Experiencing the loss of a pregnancy can be devastating and you’ll probably have a lot of questions, including why did this happen? It’s not uncommon to start blaming yourself, but most miscarriages happen in the first trimester of pregnancy for reasons that are beyond your control. In the majority of cases, there’s no way to prevent a miscarriage and nothing you could or should have done differently. Below are three common miscarriage causes.
What Causes Miscarriage?
A miscarriage sometimes happens because there is a weakness of the cervix, called an incompetent cervix, which cannot hold the pregnancy. A miscarriage from an incompetent cervix usually occurs in the second trimester. There are usually few symptoms of a miscarriage caused by cervical insufficiency.
More than half of early miscarriages are due to a chromosomal abnormality when the sperm and egg come together but one of them has too many or too few chromosomes, those tiny structures in each cell that carries our genes. A chromosome abnormality, disorder, anomaly, aberration, or mutation is a missing, extra, or irregular portion of chromosomal DNA. It can be from a typical number of chromosomes or a structural abnormality in one or more chromosomes.
Chronic medical conditions such as blood clotting disorders, thyroid disease, and diabetes can increase your miscarriage risk. Certain autoimmune diseases, such as lupus, can also directly affect pregnancy. That doesn’t mean that if you have an autoimmune problem, you can’t deliver a healthy baby, but you do need to talk to your doctor about the risks of miscarriage and complications, and the best ways to plan for pregnancy.
A uterine malformation is a type of female genital malformation resulting from an abnormal development of the Müllerian duct(s) during embryogenesis. Symptoms range from amenorrhea, infertility, recurrent pregnancy loss, and pain, to normal functioning depending on the nature of the defect.
Missed miscarriage or miscarriage at 4 weeks
A missed miscarriage, also sometimes known as a silent miscarriage or missed abortion, can happen anytime prior to week 20 when an embryo or fetus dies but the body hasn’t recognized the loss or gotten rid of the pregnancy tissue. Since the placenta may still continue to release hormones, some women keep having pregnancy symptoms, but others may have a loss of pregnancy symptoms and a brownish discharge. A missed miscarriage is often diagnosed during a checkup when a doctor no longer finds a heartbeat.
A missed miscarriage, also known as a missed abortion or a silent miscarriage, occurs when a fetus dies, but the body does not recognize the pregnancy loss or expel the pregnancy tissue. As a result, the placenta may still continue to release hormones, so the woman may continue to experience signs of pregnancy. A threatened miscarriage is your body’s way of giving you a warning sign that miscarriage is a possibility during the first three months. You may experience symptoms of vaginal bleeding and abdominal pain, but the cervix remains closed and a heartbeat remains.
An incomplete miscarriage happens when your body only pushes out some of the pregnancy tissue. Symptoms include bleeding, cramping and a dilated cervix. A pregnancy test might still be positive but the fetus is no longer viable. Most of the time an incomplete miscarriage will become complete on its own, but you may need medical intervention to help remove the remaining tissue. An incomplete miscarriage often requires treatment. Medicine or a procedure call dilation and curettage (D&C) is used to clear the tissue from the uterus.
A blighted ovum occurs when a fertilized egg implants in the uterus but doesn’t develop into an embryo. It is also referred to as an anembryonic (no embryo) pregnancy and is a leading cause of early pregnancy failure or miscarriage. Often it occurs so early that you don’t even know you are pregnant. Your doctor may call this an “anembryonic pregnancy,” and it almost always happens in the first trimester. It means that the fertilized egg attached to the wall of your uterus, and while it may have begun to develop a placenta, it never developed into an embryo.
What Does Miscarriage Feel Like?
The amount of pain varies for everyone. Some women feel nothing and don’t even realize it’s happening; others feel a range of aching and cramping, from mild to strong, like a really bad period; and some women experience full-on, painful labor contractions that last for hours or even days.
If the pain is really intense, the bleeding is very heavy (you’re soaking a pad every hour) or the remains of the pregnancy don’t pass completely (an ultrasound will confirm this), your doctor may perform a D&C (dilation and curettage) or, if you’re beyond the 14-week mark, a D&E (dilation and evacuation). Brief surgical procedures will put an end to cramps and bleed and help prevent an infection, which may happen if any of that tissue remains behind in the uterus. Both procedures are typically done in a hospital or surgical center, and you’ll either get local or general anesthesia, so you shouldn’t feel anything. Unless there are complications (which are rare), you can usually go home the same day. Expect some strong cramping the first 24 hours after the procedure—that’s totally normal—and then mild cramping and light spotting for a few days up to two weeks. Taking Tylenol or Advil can help alleviate any post-procedure pain.
Can stress cause miscarriage?
There’s no evidence that stress directly affects miscarriage risk, but it may play a role. Research shows that a mother’s physical and emotional state—including her fitness level and quality of nutrition—can raise or lower her level of stress sensitivity, potentially influencing everything from fertility and conception to the quality of the placenta and the risk for premature labor. Focusing on nutrition, exercise (approved by your doctor) and mind-body relaxation, especially in the first and second trimesters of pregnancy are best options. But there’s no need to check yourself into a month-long spa retreat (well, unless you want to!). It could be as simple as taking an extra 15 minutes after lunch to listen to some relaxing music, decompress and let your body absorb the nutrients you’ve just eaten.
Healthy pregnancy after a miscarriage
How soon after a miscarriage can you try to get pregnant again?
It depends on physical and emotional factors. Every case is different, but unless you’ve had other physical complications from your miscarriage, you can usually start trying to conceive once your doctor has given you a green light. Usually can wait until your next normal cycle, anywhere from four to six week. If you want to wait longer that’s totally normal too—give your mind and body the time they need to heal, and you’ll know when you’re ready to try again.
Miscarriage is usually a one-time occurrence. Most women who miscarry go on to have healthy pregnancies after a miscarriage. A small number of women — 1 percent — will have two or more miscarriages. The predicted risk of miscarriage in a future pregnancy remains about 14 percent after one miscarriage.
If the cause of your miscarriages can’t be identified, don’t lose hope. Most women who experience repeated miscarriages are likely to eventually have healthy pregnancies.