Worldwide, 23 million miscarriages are reported each year. This means that officially every 44 minutes a woman loses her child in this way. Expert estimates even assume that unofficially there are significantly more. The reasons: Numerous women do not talk about it or do not notice it.
Every tenth woman experiences a miscarriage once in her life. Almost 2 percent even more often. This was found by scientists in a study led by Professor Siobhan Quenby at Tommy’s National Centre for Miscarriage Research at Coventry and Warwickshire University Hospital in the UK. are convinced that the phenomenon has been downplayed and not taken seriously for far too long. In 2016, 2017, 2018, and 2019, an average of about 2 died of respiratory distress syndrome.700 babies and fetuses by a miscarriage in Germany. This means that, officially, slightly more than seven women suffer the trauma of a miscarriage every day in the Federal Republic of Germany.
- What is a miscarriage?
- Signs of miscarriage
- Causes of miscarriage
- Risk factors for miscarriage
- How to cope with a miscarriage?
- Deliberate induction of miscarriage – advantages and disadvantages
- How long should I wait before trying to get pregnant again??
What is a miscarriage?
Pregnancies and the birth of a child are usually joyful events – but unfortunately not always. Sometimes a pregnancy comes to an unexpected, emotionally painful end.
From the medical point of view, a miscarriage is defined, among others, as follows:
Abortion/miscarriage: complete or partial loss of pregnancy material with dead fetus. Early miscarriage is referred to as early abortion until the end of the 12th week of pregnancy. If you have a late abortion between the 12th week of pregnancy and the 12th week of pregnancy, you may have a miscarriage. and 24. SSW.
An abortion can be divided into different phases:
- Threat of abortion
- Beginning abortion
- Incomplete abortion
- Complete abortion
An impending miscarriage is usually accompanied by light bleeding. There is often a pulling pain. The cervix remains closed and there is no tissue loss.
When a miscarriage begins, it is also called an irreversibly disturbed pregnancy. The cervix is partially open. There is cramping lower abdominal pain as well as heavy bleeding.
If an incomplete miscarriage occurs, only part of the uterine contents are expelled and parts of the placenta, for example, may be left behind. In the case of a complete miscarriage, the fetus, the membranes and the placenta are expelled in their entirety.
Are there different miscarriages?
Even though the sad consequence is the same, a distinction is made between a miscarriage and a stillbirth based on the timing and the weight of the child, as stated above.
- Miscarriage: weight of the child below 500 grams
- Stillbirth: weight of the child over 500 grams
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Signs of miscarriage
There are different symptoms that can announce a miscarriage. The most common include cramping lower abdominal pain, vaginal bleeding, and the onset of early labor. If you have one or more of these symptoms, we advise you to seek medical help immediately.
According to a publication of the Austrian Ministry of Health, the majority of miscarriages occur completely unnoticed directly after fertilization. This happens when the fertilized egg does not implant correctly and does not develop as expected. In this case the fertilized egg is expelled with bleeding. This process acts like a normal menstrual period. If you get your period at an unusual time, a miscarriage may be the cause.
This also applies to the movements of your baby in the abdomen: in late miscarriages or stillbirths, the sudden absence of the baby’s movements can be a sign.
Unfortunately, there are also miscarriages or stillbirths in which there are no symptoms at all. These are usually detected during a regular pregnancy examination.
Causes of miscarriage
What are the causes of miscarriage? Dr. Thomas Philipp from the Donauspital SMZ-Ost of the city of Vienna works there in the obstetrics-gynecology department. He has studied the causes of miscarriages. Experts distinguish between causes in the child, in the mother and in the father.
Causes in the child:
- Malformations in embryonic development
- Genetic change in the fetus (deviation in the number and shape of chromosomes)
Causes in the mother:
Tumor in the uterus
The supply of the child can be disturbed by a uterine tumor. A tumor located there may also prevent implantation of a fertilized egg.
Pathogens can infect the lining of the uterus or even the cervix. The following inflammation can reach the placenta and the child.
It can happen that the cervix opens too early. This can lead to the child not being able to be held or germs getting into the womb.
The risk of miscarriage increases with age.
Numerous vaginal births can lead to cervical weakness.
Hormonal imbalances such as luteal insufficiency can be a cause of miscarriage. Diabetes is also a trigger.
Causes in the father:
The fact that the causes of miscarriage can lie with either parent was not known for a long time. For example, defective sperm can be a factor in increasing the risk of miscarriage. A spermiogram can provide information here. The results show the number, the appearance as well as the motility of the sperms.
Risk factors for miscarriage
External factors can also lead to a miscarriage. These include:
- Hard drugs
- Medical actions
Hard drugs, alcohol and nicotine
If an expectant mother takes drugs during pregnancy, it can dramatically increase the likelihood of miscarriage.
A study at Berlin’s Charite University Hospital investigated whether stress increases the risk of miscarriage. Stress causes imbalance in hormones and immune system during pregnancy, study finds. If the production of progesterone is disturbed, the body has difficulty maintaining a pregnancy. Immune cells disrupted by stress can also trigger an abortion. Fear also appears to have an impact on pregnancy, according to the study.
As soon as you know you are pregnant, talk openly about it at any doctor’s appointments.
The risk of miscarriage is also why many doctors advise against surgery during pregnancy. Anesthesia can also increase the risk of miscarriage.
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How to cope with a miscarriage?
"The loss of a child is the hardest thing for parents to imagine. The grief is usually overwhelming. Talk to trusted people. To be unhappy, even if it is the first impulse, is usually a psychologically unhealthy path," advises DAK psychologist Franziska Kath (photo).
Affected parents can find contact points in their vicinity at the following links:
" Another impulse is to look for someone or something to blame. However, no one is usually to blame for a miscarriage. This search burdens rather than helps. Instead of assigning blame, be aware that grieving after a miscarriage can last a long time. This is one of the most painful experiences you will ever have to deal with," says the DAK psychologist.
"Do not minimize the loss."
If you are looking for someone to talk to in the event of a miscarriage, you should choose someone who understands that the grieving period is not over after a few weeks. As soon as someone utters a sentence with this or similar wording, it is better to confide in another person: "That wasn’t a real pregnancy yet after all. Everything half as bad."
"Anyone who tries to talk down the loss has not understood the pain behind it," says Franziska Kath.
"Taking time to say goodbye"
Consciously saying goodbye is important for many parents to let go of their child. "My advice is to give yourself all the time you need to say goodbye," says Kath. Depending on the state, different options are provided by law for burying a child after a miscarriage.
"Men and women grieve in different ways," explains Dr. Kath. Women mostly want to talk, men often respond with activism. For example, you throw yourself into work. "This," says Franziska Kath, "is just as valid a mourning strategy as that of women. Both parents should know how the other is grieving. This is how you can support each other in this process."
Deliberate induction of miscarriage – advantages and disadvantages
It sounds like a horror scenario – and unfortunately for many parents it is. When doctors determine that the child is dead in the womb, it must be removed quickly. This is called a restrained abortion: the fetus dies completely unnoticed in this case.
If a restrained miscarriage occurs in the early stages of pregnancy, i.e. in the first trimester, medical personnel will perform a curettage. The baby is scraped out of the mother’s womb. More gentle is the so-called suction curettage. In this procedure, the contents of the uterus are suctioned out.
Curettage may also be necessary if a miscarriage leaves remnants of the fetus as well as the placenta in the uterus. They need to be removed to reduce the risk of infection.
When the baby is older and the mother is already in the late stages of pregnancy, doctors often decide to induce artificial labor. During induction there are several risks. There may be bleeding, infection, and pain. The more advanced the pregnancy, the more severe it can be. There are women who consciously choose a self-determined miscarriage without support. A team of doctors, physicians, psychologists and many other helpers support and ensure that nothing happens to the woman. It is important that affected women should seek detailed advice.
How long should I wait before trying to get pregnant again??
There is no clear answer to this question. The WHO recommends waiting six months after a miscarriage including curettage before trying to get pregnant again. This recommendation is contradicted by the results of a study at the University of Aberdeen.
This studied whether pregnancy within less than six months after a miscarriage leads to an increased risk of recurrent miscarriage. Nearly one million pregnancies were evaluated for the results. The result not only contradicts the six-month waiting period according to the WHO recommendation – it says the exact opposite. Repeat miscarriages actually occurred less often in women who became pregnant again within less than six months.
In any case, you should talk to your gynecologist, as there may have been risk factors that led to the miscarriage, which should be corrected before a new pregnancy. Medical reasons may also have led to the miscarriage, which should be treated before getting pregnant again.
Parting can also mean a new beginning
When we lose a child, we are overwhelmed by grief and cannot imagine ever being happy again. This grief is important. It helps us to say goodbye – to our lost child. But at the end of the mourning there can be a new beginning. Many couples even come out of it stronger. A miscarriage does not have to shake the desire to show a child the world, to teach it everything you have learned yourself. But even if this is the case and you decide never to try again, it is OK.