What is miscarriage?

A miscarriage is when a pregnancy spontaneously ends on its own, most commonly in the very early stages of pregnancy but they can occur up until approximately 20 weeks. When a pregnancy stops growing, the tissue needs to be passed out of the body, generally resulting in period-like bleeding. Sadly, miscarriage is a common issue faced by many women, with up to 1 in 5 confirmed pregnancies ending in miscarriage. It is actually thought that this number could be higher, as some women will miscarry without realising they were ever pregnant [1].

Common signs to suggest miscarriage include cramping and stomach pain (similar to period pain) and vaginal bleeding.

Unfortunately miscarriage is a normal part of human reproduction and most cases cannot be prevented, however it is important to note that many women who miscarry will go on to have a successful pregnancy.

Types of miscarriage

There are a number of different types of miscarriage, along with some other types of pregnancy loss which can also result in miscarrying.

Threatened miscarriage

This is when your body shows signs suggesting you might miscarry – such as a small amount of vaginal bleeding or some lower abdominal pain. In some cases, the pain and bleeding will go away and you will continue on to have a successful pregnancy, however there is a possibility that your symptoms worsen and you go on to miscarry.

If you experience any of the above symptoms and suspect you may be experiencing a miscarriage, it is important to contact your fertility specialist or obstetrician as soon as possible.

Incomplete miscarriage

As opposed to a complete miscarriage, an incomplete miscarriage refers to when some of the pregnancy tissue remains in the body. Bleeding and cramping may continue as the body tries to dispel what is left.

Often when this happens, you will need some intervention to help your body rid itself of the leftover tissue. This is completed by way of a medical procedure called a ‘dilation of the cervix and curettage of the uterus’ (or otherwise known as a ‘D&C’).

Complete miscarriage

A complete miscarriage is when all the pregnancy tissue has been passed through the body.

If you miscarry at home or elsewhere when you are not able to contact your nurse, fertility specialist or obstetrician, you should make contact with them and have a check-up as soon as possible.

Missed miscarriage

Sometimes when a baby stops growing, it can remain in the uterus. Some women may experience a brownish discharge and notice that regular pregnancy symptoms (such as nausea) have subsided. Sometimes nothing seems out of the ordinary until it is picked up on routine ultrasound, which is why this is referred to as a missed miscarriage.

If you experience this, it is important to discuss treatment options with your fertility specialist or obstetrician.

Recurrent miscarriage

Unfortunately, some women experience repeated miscarriages. Recurrent miscarriage is defined as someone experiencing miscarriage two or more times without any successful pregnancies in between.

If you experience recurrent or multiple miscarriages, it is important to consult with a fertility specialist in order to assess why this may be happening and discuss a treatment plan to try and prevent it from continuing to happen.

Other types of pregnancy loss

Ectopic pregnancy – when an embryo implants outside of the womb and cannot develop safely, resulting in the need to stop the pregnancy.

Blighted ovum or anembryonic pregnancy – when the sac develops but there is no baby inside, which is usually discovered via scan.

Causes of miscarriage

Sometimes, there is no clear reason why you have had a miscarriage.

In most cases, a miscarriage has nothing to do with you and there wouldn’t have been anything you could have done to stop it from happening. Research suggests that most women experience miscarriage due to chromosomal abnormalities in the embryo that mean the pregnancy would never have been viable [2].

Some other contributing factors include:

  • Age (women aged over 40 have a higher chance of miscarriage than having a live birth [3])
  • Abnormal uterus
  • Hormonal disorders
  • Infections and diseases
  • Lifestyle factors (such as obesity, smoking, alcohol or drugs)

Although living a healthy lifestyle may decrease your chance of miscarriage due to lifestyle factors, even the healthiest of women may experience miscarriage.

Miscarriage and fertility

The good news is that generally miscarriage will not affect your future fertility, with your fertility levels usually returning to normal during your next menstrual cycle.

However, you also need to ready emotionally to try and conceive again and sometimes this can take a little bit longer.

Talk to your GP or fertility specialist about any concerns you may have about trying again for a baby.

Coping with miscarriage

Although it’s hard, try to stay positive as most women who experience miscarriage will go on to have a baby [4].

Everyone is different, so there is no right or wrong way to feel when coping with the loss associated with miscarriage. Whilst some people cope by preparing to try again, others need time and space to grieve before moving on. Grief is a common emotion and can be experienced both physically and emotionally.

Often, people may find solace in counselling and support services which allow you to voice your feelings. You can also turn to your doctor, health processional or family and friends for support during this time.

In the instance of a miscarriage occurring during treatment, Monash IVF counsellors are on hand to support you through this difficult time. Our counsellors are experienced at dealing with miscarriage and will offer unlimited support and follow up.

Genetic Screening – giving your embryos the best chance

If you experience recurrent miscarriage or are trying to conceive at a later stage in life, your fertility specialist may suggest genetic screening. Pre-implantation genetic screening, or PGS, is a way of testing the embryos before they are implanted in order to detect any with chromosomal or gene related issues. Screening allows our scientists to handpick healthy embryos. Only embryos with the potential to result in a healthy baby are transferred, so the chance of miscarriage due to chromosomal abnormality significantly decreases. Learn more about PGS here.

If you have suffered from recurrent miscarriage or believe you might be at an advanced risk of experiencing one, consult with a fertility specialist to discuss your options. And remember, miscarriage is not your fault – it’s just nature’s way of telling us that the pregnancy would have never resulted in a healthy baby.

 

 

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