Miscarriage: Causes, Symptoms & Treatment Options 

Losing a pregnancy before the 20th to 23rd week of gestation, commonly known as miscarriage or spontaneous abortion, can be a difficult and emotional journey. It happens quite frequently, affecting around 10-20% of pregnancies.

To navigate through this experience and prepare for future pregnancies, it is important to comprehend the causes, symptoms, and available treatment options. Emotional healing is key during this time.

Understanding the Causes of Miscarriage

Miscarriage, a heartbreaking experience for many, can occur due to a variety of factors. Let’s explore some common causes:

• Chromosomal problems: The most prevalent cause of miscarriages, chromosomal abnormalities are responsible for about half of all cases.

• Maternal health conditions: Certain health conditions, such as uncontrolled diabetes, infections, hormonal imbalances, issues with the uterus or cervix, and thyroid disease, can increase the risk of miscarriage.

• Infections: Infections like rubella (German measles), cytomegalovirus (CMV), bacterial vaginosis, HIV, chlamydia, gonorrhea, syphilis, malaria, and food poisoning can heighten the risk of miscarriage.

• Long-term health conditions: Chronic health conditions like poorly controlled diabetes, severe high blood pressure, lupus, kidney disease, hyperthyroidism (overactive thyroid gland), hypothyroidism (underactive thyroid gland), and antiphospholipid syndrome (APS) can increase the likelihood of miscarriage.

• Uterine conditions: Abnormalities in the uterus, such as fibroid tumors, can lead to late miscarriages.

• Smoking, alcohol, caffeine, and illegal drugs: Individuals who smoke, consume excessive caffeine, or indulge in alcohol or illegal drugs like cocaine face a higher risk of miscarriage.

• Being underweight or overweight: Both being underweight and overweight can contribute to an increased risk of miscarriage.

• Genetic conditions: In some cases, genetic conditions can play a role in miscarriage.

Understanding these causes can help individuals take necessary precautions and seek appropriate medical guidance to minimize the risk of miscarriage. It’s important to emphasize that numerous miscarriages occur as a result of random chromosomal issues, and they are not influenced by any actions or choices made by the individual.

Symptoms of Miscarriage 

Experiencing a miscarriage can be a distressing event that occurs within the first 13 weeks of pregnancy. The most common indication of a miscarriage is vaginal bleeding, which can range from light spotting or brownish discharge to heavy bleeding with bright-red blood.

Additionally, you may also experience pelvic or lower back pain, passing of fluid or tissue from the vagina, fever, chills, pain in the lower stomach area, foul-smelling discharge, or a rapid heartbeat.

If you notice any of these symptoms, it is crucial to reach out to your healthcare provider or visit the emergency department immediately. Seeking medical evaluation is essential to determine whether you are experiencing a miscarriage or if there is another underlying medical condition that requires treatment.

Types of Miscarriage 

Miscarriages can occur at various stages of pregnancy, and there are several different types. These types of miscarriages encompass a range of possibilities.

• Threatened Miscarriage: When a pregnant woman experiences vaginal bleeding within the first 20 weeks, it can be a cause for concern. However, it’s important to note that this doesn’t necessarily mean the pregnancy will end in a miscarriage. Along with bleeding, symptoms such as lower back pain and abdominal cramps may also be present. The likelihood of a miscarriage increases if the cervix has opened.

• Inevitable Miscarriage: If a woman experiences unexplained vaginal bleeding and abdominal pain, and her cervix opens, it is classified as an inevitable miscarriage. In this case, the bleeding is heavier and the stomach cramps are more intense compared to a threatened miscarriage.

• Complete Miscarriage: When all the pregnancy tissue is expelled from the uterus, it is known as a complete miscarriage. This type is characterized by heavy vaginal bleeding, severe abdominal pain, and the passage of pregnancy tissue. However, the bleeding and pain should subside relatively quickly.

• Incomplete Miscarriage: An incomplete miscarriage occurs when a miscarriage begins, but not all of the pregnancy tissue is expelled. This may result in symptoms such as discharge and cramps.

• Missed Miscarriage: Sometimes, a miscarriage can occur without any noticeable symptoms. This is known as a missed miscarriage or silent miscarriage. It may only be discovered during a routine ultrasound.

• Ectopic Pregnancy: In an ectopic pregnancy, the baby develops outside the uterus, typically in one of the fallopian tubes. This type of pregnancy is not viable and requires immediate medical attention.

• Other Pregnancy Losses: Apart from miscarriage, there are other types of pregnancy loss. Stillbirth refers to the loss of a pregnancy after 24 weeks, while late miscarriage occurs between 12 and 24 weeks of pregnancy. These are heartbreaking experiences that require support and medical care.

It’s crucial to understand that every miscarriage is unique, and the signs and treatments can differ based on the type of miscarriage. If you suspect a miscarriage, it’s vital to seek medical assistance for a thorough evaluation and appropriate care.

Diagnosis 

When it comes to diagnosing a miscarriage, healthcare providers have a range of tests and procedures at their disposal. Firstly, a pelvic exam may be conducted to determine if the cervix, the lower end of the uterus, has started to open, indicating a higher likelihood of miscarriage.

Additionally, an ultrasound can be performed to check for a fetal heartbeat and assess the viability of the pregnancy. In cases where the ultrasound results are inconclusive, a follow-up ultrasound may be scheduled for about a week later.

Tissue tests are another option, where any pregnancy-like tissue that is passed can be sent to a lab for confirmation of a miscarriage and to rule out other potential causes. For couples who have experienced two or more previous miscarriages, blood tests may be recommended to check for chromosomal abnormalities in both partners.

Furthermore, blood tests can also be conducted to measure the level of the pregnancy hormone hCG, which can provide further confirmation of a miscarriage. Lastly, after a third miscarriage, it is advisable to perform karyotyping, a test that examines the fetus for chromosomal abnormalities.

Treatment Options 

Different treatment options are available for miscarriage, depending on the type of miscarriage and the individual’s circumstances. There are three main approaches to addressing early pregnancy loss: expectant management, medication, and a surgical procedure.

• Expectant management involves allowing the tissue to pass naturally, without the need for medication or surgery. In most cases, women pass the tissue within two weeks of being diagnosed with a miscarriage, although it can sometimes take longer.

• Medication can be prescribed to expedite the miscarriage process. Pills like misoprostol, also known as Cytotec, may be used to help facilitate the miscarriage.

• A surgical procedure called suction dilation and curettage (D&C) can be performed by a healthcare provider. This minor procedure involves removing the pregnancy tissue using a simple office procedure.

After experiencing a miscarriage, it is crucial to rest and avoid activities that could potentially lead to infection, such as using tampons or engaging in sexual intercourse while still bleeding. Additionally, if you are Rh-negative, you may receive a shot of a medicine called Rh immunoglobulin to prevent any potential complications.

Emotional and Psychological Impact 

• Grief and emotional healing 

Dealing with the aftermath of a miscarriage can be a complex and lengthy emotional healing process. Women often find themselves grappling with a mix of emotions such as sadness, guilt, anger, and depression. It’s crucial to permit oneself to grieve the loss, as this can aid in accepting and moving forward with time.

Remember, there is no right or wrong way to experience grief after a miscarriage. It’s also important to note that partners may have their unique emotional responses. Seeking support from a healthcare provider or a support group can be incredibly helpful for both men and women.

Taking care of your physical and emotional well-being is paramount during this period, and allowing yourself to go through the grieving process is a vital part of the journey towards healing.

• Supporting a loved one through miscarriage 

Experiencing a miscarriage can be an incredibly challenging and emotional time for someone you care about. It’s crucial to approach the situation with empathy and understanding. Instead of offering solutions or passing judgment, simply listen attentively to their words.

By acknowledging their loss and expressing your condolences with a simple phrase like “I’m sorry,” you create a safe space for them to open up if they wish to share their feelings. Additionally, you can demonstrate ongoing support by providing practical help, such as delivering meals for the family, assisting with transportation for older siblings, or surprising them with a cup of coffee, a treat, or a heartfelt note.

Engaging in everyday activities together, just as you would have before the miscarriage, can also help alleviate their sense of isolation. Remember, it’s essential to respect their grieving process and not downplay their loss. You don’t need to have all the right words; sometimes, saying something is better than saying nothing at all.

If you sense that your loved one is struggling and may require additional support, consider assisting them in finding the resources they need, such as connecting them with others who have gone through a similar experience or suggesting professional help.

• Seeking professional counseling and support 

Dealing with the emotional aftermath of a miscarriage can be incredibly challenging, which is why seeking professional counseling and support is highly recommended. This approach is widely recognized as a helpful way to navigate the complex emotions that come with such a loss.

There are various avenues through which you can access professional counseling, including your general practitioner, hospitals, self-referral programs, charities, specialist counseling organizations, and private counselors. It’s important to remember that counseling and therapy should be tailored to your individual needs, as everyone’s experience of miscarriage is unique.

Psychologists often utilize cognitive-behavioral therapy (CBT) to assist patients in their healing journey after a pregnancy loss. Additionally, grief therapists are available to provide support and guidance throughout the grieving process.

Remember, it’s crucial to acknowledge that the miscarriage was not your fault, allow yourself to grieve, remain open to the support of others, and prioritize your physical and emotional well-being. If you find it difficult to cope with the emotional impact of a miscarriage, seeking professional counseling and support can be an invaluable step towards healing.