Women need to give themselves time and space to grieve.
Gynaecologist Dr Suman Bijlani says there are several reasons for a miscarriage. “The commonest reason is nature’s selection. It is believed that 75% of pregnancies end in miscarriages. But most go unrecognised. They happen so early that it looks like normal menstruation, though slightly delayed. Only about 15 to 20% miscarriages are clinically recognised.” she says.
These account for about 50% of all clinically recognised early miscarriages. Here, the fetus is genetically or chromosomally defective. This occurs as a random event — a vast majority of women end up having a normal pregnancy the next time. Occasionally, one parent may carry structurally abnormal genetic material, which may result in an abnormal offspring. Couples who suffer repeated miscarriages can opt for genetic testing of the fetus.
Antibodies a threat
Some women have antibodies in their blood, which may attack their own cells. Some of these antibodies may attack the placenta or lead to formation of clots in the blood that is supplied to the foetus. This may cause slower fetal growth and eventual miscarriage. Au t o – a n t i – bodies usually cause fetal loss towards the third month of pregnancy or later.
Some women may have, from birth, a septum (wall) in the uterus. Some may have a ‘double’ or ‘half ’ uterine cavity. Miscarriage may result from that, though it is not necessary. Very large fibroids, especially those which encroach upon the uterine cavity, may also hamper a successful pregnancy outcome. Sometimes, the cervix (the mouth of the uterus) opens in the second trimester, causing miscarriage.
Beware of infections
Many bacteria, viruses and other parasites have been seen causing pregnancy loss.
Early pregnancy is an interplay of multiple hormones, which work in balance to provide an ideal environment for the developing embryo. Some women with menstrual disturbances and Polycystic Ovary Syndrome may have a higher risk of early pregnancy loss. Women with uncontrolled diabetes and thyroid disorders are also at a higher risk.
Environment plays a part
Women need to be careful during the first trimester, because what she consumes orally or through her lungs may reach her unborn baby who is at a crucial stage of growth. Certain drugs, alcohol, smoking, excessive caffeine intake and stress may harm the fetus. Pregnant women should not undergo X-ray or CT scan, unless recommended by the doctor.
“A miscarriage is relatively common and difficult to prevent. Though the risk is higher in women with a history of more than one miscarriage, they can still conceive. With proper prenatal care, avoiding risk factors — smoking and drinking alcohol — and understanding what causes a miscarriage, you can plan your pregnancy under a doctor’s supervision. Experts recommend waiting for at least one menstrual cycle — after a miscarriage — before trying to conceive. Make sure you and your partner are physically and emotionally fit before you plan a baby,” says health consultant Parul Sheth.
Every woman’s ability to cope with a stressful situation differs. “Women need to give themselves time and space to grieve. She may decide to take time off from work, involve herself in prayer or spiritual practices, revive an old hobby, or take up a new one. Her family needs to make her feel that they are with her. Most partners support each other and usually, a miscarriage brings them closer. But some women may perceive their husbands as ‘cold’. Sometimes, a man may also feel that his wife is taking too long to get over the grief. This may strain the relationship,” says Dr Bijlani.
“In most cases, physical recovery takes only a few hours to a couple of days. Emotional healing takes longer. Losing a baby can be heart-wrenching. You may feel angry, sad and depressed. Give yourself time to get over it,” says Sheth.
Uncontrolled diabetes, infections, hormonal imbalance and problems related to cervix or uterus can lead to miscarriage.
A woman who has suffered one miscarriage has a 15% chance of suffering another one. After two losses, the risk rises to 30 per cent. After three miscarriages, it may rise up to 45%. Healthcare professionals play an important role in the coping process. Doctors should answer couples’ queries sensitively and provide all relevant information.
A woman might experience fatigue, loss of interest in everything, body ache, lack of sleep or excess sleep, loss of appetite, mood swings and depression after miscarriage.
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