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Miscarriage: the most common pregnancy complication

This week is Baby Loss Awareness Week (9 – 15 October).  Miscarriage, stillbirth and pregnancy complications are incredibly personal topics and as such, rarely discussed.  And yet, one in four pregnancies sadly ends up being lost, most commonly within the first 12 weeks of pregnancy. 

Why do miscarriages happen?

In spite of it being a common occurrence, there is usually no obvious cause for a pregnancy’s failure.  It is estimated that over 60% occur due to a chromosomal abnormality, meaning that the embryo could not survive in the outside world.  Other causes include serious illnesses (such as German measles), auto-immune disorders, hormonal imbalances and anatomical issues, such as a mis-shaped uterus or a weak cervix.

It can be difficult to grasp not having a clear reason for it and it can become very easy to blame yourself or your partner, for example worrying about a drink you had when you didn’t know you were pregnant…but it’s important to highlight that it is extremely rare for any parental behaviours to cause a miscarriage. 

What happens during a miscarriage?

A miscarriage involves heavy bleeding and abdominal pain. The experience really varies from person to person.  For some, the process happens quickly but for others it can take weeks for their body to lose the pregnancy. This can be drawn out and physically very draining.

Sometimes, women experience a “missed miscarriage”, whereby the pregnancy has ended but the body has clung on to the embryo. This type of loss is only detected at the routine 12 week scan, where no heartbeat can be located.

Whatever the circumstances, miscarriage is a painful and highly distressing experience. Dreams are shattered and hope can often feel lost. The mental health impact of a pregnancy loss can last for a significant period of time and will most likely never be forgotten by anyone who has been through it.

The good news is, the vast majority of women who miscarry – even with a history of multiple miscarriages – will go on to have a live birth, without complications.

Multiple Miscarriages

When someone has three or more consecutive miscarriages, this is defined as multiple miscarriage. After three, women are entitled to investigations on the NHS. A consultant will run a series of tests to see if any underlying cause can be identified. However, in more than half of these cases, no underlying cause is found.

What is a stillbirth?

A stillbirth refers to the loss of a pregnancy at 24 weeks or more gestation.  This is the point at which pregnancy is considered to be legally ‘viable’; in other words, the baby could have a good chance of survival, if born alive.

Stillbirth is an incredibly difficult time, as the mother will need to go through the birthing process.

What is an ectopic pregnancy?

An ectopic pregnancy happens when a pregnancy develops outside of the uterus, most commonly in one of the fallopian tubes.  Around 1 in 80 pregnancies is ectopic and if not detected and treated early, it can cause serious complications.  Ectopic pregnancies sadly cannot survive, as there is no way of transferring to the uterus.

The emotional impact of miscarriage

Just as every experience of miscarriage is different, there is no ‘right’ or ‘wrong’ way to grieve for the loss of a pregnancy.

It goes without saying that it’s an incredibly sad time, regardless, and sharp fluctuations in hormone levels only intensify these feelings.

Some people may feel upset then move on relatively quickly, whereas others will need more time to heal.  It really depends on so many factors, such as age, experience, the circumstances of the loss and how hard it has been to conceive in the first place.

How to support someone through a miscarriage

The chances are, someone you know will experience the heartache of miscarriage.  Sometimes, well-intentioned comments can be quite hurtful, so the best thing you can do is express your regret and offer to listen, support or help in any way you can.

Lines such as “it clearly wasn’t meant to be” or “at least you know you can get pregnant” or “you can always try again” are tactless comments which can be very hurtful to hear.

Where to find additional support

As so many people do go through the pain of miscarriage, support from friends and family may well be available, but sometimes, people prefer to talk things through with someone who doesn’t know them.  Organisations such as Tommy’s and The Miscarriage Association have dedicated helplines. Companies who use Fertifa’s services will also have access to a trained advisor; we are there for our patients through every stage of a fertility journey.

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