What causes miscarriage and other questions about pregnancy loss
The loss of a pregnancy can be a complicated situation, and many women may feel guilty or like they caused their miscarriage to occur. The truth is early pregnancy loss is common. Kelly Brier San Miguel, MD, OB/GYN, explained what causes miscarriage and answered other common questions about pregnancy loss.
“Miscarriages occur in 10% of all pregnancies, with 8 out of 10 occurring within the first trimester,” said Dr. San Miguel.
Unfortunately, a kind of code of silence often means that a woman won’t realize just how common it is until she miscarries and realizes how many women she knows have also gone through a pregnancy loss themselves.
What causes miscarriage?
“About half of miscarriages happen due to the embryo not developing properly,” Dr. San Miguel said. “Usually because of an abnormal number of chromosomes.”
When an egg and sperm join and the egg is fertilized, the two sets of chromosomes come together to create an entirely new set of 23 pairs, or 46 total. If there are more or fewer chromosomes than usual, the embryo may not be able to develop and the pregnancy will terminate.
Other risk factors for early pregnancy loss include:
- Increased maternal age
- Prior miscarriages
- Medical conditions like uncontrolled or poorly controlled diabetes or thyroid disease
- Exposure to infection
- Substance use, including alcohol and drug use
Is there anything I can do to prevent a miscarriage?
In most cases, a miscarriage is not a woman’s fault. Despite popular myth, activities like work, exercise or intercourse or negative things like stress, arguments or depression are not what causes a miscarriage at all.
“For those who have already had one to two pregnancy losses,” Dr. San Miguel said, “low-dose aspirin (81 mg) is associated with a reduced risk of loss.”
You can speak to your doctor for more information on safely taking low-dose aspirin during pregnancy.
What are the early signs of miscarriage?
The earliest signs of miscarriage include vaginal spotting or bleeding, with or without pain. Not all bleeding during early pregnancy is because of miscarriage, but if you do have cramping or spotting, contact your OB/GYN right away.
“Your OB/GYN may want to do an ultrasound to check whether the pregnancy is growing normally,” Dr. San Miguel said. “If your pregnancy is far enough along, the ultrasound might detect cardiac activity.”
If no cardiac activity is found, the embryo may have stopped developing – or your pregnancy may just be so early in its development that it can’t be detected yet.
You may also have a blood test done to measure human chorionic gonadotropin (hCG), a hormone produced in the placenta during a pregnancy that helps signal your body to elevate existing levels of progesterone (necessary to maintain continuing pregnancy).
A low or decreasing level of hCG may signal the loss of the pregnancy.
Multiple ultrasounds or hCG tests may be needed to be sure that a pregnancy is lost. A pelvic exam may also be required to see if the cervix has begun to dilate or open.
What can I do to help heal physically and emotionally after a miscarriage?
“It is absolutely natural after a miscarriage to feel sadness or grief,” said Dr. San Miguel. “And depending on the circumstances, it is also natural not to. There is no one way to act after a pregnancy loss.”
Emotional healing takes longer than physical healing from a miscarriage, and your feelings may be different than those of your partner or support system. If you feel like your feelings are being dismissed or you’re having trouble handling them, speak with your OB/GYN or a counselor.
You can also join support groups. A few support groups that can help to provide emotional support and understanding after a miscarriage include:
How soon can I try to conceive again after a miscarriage?
“First-trimester pregnancy loss is usually a one-time occasion,” said Dr. San Miguel. “Most women who have an early pregnancy loss can go on to have successful pregnancies in the future.”
You can get pregnant again as soon as two weeks after an early miscarriage. If you’re still struggling with the loss, however, becoming pregnant again so soon may not be what you want.
In that case, contact your OB/GYN to review birth control options and speak about your pregnancy plans moving forward.
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