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Actual Miscarriage
The loss of a growing baby, is a major traumatic event in any
woman's life, and the worst part of having a miscarriage may not be
the physical pain and helplessness, but the emotional aftermath.
Miscarriage occurs in 10 to 15 percent of all confirmed pregnancies,
and may even be as high as 30 percent, if we take into account that
many may have taken place very early in pregnancy, often before a
woman is even aware that she is expecting, where at this stage it
can resemble a period that is heavier and more painful than usual.
Most miscarriages normally occur in the first three months, due to
the foetus not developing normally, and therefore not being able to
survive.
Causes of a miscarriage can range from anything between uterine
abnormalities to psychological upheavals, and often during the
remorse stage the woman will find it difficult to obtain peace
within herself, often asking the questions "Why me?" and "Could I
have done something wrong?". It will take a long time to come to
terms with the loss of your baby and no-one should make you feel
that you are being over emotional. We will never know all the
reasons, but we can offer some guidance as to why so many
pregnancies may not follow through to due-date.
Recognising the signs of miscarriage:
- Heavy menstrual bleeding.
- Pain, usually in the lower back region, stomach and thighs.
- An uneasy feeling
Cervical and Uterine abnormalities
When a womb is abnormally shaped, it cannot accommodate the growing
baby and it is believed to cause a small percentage of miscarriages.
As the result of a D&C (dilation and curettage) the cervix may have
been over dilated, causing it to become weak, thus failing to
maintain the weight of the growing baby. This problem can be
corrected by having a stitch inserted around the cervix to prevent
it from opening and give added support.
Chromosomal abnormalities
Chromosomal abnormalities present in the fetus are probably the most
important cause of fetal loss in pregnant women. Little is known
regarding the cause of these abnormalities, that seem to be present
in about 1 in 20 confirmed pregnancies, but it is thought that the
women stands a greater chance if she is older. By the time the woman
reaches 38 years of age the incidence of chromosomal abnormalities
at 16 weeks is 0.8%, where at the age of 45, it increases to 5%.
Hormones
The hormone 'progesterone' plays an important role during pregnancy,
and it is vital that sufficient is produced. If a deficiency is
suspected, treatment with progesterone would be recommended.
German Measles
Contracting rubella early in pregnancy, is known to cause severe
abnormalities in the fetus and even fetal death. Considerable
success has been obtained in reducing the incidence of rubella in
pregnancy, by effective vaccination programmes, however it is still
vital to avoid contact with sufferers and if possible have your
immunity levels tested before conceiving.
Diseases
Diseases such as an underactive thyroid gland, high blood pressure,
diabetes and collagen disease present in the woman, will increase
her chances of a miscarriage. Syphilis is rare, but if the mother
happens to be a sufferer, it could have devastating effects on the
fetus, if treated early however, there is a chance that the fetus
can be effectively protected from it.
Alcohol and Smoking
Excessive drinking during pregnancy, increases the risk of fetal
abnormality and/or spontaneous miscarriage. Unfortunately it is not
yet clear, as to what a 'safe' amount is, so it is best to aid in
preventing these mishaps, by drinking no or very little alcohol
while pregnant.
Smoking during pregnancy is likely to result in an underweight baby,
whose growth was restricted whilst in the womb. Studies have proven
that there is an increase in miscarriages in those women who smoke
heavily, so it is therefore very sensible to quit the habit as soon
as your pregnancy is confirmed, or better still, before conceiving.
Immunological problems
It is thought that a woman who constantly miscarries may be
rejecting her baby, because she lacks the antibodies needed to
control the normal immune responses and maintain the pregnancy.
Psychological elements
Stress and anxiety play a major role in recurrent miscarriages and
psychological support for women and close monitoring is vital in
their pregnancies.
Care after a miscarriage
There are times, when a miscarriage is incomplete, and some of the
placenta or fetus is not fully expelled. If this is suspected then
you will probably have to undergo a D&C to remove the remaining
tissue, thus preventing further bleeding and/or infection.
Dilation And Curettage (D&C)
A D&C is a minor operation, where most of the lining of the uterus
is scraped away. This is usually performed when trying to diagnose
problems of the uterus such as, heavy menstrual bleeding, bleeding
between periods and bleeding after menopause. This procedure is also
normally carried out following a miscarriage, in which any remaining
tissue can be removed.
How is it performed?
The Dilation and Currettage is usually done under a general
anaesthetic, with the whole procedure lasting around 30 minutes. The
vagina and cervix are stretched open (dilated) so that the
'spoon-shaped' instrument (curette) can easily reach the uterus and
remove the necessary tissue, which can then be examined further.
Being a minor operation, the patient will normally be discharged on
the same day with few side effects. There may be slight period-like
cramping, but this soon passes.
Iron:
During a miscarriage,a substantial amount of blood is usually lost,
therefore it may be necessary for you to take iron supplements
either in the form of tablets or injections to restore your
haemoglobin levels.
Fatigue:
It is common to feel totally 'washed-out' following a miscarriage,
be this due to loss of blood or the intense emotional upheaval that
you have had to endure. Therefore it is important that you allow
yourself plenty of time to recover both emotionally and physically
before trying to resume your previous lifestyle.
Breast milk:
Depending on the time of miscarriage, it is possible for you to
develop milk in your breasts, and unfortunately this acts as a
painful reminder of what could have been. In this case it is better
not to try and express any milk as this will only increase the
production. Rather seek your doctor's advice on how to relieve and
suppress milk production or try some of the homeopathic remedies on
the market.
Emotional aftermath:
A miscarriage is a deeply distressing event for the woman, and those
closest to her, although only the woman will know the actual extent
of the loss - of something that was very real to her. The couple
will have celebrated their joy of becoming future parents and they
may even have chosen a suitable name, or bought baby paraphernalia,
so experiencing a miscarriage late in pregnancy is often worse,
although suffering the loss of an unborn baby cannot be compared
with time.
Feelings of anger, jealousy self-pity and inadequacy, may persist
for a long time, eventhough they may be hidden under a veil of
happiness, only to be reawakened through visual stimuli such as
coming into contact with pregnant women, passing baby clothing
stores, or even hearing the sounds of children's laughter. It is
therefore so important that you receive adequate support during this
stage, from women who have been in a similar position. Gaining the
compassion of others will help you through your grieving stage,
relieving you of any concerns and future fears.
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