Signs, Symptoms and Causes of Miscarriage

woman in black cardigan near trees

Understanding Miscarriage, and Identifying Causes and Risk Factors

A miscarriage (sometimes called “spontaneous abortion”) is an unfortunate event that surprisingly happens more often than people may think. It is very difficult to accept, and generally causes confusion as to why, or how, it could have happened.

A woman suffering from a miscarriage may wonder why it happened or blame herself. A miscarriage is no one’s fault, and cannot be prevented, aside from a few behavioural and lifestyle changes outlined further in this article.

What Is A Miscarriage?

A miscarriage is a pregnancy loss that usually occurs during the first 20 weeks of pregnancy. It is usually the body’s way of ending a pregnancy was doomed from the start.

How Common Is It?

Miscarriages are surprisingly common. Studies suggest that approximately 20% of all pregnancies end in a miscarriage. This number is vague, however, because many women will have a miscarriage before they even know they are pregnant.

Causes Of Miscarriage

Usually, miscarriages occur because of some chromosomal abnormalities in the embryo. A miscarriage of this sort is nature’s way of terminating a pregnancy that would never develop into a healthy baby. In many cases, doctor’s cannot pin-point exactly why a miscarriage has happened.

Once the pregnancy surpasses it’s 12th week, the risk of a miscarriage is dramatically reduced. This is why many women wait until they are safely past their first trimester to announce their pregnancy.

Signs And Symptoms Of A Miscarriage

The most common signs of a miscarriage are:

  • Vaginal bleeding. This is a dangerous sign that something may be wrong with the pregnancy. The bleeding can be light or heavy, and may sometimes come on or off;
  • Abdominal, lower back, or pelvic pain or cramping;
  • Passing tissue from the vagina.

Some miscarriages are only discovered during an ultrasound or prenatal visit when the technician or doctor cannot find the baby’s heartbeat.

If any of the above symptoms are experienced, it is important to seek medical attention right away if there is heavy, constant bleeding, severe cramping, fever, weakness, or signs of infection. Otherwise, the miscarriage should just be allowed to take it’s own course and complete on its own. Many times a miscarriage takes a few days to happen.

There are times, however, when treatment may be required to clear the uterus if the miscarriage is not happening fast enough, and complications are arising. A procedure called a D&C (‘dilation and curettage’) involves surgically removing tissue from the uterus. No treatment can actually stop a miscarriage.

Types of miscarriage

It’s called a pregnancy miscarriage when a woman loses a baby before the foetus can survive outside the womb, usually considered 24 weeks of pregnancy.

If you start bleeding but your womb is still closed, you may not necessarily lose your baby. In this case,it’s called a threatened miscarriage, and you’ll be recommended plenty of rest to ensure your pregnancy continues normally. If your womb is relaxed, is considered an inevitable miscarriage, and is usually accompanied by severe bleeding and pain. Unfortunately, in this situation, you may lose your baby. 

Furthermore, it can be classed as complete or incomplete miscarriage, depending on whether all conception tissues are expelled naturally or not. It can also be an early miscarriage if it happens during the first 12 weeks, or late miscarriage, if it happens later than that. Early miscarriages are very common, and is estimated that ¾ of all pregnancies fail at this very early step, and women may not even realise they’re pregnant. Late miscarriages are less common (about 1 in 100 pregnancies) but can have more devastating effects. Your doctor can guide you better about your pregnancy miscarriage risk by week.

Common Types Of Miscarriage

Although there are a variety of ways in which a miscarriage can occur, common forms include:

  • Ectopic Pregnancy – the fertilized egg develops outside of the uterus, mostly in the fallopian tube.
  • Molar Pregnancy – an abnormality of the placenta, caused by a problem when the egg and sperm join together at fertilization.
  • Blighted Ovum – a fertilized egg attaches to the wall of the uterus, but the embryo doesn’t develop.
  • Luteal Phase Defect – when the second phase of the menstrual cycle lasts less than 10 days, and the lining of the uterus will not be able to build up to a healthy point where implantation of a fertilized egg can occur.

Unfortunately, there are two tests that are done to detect abnormalities with the fetus that have a slight chance of causing a miscarriage: amniocentesis and chorionic villus sampling (CVS). These can cause miscarriage in 1-2% of women.

Risk factors

Although it’s impossible to know whether a pregnancy is going to end in a miscarriage, there are some risk factors:

Age: 

The older you are, the more chances you have of miscarrying due to genetic abnormalities in the baby.

Health: 

It’s important to inform your doctor of any medical conditions you have, as they may increase your risk of miscarrying, such as thyroid problems and diabetes. Infections you catch while pregnant can also increase miscarriages, such as aslisteriosis, toxoplasmosis, or rubella.

Lifestyle:

If you’re a smoker and heavy drinker, you have a higher risk of miscarrying.  Also, it’s been shown that excess caffeine can have the same effect. Two cups a day (200 mcg caffeine) is the maximum recommended dose.

List of risk factors

The following factors can increase the risk of a miscarriage:

  • Smoking
  • Excessive caffeine consumption
  • Alcohol consumption
  • Previous miscarriages
  • Fibroids
  • Lupus
  • Age
  • Diabetes
  • Kidney disease
  • Thyroid disease
  • Infection

Coping with a miscarriage is very difficult, but it can be comforting to know that most women are able to get pregnant again, and deliver a healthy, full-term baby. Mourning the loss of a baby is not only normal, but it’s important to release these feelings. Losing a baby is tragic no matter how early in pregnancy it happens.

Treatment

You may not need any treatment at all after an early miscarriage, if your body is capable of completing the miscarriage naturally. The bleeding will stop within 2 weeks and you should just take plenty of rest to help your body recover. If the bleeding doesn’t stop within 2 weeks, you may be experiencing an incomplete miscarriage and need medical assistance. In this case, you may opt for medication or in surgery to completely remove all conception tissues. Unfortunately, because it’s so common, you will not be referred for further tests. In all likelihood, your next pregnancy will be successful. Only in extreme cases of three consecutive miscarriages, you’ll be advised further tests to find out why.

A late miscarriage can be as painful as labour, and you need medical assistance. Afterwards, you’ll have intermittent pain and bleeding for a few weeks. If you notice any unpleasant vaginal discharge contact your doctor, as it may be a sign of infection. You may also experience some breast discomfort and even start producing milk. Painkillers and a supportive bra will help.

In this case, both you and the baby may undergo tests to find the reason why you miscarried. The doctor will perform a vaginal examination and your blood can be tested for signs of infection, and an autopsy may be performed on your baby (with your consent). However, the chances of finding out exactly why you lost your baby are slim.

How to cope with a miscarriage?

Especially in late pregnancy, it can be extremely painful to cope with the loss of your baby. Some parents want to see the baby and keep some mementos like photos or footprints, while others prefer not to have anything that reminds them of their loss. You’ll be offered support at the hospital, including religious support if you need it. Once you’re back home, your healthcare visitor and doctor is your best option for emotional and physical support.