Why does a miscarriage happen?

Going through a miscarriage can be emotionally, mentally, and physically draining for an expecting mother, especially as it is completely out of your control. While there are some safety measures and precautions you can take to ensure a full-term pregnancy, miscarriages are often sudden.

What is a miscarriage?

Miscarriage refers to the loss of the embryo or foetus before the 20th week of pregnancy. A normal pregnancy lasts about 40 weeks or 9 months. The total period of the pregnancy is divided into three trimesters.

The first trimester is from week 1 to 12, the second trimester is from week 13 to 28, whereas the last and the third trimester goes from week 29 to 40. Miscarriages can happen during any of the three trimesters, but most occur before the 12th week of pregnancy, i.e., the first trimester. Hence, the first trimester is often very crucial, requiring regular monitoring.

Going through a miscarriage does not necessarily signify something wrong with you. Reasons for miscarriage can range from chromosomal abnormalities, hormonal imbalances, uterine abnormalities, malnutrition, accidental trauma, etc.

Types of miscarriages

Miscarriages are very common; almost 1 in 8 pregnancies end with a miscarriage. Often, mothers might miscarry even before they become aware of their pregnancy. Additionally, a lot of women struggle with repeated miscarriages. Depending on the medical situation of each woman, miscarriages are broadly divided into 5 major types:

Missed miscarriage

In a missed miscarriage, there are no typical signs and symptoms. However, when an ultrasound is performed, it shows an embryo without a heartbeat or an empty embryo sac.

Recurrent miscarriage

If a woman undergoes three recurrent pregnancy losses, she is diagnosed with the risk of a recurrent miscarriage.

Complete miscarriage

In complete miscarriage, there is a total loss of pregnancy with vaginal bleeding. All the foetal tissue passes out of the vaginal opening.

Threatened miscarriage

As the term ‘threatened’ suggests, in a threatened miscarriage, there is fear of miscarrying during the entire pregnancy due to risk factors like abnormal vaginal bleeding and abdominal pains. Around 50% of threatened miscarriages end in normal pregnancies, whereas the other 50% end in pregnancy loss.

Inevitable miscarriage

An inevitable miscarriage occurs when there is excessive bleeding and the cervix begins to open. The embryo’s chances of survival in such a case are zero.

Causes of miscarriages

It is a misconception that routine activities like exercising, sexual activities, dancing, etc., are reasons for miscarriage. An expecting mother can continue all her regular activities in moderation while following safety precautions.

If you have underlying medical conditions, your doctor will advise you accordingly. The actual causes of miscarriage are several:

• Chromosomal abnormalities
• Thyroid diseases
• Incompetent cervix
• Hormonal imbalance
• Uncontrolled diabetes
• Infections
• Recurrent miscarriage
• Cervical cancer
• Invasive prenatal tests
• Malnutrition
• Being overweight or underweight
• Severe kidney problems
• Radiation
• Medicinal side effects
• Congenital heart disease
• Improper implantation of the fertilized egg

Signs of miscarriage

Oftentimes, expecting mothers might not even be aware that they are miscarrying. Having said that, some miscarriage symptoms and signs to watch out for are as follows:

• Vaginal bleeding
• Abnormal vaginal discharge
• Abdominal cramping
• Excessive pelvic pain

Risk factors for miscarriage

Some risk factors for miscarriage are:

• Use of recreational drugs
• Alcohol abuse
• Excessive smoking
• Old age
• Previous miscarriages
• Food poisoning

Treatments for miscarriage

If a woman undergoes a complete miscarriage, the foetal tissue emerges via the vaginal opening. In such a case, no further treatment is required. However, in other cases, if a miscarriage has occurred and the tissues have not exited the body, the doctor will have to remove them.

Often doctors opt for the dilation and curettage procedure in which the cervix is dilated, and all the remaining tissues are removed using a surgical tool. Nowadays, medication is also available to remove the remaining tissue from the uterus. If a miscarriage occurs in the later stages of the pregnancy, when the foetus has been completely formed, the doctor will induce labour and deliver a stillborn baby.

In cases like recurrent miscarriages, the doctor will closely monitor your pregnancy. They might routinely schedule tests like a pelvic ultrasound, hysteroscopy, hysterosalpingogram, etc., to make sure the pregnancy is progressing well.

Pregnancy after miscarriage

A miscarriage does not imply that you cannot get pregnant again. You will have to be cautious and follow more precautions and safety measures. 85% of women go on to have normal pregnancies after miscarrying for the first time.

In case of recurrent miscarriages, with proper advice from the doctor, it is possible to become pregnant again. You can schedule tests like chromosome tests, hormone tests, ultrasound, and blood tests to understand all the risk factors closely and proceed accordingly.

In conclusion

It can take a few weeks for your body to recover from the stress of miscarrying. After a miscarriage, you might also need time to heal yourself emotionally. You might experience strong feelings of loss and grief.

After a harrowing miscarriage experience, many couples find it difficult to plan their next pregnancy. Health conditions also make this difficult. Keep in mind that there is no rush to plan your next pregnancy; you can take your time to deal with your emotions.

Are you struggling with a tumultuous miscarriage and wish to find a professional and experienced health practitioner to help? Visit the CK Birla Hospital near you or book an appointment with Dr. Aruna Kalra who will help you learn about your condition and provide you with the best treatment options available.

FAQs

Q1. How long does a miscarriage last?

A miscarriage can last from a few hours to a few weeks. Symptoms like abdominal pain and vaginal bleeding are normal during pregnancy, but the moment you notice something abnormal, you are advised to visit a doctor as soon as possible.

Q2. What happens first during a miscarriage?

If a woman is miscarrying, she might notice some initial symptoms like spotting, vaginal discharge, and bleeding. The cramps might also get worse with time. Symptoms differ for each woman, but the common symptoms are usually cramping and bleeding.

Q3. How do miscarriages start?

The start of the miscarriage varies for each woman. Normally miscarriages start with abdominal cramping and vaginal bleeding. With time, the symptoms worsen. It is thus advisable to visit a doctor as soon as possible.

Q4. What should you not do after a miscarriage?

Refraining from putting anything in your vaginal opening for the next few weeks after miscarriage. Avoid using period products like tampons and menstrual cups. Give yourself time to heal emotionally and mentally.