Early Pregnancy Loss

Experiencing a miscarriage can be very difficult. As a health care professional, whenever I sit with a patient or a couple going through early pregnancy loss, I get a glimpse of the turmoil they experience as they process the medical information given to them about miscarriage.

It’s not unusual to get a sense of failure, particularly when the pregnancy was planned and quite wanted. Quite often the women experiencing miscarriage will feel helpless or angry with themselves for not being able to hold the pregnancy and sometimes there can even be frustration directed at medical profession for not being able to offer any help in avoiding this unfortunate incident.

But rarely do I hear a woman say that she has heard of this happening to someone she knows or any such recollection about hearing the experience touching the life of someone else in their social circle. This makes it even harder for people to process this sad event as they go through it. There’s a sentiment that other people try for pregnancy and seem to get pregnant so why couldn’t they do it too?

The reality in answering these questions is that early pregnancy miscarriage is quite common. As common as 1 in every 5 pregnancies.

So obviously if people aren’t hearing about it as much in their personal environment then its likely that people deal with their loss at personal level but they aren’t talking about it.

So when it does happen to someone they can feel quite isolated in their experience.

Some of us prefer to deal with our losses in private and that’s fine but the kind of silence I am talking about is when we do want to talk about or discuss our loss to make some sense of it but just don’t feel comfortable enough doing so as it hasn’t been brought up in a conversation sort of way.

Talking about lived experiences normalises things in a way which makes it easier for people when they are living through those experiences themselves or if they find themselves in a supportive role for someone else living through it.

The first question that comes to a woman’s or couple’s mind as they face early pregnancy loss is why? Why did it happen? And why did it happen to me?

So lets discuss the most common causes of miscarriage:

  1. Chromosomal abnormalitis : This is the most common cause – about 80% of all cases. Just as a house is made with bricks, our basic structural foundations come from chromosomes which hold our genetic make up together. To make a sturdy house, the bricks have to be good quality and laid in a perfect manner, without any gaps or slants. Otherwise the building is not strong and will get damaged quite quickly. Similarly, to make a perfect baby, the genetic material has to come from mother and father and has to meet together in a required manner to make a healthy baby. Nature tries it every time but things don’t quite work out perfectly each time. Our bodies are clever enough to recognise the mistake when its made and sets the wheels in motion for damage control by not letting this pregnancy grow any further as the imperfections in genetic sequencing mean that such pregnancy will give rise to baby with physical or mental disabilities. Nothing you have done or not done is responsible for this. It just happens by chance.
  2. Mother’s health and age : If mother has other health issues such as undiagnosed or poorly treated diabetes, high blood pressure, thyroid disease, anaemia etc then these can interfere with growth of a pregnancy in early as well as later stages. So it’s a good idea to attend for a pre pregnancy consultation with your health care provider when you’re thinking about having a baby. Advancing maternal age also plays a role in the rate of chromosomal anomalies and the related higher rate of miscarriages in early pregnancy.
  3. Smoking, alcohol, drug use: All these factors play a significant role in rates of early pregnancy loss. Abstinence is the best advice but even if you feel you can’t quit completely, it’s always worth discussing to see what steps you can take to minimise any harm.
  4. Previous history of miscarriages: If you’ve had three miscarriages, particularly with no normal pregnancies in between, then it’s quite suggestive of an underlying health issue which may be making it difficult for the pregnancy to grow and definitely warrants further investigations under specialist care for such possible causes.

So the take home message with miscarriages is that they are common – as common as 1 in 5. Don’t stress too much if you’ve had 1 or even 2 miscarriages as they are very likely related to a chance chromosomal problem and is not likely to happen again. It’s not your fault as foods you eat, usual chores or work you do, continuing gym exercises doesn’t cause miscarriage except in some rare circumstances. Don’t hesitate to talk about it if you feel it may help you feel better. Offer positive support to anyone you think might benefit from it to make the experience bit easier for them. If possible plan your pregnancy, seek advice from your health care professional before you start trying so that they can help you start the process in a healthy state. Keep positive. It’s good to know your facts and be aware that early pregnancy miscarriage rate is high but for each miscarriage there are four healthy pregnancies coming to a happier and far more desirable end:)

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