"To be in good hope" – this is how being pregnant is also referred to. Unfortunately, this hope is not always fulfilled. A miscarriage is an unbelievable blow of fate, no matter in which phase of pregnancy it occurs. It also often happens completely unexpectedly. Although there are many women and couples affected, the topic of miscarriage is still a taboo in our society.
It is no wonder, then, that many couples conceal their pregnancy during the first twelve weeks, as the risk of losing the unborn child is comparatively high during this time 1 . Overall, the risk of miscarriage decreases with each week of pregnancy 2 . If there is really heavy bleeding or if the ultrasound shows that the heart of the offspring is no longer beating, the world suddenly seems to stand still.
"Well, it’s about time you had an offspring!!" "Don’t you want another sibling??" – careless statements like this at the next family or company party then feel like a punch in the stomach. Finally, no one suspects what a sad secret the affected couple carries inside them. Yet the orphaned parents are by no means alone with their fate. Unfortunately, these tragic losses are spoken about far too seldom.
Are you pregnant and worried about something happening to your baby? Or maybe you have already experienced one or more miscarriages? In this article you will learn about the possible causes of a pregnancy ending too early. We explain what a miscarriage is like, where you can find help, what your rights are, and how to say a loving goodbye to your starchild.
Risks and statistics – when to speak of a miscarriage?
Unfortunately, not every pregnancy takes a happy turn. A miscarriage (also called spontaneous abortion) is when the non-viable child weighs less than 500 grams or. before 24. Is born in the second trimester. 3 If the baby weighs more than 500 grams and is born dead, this is often referred to as a Silent birth referred to as. 4
It is estimated that about 11 to 15% of all proven pregnancies end in miscarriage. 5 In addition, there is a much larger number of miscarriages that happen so early that the woman doesn’t even notice them and they are considered a slightly heavier menstrual bleeding Are held. 6 If the child dies in the first twelve weeks of pregnancy, there is a Early miscarriage in front of. 7 Spontaneous abortions after 12. The term "stillbirth" is used for pregnancies in which the child weighs less than 500 grams Late abortion Designated. 8
There are different types of miscarriages. These include, in particular:
- Missed Abortion: A miscarriage is not always noticeable through bleeding or other signs. If the embryo or. fetus dies in the womb but is not rejected, this is called a missed abortion or restrained miscarriage. 9 In most cases, it is discovered by chance on ultrasound that the little heart is no longer beating and that the baby has not developed further. 10
- Abortive egg (wind egg): In this case, the fertilized egg develops into the amniotic sac and placental anlagen, but no embryo is formed. The fertilized egg will remain in the womb until the 8. Expelled during the first week. This is also referred to as an ovarian abortion. Causes of abortive egg include genetic sperm or egg defects, nidation weakness or mole formation, i.e. difficult implantation of the egg in the uterine lining or developmental abnormalities of the embryo, respectively. External effects can also lead to an abortive egg. This includes damage caused by, for example, X-rays, hypoxia or diaplacental viral infections. 11
- Bladder mole: The fertilized egg does not develop properly due to a chromosomal defect. Often no embryo develops at all. For this, there may be growths of connective tissue that need to be removed. 12
- Habitual abortions: If a woman has three or more miscarriages, they are called habitual abortions. 13 If you are affected by repeated miscarriages, contact your health care provider. Often a cause is found that can be treated well, so that nothing stands in the way of your baby’s happiness. 14
Possible causes and risk factors of miscarriage
What happened to the little life inside me? Losing the unborn child is a big shock. The question of "why" remains. A cause cannot always be found. 15
Common reasons for premature termination of pregnancy are:
- Genetic causes (chromosomal disorders of the embryo) 16
- Anatomical causes (z. B. fibroids or adhesions in the uterus or cervical weakness) 17
- Blood clotting disorder (z. B. Factor V Leiden mutation) 18
- Hormonal disorders (z. B. Corpus luteum insufficiency, also called luteal weakness) 19
- Infections (z. B. Measles, rubella, toxoplasmosis and bacterial infections of the vagina) 20
- Immunological disorders (z. B. Autoimmune diseases such as antiphospholipid syndrome (APS)) 21
- Pollutants and stimulants such as alcohol 22 , cigarettes 23 , and other drugs 24
In addition, certain factors increase the risk of having an abortion. These include obesity 25 and high blood pressure 26 . Metabolic disorders of the expectant mother, such as diabetes mellitus 27 , thyroid dysfunction 28 and PCO syndrome 29 also play a role. In addition, the risk of complications and abortions increases significantly in women over the age of 35. 30 If one or more of these risk factors apply to you and you wish to have a child or are perhaps already pregnant? Don’t worry, in most cases a pregnancy without complications is still possible. It is best to contact your gynecologist. This:r will advise and support you. Often the risk can be minimized by specific medical treatment. 31
What can be signs of miscarriage?
While a miscarriage goes quite unnoticed in a restrained abortion, in many cases there are clear signs that something is wrong. One of the first symptoms to appear is often a vaginal bleeding at. 32 If you experience bleeding – regardless of the trimester of your pregnancy – you should urgently contact your gynecologist. But try not to imagine the worst immediately. Light bleeding can occur from time to time, even in an intact pregnancy, and does not necessarily mean that you will lose your baby. 33
Other symptoms of an incipient or threatened miscarriage are cramping pain in the lower abdomen and preterm labor. In the case of a late miscarriage, the amniotic sac may also break and amniotic fluid may leak out. 34 Some women also notice the miscarriage through a decrease in the typical pregnancy symptoms or. in the advanced stage of pregnancy by a the absence of fetal movements. 35 Keep in mind, however, that towards the end of the third trimester it can be quite normal if you feel your baby a little less often. Finally, the space for gymnastic exercises in the abdomen becomes smaller and smaller. 36
What happens in case of a miscarriage?
The treatment of an abortion depends on the week of pregnancy in which it occurs and what the causes are. 37
Miscarriage in the first trimester
In an early miscarriage in the first weeks of pregnancy, two situations are particularly common: Either the pregnant woman notices signs such as bleeding, cramping, or severe abdominal pain, or a routine ultrasound exam reveals that the baby’s heart is no longer beating (Missed Abortion). In the first case, no medical intervention is often necessary, as the embryo, together with the placenta and amniotic sac, is expelled by bleeding on its own. Only if there are remains in the uterus (incomplete abortion), it is necessary to remove them during a curettage. This is a surgical procedure under anesthesia, usually performed on an outpatient basis. 38
If you have been diagnosed with a Missed Abortion (restrained miscarriage), you usually have three options: In most cases, a curettage is performed directly. Alternatively, the pregnant woman may be taking medications that cause the tissue remnants to be rejected from the uterus. However, there is usually no reason not to wait and see if the bleeding starts on its own. 39
Miscarriage in 2. or 3. Trimester: Late miscarriage
If you have already had a miscarriage in 2. or 3. If you are in the second trimester of your pregnancy and sadly learn that your baby has died, you may want to get out of this nightmare situation as quickly as possible and end the pregnancy immediately by cesarean section. This is understandable. It may be advisable to take some time to make this decision and to consult with your midwife and doctors. Even if it seems impossible at first, a natural birth can help you to keep up emotionally and to say goodbye to your child in peace. Often it is possible to wait for labor to begin on its own, but birth can also be induced. 40 This decision is a very personal one and is neither pleasant nor easy. Unfortunately, there is no one right way to deal with this blow of fate. Besides the medical factors, this is mainly an emotional decision. If you are faced with such a decision, trust your intuition and feel inside yourself how you can best deal with the loss. Talk to your partner. Together you will find the right way for you.
Saying goodbye and finding comfort
Nothing is the same as before. When the unborn child dies, the expectant fathers and mothers are devastated. It is not uncommon for grief to be accompanied by guilt. Did I do something wrong?? Why couldn’t my body carry the baby to term?? These thoughts are quite normal. In the vast majority of cases, there is a reason for the miscarriage that you cannot control. It’s not your fault.
Everyone deals with loss and grief differently. There is no one right way to deal with a spontaneous abortion. In any case, you should know that you are not alone.
In the case of a miscarriage after 13. During the first week of pregnancy you are entitled to up to ten home visits from a midwife. 41 There are also midwives who help women who have miscarriages in the first trimester. However, these costs must then be paid out of pocket. In addition, you are entitled to 14 weeks maternity leave, provided that the pregnancy has lasted at least 23 weeks. 42
If the pregnancy was already advanced, it is possible in most cases to hold the baby in your arms after the breastfeeding birth and to slowly say goodbye to him or her. Also, there are photographers who specialize in star babies and capture these very special moments for you. 43
Depending on the weight at which your child is born, a funeral is mandatory. In most states, the weight limit is 500 grams. At the request of the parents, a funeral is usually permitted even for a smaller fetus. 44 There are often special services for orphaned parents and also special areas in cemeteries where star children find their final resting place.
If you had an early abortion and a funeral is not possible, you can say goodbye to your little miracle through another personal ritual. Whether you fly balloons, light a candle every night, get a tattoo or plant a tree for your star child, you know what feels right for you. Such a farewell ritual can help you come to terms with the loss and regain your courage. Perhaps you will find comfort in the thought that although your child did not make it into life, he or she will have a place in your heart forever.
Here’s how you can support as a partner:in, family member or friend:in
A miscarriage is particularly stressful for the pregnant woman, because she is affected not only emotionally but also physically. But your partner has also lost a child and is grieving the loss. Try to be supportive of each other and not judge each other if you are dealing with grief differently. Talking about feelings is an important part of grieving and can bring you even closer together.
Outsiders often do not know how to deal with the orphaned parents. To withdraw completely for fear of saying the wrong thing is always the wrong way to go. It helps many of those affected to talk about what happened and they are grateful for a sympathetic ear. Take grief seriously and do not downplay the loss. Show your sympathy and offer your support without being intrusive.
Getting pregnant again after a miscarriage
While some women immediately long for another pregnancy after a spontaneous abortion, others need a bit longer to process what happened. As long as there is nothing medically wrong, you can get pregnant again as soon as you feel mentally and physically able to do so. 45
If a new pregnancy occurs, you will certainly ask yourself one question over and over again: "Will everything go well this time?? As soon as this second line appears on the pregnancy test, fears and worries join the blossoming feelings of happiness.
Whether the risk of another miscarriage is increased depends on the cause of the miscarriage. Fortunately, most women experience a normal pregnancy after a miscarriage. 46
In certain cases, for example, if there are underlying genetic diseases or malformations of the uterus, there is an increased risk of repeated miscarriages. At the latest, if you have had two or three miscarriages, you should contact your doctor. If a cause is found, in many cases there is a medical solution that will allow you to get pregnant without any problems and to hold a healthy baby in your arms in the end. 47 Just as a rainbow often appears on the horizon after a storm, healthy babies who follow a miscarriage are called rainbow babies. The expression rainbow baby should encourage parents not to lose hope in having a baby: After the storm comes the sun and even after the dreary time life can shine again in bright colors.
Here you can find help
Many women and couples are helped by the exchange with other affected people. You can find a lot of forums on the Internet, as well as self-help groups and psychological counseling centers.