Why miscarriages happen and how to avoid them

A miscarriage which is also known as ‘spontaneous abortion’, occurs when a baby (foetus) is lost spontaneously before the 24th week of pregnancy. After this time, the death of a baby is called a ‘stillbirth’. Many women feel well and will not notice anything before a scan confirms that the baby has stopped developing and […]

A miscarriage which is also known as ‘spontaneous abortion’, occurs when a baby (foetus) is lost spontaneously before the 24th week of pregnancy. After this time, the death of a baby is called a ‘stillbirth’.

Many women feel well and will not notice anything before a scan confirms that the baby has stopped developing and has died. In this situation, the miscarriage is called a ‘missed abortion’ because the baby has died, but has not been expelled from the womb. In some cases, a fertilized egg will not have developed, or developed poorly. On a scan, this would show as a pregnancy, but there would be no embryo because the foetus will have stopped growing earlier on. This is known as a ‘blighted ovum’. Unfortunately, you may not know anything is wrong until you have the first routine scan which is a great shock to an expectant mother.

Dr Nathaniel Adewole, Consultant Gynecologist and Obstetrician at the University of Abuja Teaching Hospital says, “the reason for miscarriage is varied and most often, the cause cannot be identified. During the first trimester, the most common cause of miscarriage is chromosomal abnormality – meaning that something is not correct with the baby’s chromosomes. Most chromosomal abnormalities are the cause of a faulty egg or sperm cell. Consequently, if the child is born, this could lead to Down Syndrome, or a child having speech defect in future. Hence, early miscarriages are nature’s way of averting what may turn out to be a bigger problem in feature.”  

Again, Adewole says “infection such as malaria and high fever could cause first trimester miscarriage. For instance, I have heard women say when the doctor gave me chloroquine and other quinine drugs that is when I had the miscarriage. Research has shown that it is not chlorquine that caused the miscarriages but the fever.   So women should not take malaria lightly as if not treated, it can lead to miscarriage,” Adewole advised.

Hormonal imbalance could lead to first trimester miscarriage. Usually, a pregnancy is sustained by the hormones. So, when there is no adequate hormone, the baby could be lost. But when we notice it at the early stage, we can give the woman a progetogene support to increase the chances of that baby surviving.

For women of childbearing years, the chances of having a miscarriage can range from 10-25% and in most healthy women, the average is about a 15-20% chance.

Health experts say an increase in maternal age affects the chances of miscarriage. Women under the age of 35 years have about a 15% chance of miscarriage

If you experience any or all of these symptoms, it is important to contact your doctor or a medical facility to evaluate if you could be having a miscarriage:

•    Mild to severe back pain (often worse than normal menstrual cramps)

•    Weight loss

•    White-pink mucus

•    True contractions (very painful happening every 5-20 minutes)

•    Brown or bright red bleeding with or without cramps (20-30% of all pregnancies can experience some bleeding in early pregnancy, with about 50% of those resulting in normal pregnancies)

•    Tissues with clot like material passing from the vagina

Treatment of miscarriage

If your miscarriage is complete (when the embryo or products of conception have emptied out of the uterus), you won’t usually need any further treatment. For an incomplete or missed miscarriage or when you have a lot of bleeding, you may need treatment with medicines or surgery to remove the remaining pregnancy tissue, although some women may prefer to let nature take its course (this is called expectant management).

Expectant management is linked with an increased risk of bleeding, whereas surgical treatment carries a slightly increased risk of infection.

On how a woman can cope with miscarriages, Dr Adewole explained that the loss of a pregnancy is a psychological burden on the woman. And this could lead to delay in further pregnancies. So the woman should realize that the loss of a pregnancy is not her fault.  So the husband and the society at large must give psychological support to her. Also, women who are overstretched should rest.

He advised that women should always seek to know the cause of their miscarriage, so that it does not occur again.   

However, there is no perfect amount of time to wait before trying to conceive again. Medically experts say it is safe to conceive after two or three normal menstrual periods if tests or treatments for the cause of the miscarriage are not being done. Some physicians routinely recommend that couples wait six months to a year before attempting another pregnancy in order to come to terms with their loss, whereas other physicians feel there is no compelling reason to wait so long.