COPING WITH THE FEAR OF MISCARRIAGE

Women are often surprised by how deeply sad they feel following a miscarriage. One day there’s a baby on the horizon, the next day it’s over. Couples who miscarry are often surprised at the depth of grief and disappointment they feel. Even if you’re only a few weeks pregnant, it’s natural to dream about the baby you’ll have, and plan for your future together. It’s a miserable experience to be left with nothing, often not knowing why you lost your baby or whether you’ll be able to conceive another.

How common is miscarriage?

Professor Peter Stone, head of department at the University of Auckland’s department of obstetrics and gynecology, estimates that 15 per cent of “identified” pregnancies miscarry, and around 40 per cent of all conceptions do not lead on to a live baby – women lose the baby so early they don’t even realize they had conceived. “The further on in the pregnancy you get, the less common it is, although five per cent still occur after 13 weeks. We call it a miscarriage up to 20 weeks and following that it is known as a prenatal loss,” says Professor Stone.

How will I know if I’m having a miscarriage?

The most obvious signs are period-like pains and heavy bleeding, which may include blood clots. The good news is that not all bleeding heralds a miscarriage. “Early pregnancy bleeding is very common and the majority of people who bleed will not miscarry,” says Professor Stone, describing what is known medically as a “threatened miscarriage”. You need to see your LMC if you experience any bleeding.

What happens during a miscarriage?

An “inevitable miscarriage” occurs when the cervix opens and the placenta breaks free from the uterine wall, usually causing heavy bleeding (including pieces of the placenta resembling clots) and cramping period like pains. Once an inevitable miscarriage has begun there is nothing you can do to stop it: how it is dealt with depends on whether the placenta is passed completely or some of it remains inside the uterus. While most women miscarry at home, some require hospitalization. “The further on in the pregnancy, the less likely it is for the miscarriage to be complete. Most miscarriages of up to eight weeks will miscarry completely at the time and over the next few days, but the further on you go after that it’s more likely the miscarriage will be incomplete and you will require a D&C [dilation and curettage].” A D&C is an operation to open the cervix and empty the uterus, usually performed under a general anesthetic.

What can I do to avoid miscarrying?

Often there is no explanation for a miscarriage. “Isolated miscarriage causes are generally unknown, it is most likely to be genetic or chromosomal problems in that particular pregnancy and they are not likely to be recurrent in another pregnancy.” Professor Stone says all you can do prevent a miscarriage is avoid cigarettes, excessive alcohol and extremely strenuous exercise.

If I’ve had one miscarriage, am I at risk of having another?

Professor Stone admits that women who have had one miscarriage are slightly more likely to have another one, and those who have had two are more likely to have a third, but he also says it is important to remember that in each pregnancy “you are still more likely to have a healthy pregnancy” than to miscarry. However much it feels like the odds are stacked against you, they are not.