately visit her gynecologist.
2. Pelvic cramps – There may be some sort of pain at the abdominal region, belly and/or lower back which likely starts from a few hours to several days post bleeding, and could be mild to severe.
3. Blood clots – If the blood clots are there along with the bleeding and a grayish substance, it likely indicates that there is a miscarriage. Sometimes the grayish tissue isn’t there but the woman still goes through the miscarriage. Only a doctor can confirm what is happening.
All the above symptoms may also accompany with fever and weakness. The symptoms mentioned here are a series of events that occur for several days and are usually not sudden. It must be noted that all women’s experiences are different and so it is possible that the symptoms that showed up to you might not show up to somebody else and vice-versa. Having a general idea of signs of a miscarriage is necessary so that whenever you suspect something is wrong you may quickly contact your gynecologist to confirm, whether it was worth bothering.
Risk Factors for Miscarriage
There are some risk factors for miscarriage that heighten the chances of the pregnancy termination. Although, it does not imply that these are the sure factors that will definitely result into the disaster but extra precautions could be taken into consideration in order to successfully go through this tender phase and manage that with prescribed medications, if needed. Following are the miscarriage risks:
1. Bacterial or viral infections of certain kinds during the pregnancy.
2. History of three or more miscarriages.
3. Age of 35 years old or more than that.
4. Altered structure of the uterus.
5. Lifestyle habits such as heavy caffeine intake, doing drugs, smoking, drinking alcohol, etc.
6. Exposure to toxic substances.
7. Polycystic Ovary Syndrome (PCOS).
8. Blood-clotting disorder, such as antiphospholipid antibody syndrome.
Pregnancy and nutrition – What to eat and what to avoid
Once you get pregnant, it is important for you to keep in check of your dietary habits because it directly affects your unborn baby’s overall health and development as well as you. Below are the basics that you could follow.
Avoid unwashed, raw/uncooked, half-cooked and unpasteurized foods. This means if you are planning to cook something, make sure that you wash them well and entirely cook, whether it is about cooking your vegetables, meat, poultry, or boiling/frying your milk/eggs. The eggs must be entirely cooked (hard boiled/full fried) having white and yolk being solid. This avoids (potentially harmful) bacteria enter your body. Also avoid foods that are high in mercury content such as Swordfish, Shark, King mackerel and Tilefish. Always remember that the bigger and older the fish is, it is more likely containing the mercury. You must also avoid canned and packed foods and if you do you must go through their key ingredients in detail.
Do not have your salads, fruits and sprouts in raw form while you are pregnant because of the elevated chances of entering of bacteria and viruses into your system. If you are so interested in having your fruits and salads then go for boiling or steaming them properly. Cook your sprouts as well by thoroughly steaming or frying.
You will have your share of specific food cravings that might also go extreme such as cakes, pastries, chocolates, and some specific meals. You are free to have them at times but in moderation. Do not indulge too much into sugary treats and particularly that contain wheat because it will eventually lead to extreme constipation and discomfort, and even worse gestational diabetes in case of high sugar content. Instead, go for foods that are high in fiber such as oatmeal. Pregnant women are also likely showing hate towards specific meals. Now that is quite possible that it could be healthy for your body and so avoiding it entirely might not be a good idea. You may take those meals in moderation.
Most Indian households never encourage pregnant ladies to consume papaya at all. Pineapple could be eaten in moderation. As per studies, raw papaya is a strict no-no but one could take it if it is riped. But again, why to risk!
Your doctor will tell you in detail which foods are must and what to avoid based on your present health conditions. In general, women are suggested to have lots of calcium and iron and they are prescribed to take supplements as well, if required.
Myths about miscarriages
Miscarriages are not that common – Most couples grieve in silence and whole world doesn’t know that they went through it. Miscarriages happen once in every 4 to 6, or you can say 15 to 25 percent of the time of all confirmed pregnancies. It is much more common than one might think.
It’s mom’s fault – In most cases, it isn’t mom’s fault but other factors such as abnormal number of chromosomes (that might even lead to down syndrome, or any other physical or mental ailments, to the child if he/she is even born), autoimmune disorders, PCOS, bacterial infections, and weak cervixes. As far as lifestyle is concerned, the doctor already recommends what changes need to be made and women in general follow that.
If you went through one, you will get next time as well – If you had a miscarriage once, it does not imply that you will be having multiple miscarriages in a row and that it would not allow you to deliver a child ever. Although, if you went through three subsequent miscarriages, chances are raised of facing it, which is then tested by doctors to know the actual cause(s). But again, there are still 60% of chances that you are going to deliver a healthy child in the coming future, no matter how many failed attempts you went through.
Physical exercising leads to miscarriage – Doing mild to moderate physical exercise, yoga and meditation is actually beneficial to the expecting mothers and that leads to less trouble while bearing natural childbirth. Although, depending on your own health condition, you must listen to your gynecologist’s advice, who is most likely going to tell you the same if you are a healthy mom, except for those who are already dealing with severe health conditions.
Blood spots and sickness is the sign of a miscarriage – It could be or it could not be. This is because there are also the cases of blood spots of those who went through healthy pregnancy and a successful childbirth. If you suspect that you might be having a problem you must consult your doctor who will confirm your case.
The body needs to rest for longer – It is believed that the chances of another miscarriage increases if the next pregnancy occurs right after the previous pregnancy’s termination, which is far from the truth. Most doctors will advice to go for it after two to three months and a woman does not have to wait for a year or so.
It’s the physical or emotional stress – It’s an age-old advice to keep a pregnant woman away from any kind of stress. In general, physical stress (such as lifting heavy objects) does not harm much to the woman’s womb health. However, those whose body is weak and fragile, and already have experienced more than three miscarriages in a row, must take extra care of themselves and take their doctor’s advice seriously.
Emotional stress could be extreme (such as death of someone in the family) but it hasn’t been proved yet that it causes that much amount of distress to the fetus to the point of a miscarriage.
Miscarriage cannot lead to mental trauma – A miscarriage is much as capable to bring mental trauma to the mother (and father), as it would do to her losing a healthily born and brought-up child who dies at any age due to any reason. Just because the fetus is anonymous to the expecting mother does not mean that she isn’t going to get upset.
Even though there are several causes and risk factors that lead to a miscarriage, we still cannot pin-point the actual cause that might have resulted that. Most women simply want to know because they think that it’s their fault. Although, prevention is better than cure, you simply have to have regular check-ups with your gynecologist and rely his/her recommendations, rather than numerous advices from countless people who you meet on daily basis. Everyone’s body is different and certain kinds of lifestyle and other habits, if suited to some women, may or may not be suitable to others. Your doctor keeps a record of certain tests being conducted after specific intervals, as well as your previous medical history. This means your doctor knows your body the best!