Written by: Alison Todd
Miscarriage is a very sensitive issue which tends to be brushed aside in our society due to the fact that there is simply no ‘cure’ for it. It is thought that about 12% of pregnancies miscarry in the first 23 weeks, with about three quarters of those happening in the first trimester.
There is now more information available than ever on how to reduce the risks, the most common being not to smoke during pregnancy, closely followed by eating a healthy diet along with plenty of other common sense, ‘looking after yourself’ advice.
How do you reduce the risk of miscarriage?
However, no amount of caution is a guarantee, and it is important to distinguish the truths from the myths when it comes to some commonly held beliefs. For example; consuming too much caffeine; taking drugs; drinking more than two units of alcohol per week; being obese or over the age of 45 will all increase the risk of miscarrying. Contrary to the more traditional perspective, though, exercising (sensibly), having sex, working and being stressed will not, statistically, make any difference to the outcome of a pregnancy.
Unfortunately, even going completely by the book cannot ensure pregnancy reaching a healthy full term and, once the process of miscarriage starts, particularly in early pregnancy, there is still very little that can be done to stop it. In fact, many doctors believe it is nature’s way of ‘making things right,’ with an estimated two thirds of early losses being due to chromosomal abnormalities. Miscarriage at a later stage is more likely to be linked to health issues in the mother.
For couples going through a miscarriage it can be a truly sad and emotionally confusing time. In a first pregnancy, with nothing to compare to, it can be very difficult to know what is normal and what is not and, whilst symptoms such as pain and bleeding can both signal a miscarriage, neither is a definite indication that the pregnancy will terminate itself.
If you think you are miscarrying
If there is a possibility that you are miscarrying then the best starting point is your GP. There is no cast-in stone process, with some doctors recommending bed rest and others advocating a normal routine. There can be equally disparate attitudes towards ultrasound scanning in the very early stages but there are an increasing amount of Early Pregnancy Units in hospitals now, and a referral to one of these is far preferable to a lengthy wait in and A and E unit or a costly private scan.
If the outcome is confirmed as a miscarriage then it is important to start the recovery process as soon as possible. Physically, you may be offered the option of a small procedure to remove any remaining tissue or, alternatively, just to let nature take its course. Health professionals will take into account such factors as risk of infection as well as the possibility of future healthy pregnancies.
The grieving process is definitely the hardest aspect to cope with. There is usually a strong sense of bereavement and, depending on the stage of the pregnancy and the circumstances of the loss, there could be considerations of how to dispose of the remains. Legally, until 24 weeks there is no requirement to bury foetuses, but hospitals vary in their policies on offering sensitive options with many couples now opting to mark their loss in some formal way.
Physically, you may feel run down and generally unwell and this is normal. Your body has been through a form of trauma. Just as in normal pregnancy you need to nurture yourself with plenty of rest and care.
Aside from practical and physical considerations, emotional recovery can vary. It is common for women to feel a devastating sense of loss but, equally, some women feel numb or simply manage to carry on with their lives with little disruption.
There is no right or wrong reaction. Even a sense of guilt is normal, with women often fearing they did something wrong to cause the miscarriage. This is surely a natural extension of maternal feelings of responsibility to protect our offspring and if these feelings escalate then counselling might help. Some women may find it incredibly difficult, at this time, to be around friends or family who are pregnant or nursing young babies. This too is understandable.
In some ways it can be even more confusing for the father to cope with miscarriage. Not only is he grieving for a lost baby, he is also seeing his partner suffering both physically and emotionally. Feelings of anger and injustice are common and, often, men feel like their grief is not taken into consideration. They are generally expected to be strong for everyone else.
Miscarriage can sometimes put a strain on a relationship, especially if you both experience different levels of grief or deal with it in different ways.
If you already have children it can be difficult to know how to involve them, if at all. They may sense the emotional pain but not understand its cause. The best way to cope is by doing what feels right.
The same goes for telling friends and family. You may choose to share your loss and the reactions and support will vary.
One of the most difficult decisions following a failed pregnancy is if and when to start trying again. There is usually no reason why this cannot happen quite soon, unless there is still risk of infection. Therefore it has to be a personal choice and one that a couple will need to reach together.
Help and advice
Coping with a pregnancy after a miscarriage can be and anxiety-filled time and it would be advisable to make use of the many resources and organisations and helplines that exist specifically for that purpose.