Losing Your Baby

From the earliest beginnings of your pregnancy, you probably felt that the fetus was an integral part of yourself. This instinctive response to pregnancy means that miscarriage or stillbirth can be devastating.

Miscarriage is far more common than you may realize. An estimated one in four women experience miscarriage, and one in three hundred have had three or four miscarriages. Nevertheless, if you lose a baby, your loss will feel both intense and painful. On a physical level, there had been an immediate bond between mother and baby-to-be. Your instinct may be to rush ahead with another pregnancy, but do give yourself time to mourn. Studies show that unresolved grief may affect your fertility or stop you from fully experiencing the joy of a future pregnancy.

What is a miscarriage?

A miscarriage is the loss of your developing baby. The medical profession categorizes that loss according to the point in your pregnancy when you experienced it. At 24 weeks, a live birth is considered “viable” – that is, the baby would stand a chance of surviving (probably with intensive care). If you lose a baby before this milestone, you’re said to have suffered a “spontaneous abortion”; after 24 weeks, the los is called a stillbirth.

When miscarriage occurs it’s important that all the “products of conception” are removed from your uterus (the placenta, amniotic sac, and fetus). Often doctors will offer a procedure called a dilation and evacuation (D&E) that confirms your uterus is clear. If you do have a D&E, ask the doctors to test the baby’s tissue, as it can sometimes give information as to why you miscarried. In many cases, this information can help the grieving process.

There are three other kinds of fetal loss that aren’t strictly miscarriages inasmuch as the body doesn’t expel anything spontaneously. These are “blighted ovum”, “missed abortion” and “chemical pregnancy”. A blighted ovum occurs when an ultrasound shows an amniotic sac, but sadly no embryo within it. A missed abortion occurs when you go for a scan thinking that all is well, only to discover that tragically your baby has died. In a chemical pregnancy, hormone levels have indicated that you’re pregnant, but it’s thought that the fetus died before it could implant.

Symptoms of miscarriage

The symptoms that most commonly alert an expectant woman to the fact that something might be wrong are severe abdominal cramping and/or bleeding from the vagina. This might be heavy or just a few spots that continue to appear over several day. You may experience pain in your lower back, bleeding may contain clots, and vaginal mucus may contain flecks of gray-brown matter. If you’re at all concerned at any time during your pregnancy, you must call your doctor.

Moving on

Understanding what has happened in your body can be overwhelming when you lose a baby. Doctors may bombard you with information that, at the time, can be hard to absorb.

The great majority of miscarriages occur in the first or second trimester of pregnancy. The experience can be both physically and mentally devastating – but you’re not alone.

What causes a miscarriage?

The women understandably want to know why they’ve suffered the devastating loss of their baby. By having this knowledge, they then feel they can do something to prevent a miscarriage from occurring in future pregnancies. Unfortunately, although your doctor may be able to find a tangible reason why you miscarried, in some cases, all your tests results will appear normal and an explanation as to what happened will remain frustratingly elusive. Equally, there may be a single, definable cause for your miscarriage; or it may have been caused by a combination of factors.

The answers are unlikely to be straightforward, but while some of the possible causes and risk factors are out of your control, others (such as smoking, drinking, and weight problems) are not. This goes as much for your partner as it does for you.

Causes Beyond Your Control

Chromosomal abnormality A chromosomal abnormality is different from an inherited genetic problem and can occur (in the sperm or egg) before or during fertilization – of after it, when the embryo’s chromosomes divide. A human being has 46 chromosomes, which make 23 pairs. In a baby, 23 of these chromosomes come from you and 23 come from your partner. If the baby has, say, three chromosomes in a grouping, instead of having a pair, he or she will suffer a trisomy, which will cause a malformation. In some cases, trisomies will cause miscarriage, in others they will not. For example, one of the most common causes of early miscarriage is trisomy 16 (an extra chromosome on the 16th pair); while trisomy 21, which causes the condition Down’s syndrome, does not result in miscarriage.

Trisomies are the cause of up to 50 percent of miscarriages, nature’s way of ensuring the survival of the fittest. But if you have had a trisomy miscarriage once, you should be reassured that it’s unlikely to happen again, although age is a factor. As women get older, their eggs become less healthy, perhaps damaging the 23 chromosomes the woman contributes to the baby. This may explain why older women are more likely to have Down’s syndrome babies and are at greater risk of miscarriage.

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