Miscarriage, though very common, can be quite challenging and often devastating to expectant mothers. Below, we provide answers to common questions related to miscarriage as well as information to dispel any myths.
Causes & Predictors for Miscarriage
The incidence for miscarriage is approximately 8 to 20 percent in early pregnancies (less than 20 weeks). Risk decreases as the pregnancy progresses. Studies have shown that miscarriage occurs in about 5 percent of women in their first pregnancy or in those with a prior child.
One of the most important risk factors for miscarriage is history of prior miscarriage and advancing age. Younger women experience less miscarriages than older women. These calculations come from large studies of women*. Of course each person’s risk is different based on their health and history. The following are some common causes and predictors for why miscarriage may occur.
#1 – Insufficient Number/Types of Chromosomes
There are many reasons that miscarriage occurs. The most often resulting from the egg and sperm not having the appropriate number or types of chromosomes that are necessary for a pregnancy to continue to grow.
#2 – Infections/Medical Issues
Infections, structural problems with the uterus or cervix, medical problems/diseases and certain medications (such as clotting/bleeding, endocrine disorders, cancer treatment) can also cause miscarriage.
#3 – Stress
Psychological or physical stress may be linked to miscarriage based on medical studies, however further research is needed.
Miscarriage Myths
Women can often be mislead into thinking they somehow caused their miscarriage. Myths surrounding miscarriage are many! For example, running, eating certain foods, or traveling on an airplane are NOT likely to be the cause of miscarriage.
Does having a miscarriage increase my chances of having twins?
Women have asked if after having a miscarriage they have a higher chance of twins or triplets! Medications used to help with ovulation do increase the chance of multiples, but the risk is not increased in spontaneous pregnancy, which is approximately 3 percent.
If you have fears about miscarriage, please discuss them with your provider.
Signs of Miscarriage
Signs of a miscarriage include abnormal bleeding and cramping. Many women will experience bleeding in the early first trimester of pregnancy, but most go on to have full-term deliveries.
There are times where a women has no signs that a miscarriage has occurred. If you experience bleeding or other worrisome symptoms in pregnancy it is always best to contact your provider’s office.
Treatment for Miscarriage
Treatment of a miscarriage includes expectant management (i.e. close follow-up but no medications or surgery), medical or surgical management. You will make a plan with your provider to choose which is the best route depending on your unique situation.
Grieving After a Pregnancy Loss
Grieving after a miscarriage has occurred is important. There is no “right” way to feel.
Families often ask if they did something wrong, and they may feel angry and desperate for answers. Depression, anxiety and mood disorders can occur, so it is important that you follow up with your provider and have these conversations. There are resources and support groups available should you desire.
Feeling supported by your family, friends, and loved ones during this time can help you to heal.
Resources & Support for Miscarriage
The following are some online & local resources for grieving after the loss of a pregnancy:
- After a Miscarriage: Surviving Emotionally – American Pregnancy Association
- Unspoken Grief
- Still Standing
- Pregnancy After Loss Support (PALS)
- Healing Hearts: Baby Loss Comfort
- Share: Pregnancy & Infant Loss Support
- Covered in Love (support group in Raleigh, NC)
Pregnancy After Miscarriage
Often women wonder when or if they should try to conceive again. There is no “right” time.
I tell my patients that they should wait until they feel emotionally ready. Some experts recommend waiting at least one menstrual cycle.
Preconception planning may be helpful as you and your provider can discuss ways to make sure you are in good health. Lab tests, ultrasounds, and/or genetic testing are sometimes helpful in situations when miscarriages are recurrent.
Reference(s)
Influence of past reproductive performance on risk of spontaneous abortion. Regan et al.
BMJ. 1989;299(6698):541.
About Chantel Roedner, MD
Dr. Chantel Roedner joined WakeMed Physician Practices as an OB/GYN after completing her residency at The University of North Carolina at Chapel Hill and earning her medical degree at the Medical University of South Carolina in Charleston. Her clinical interests include high risk obstetrics, infertility, minimally invasive gynecological surgery including robotic surgery, well woman care and contraception.
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