Break the silence: What every woman needs to know about miscarriage

Woman lying on bed

Miscarriages are far more common than we think, and yet it often remains a silent trauma, something women deal with quietly and painfully. Here we look at some of the facts around miscarriage and how to find support when you need it.

Warning: this post deals with pregnancy loss and information that may disturb some readers.

The reality of miscarriage in Australia

In Australia, it’s believed that up to 1 in 4 pregnancies end in miscarriage before 20 weeks. And this doesn’t include the many other women who miscarry without realising they’re pregnant. 

Miscarriage is common. Devastatingly common, and it often occurs for reasons that are completely beyond our control, where nothing could have been done to prevent it. And yet, despite the staggering figures, many women still suffer in silence, often dealing with inexplicable feelings of guilt and shame. It’s a tough road back from this kind of trauma, but the good news is that most women who have had a miscarriage will still go on to have a healthy pregnancy in the future. 

What is miscarriage?

A miscarriage refers to the loss of a baby before 20 weeks of pregnancy. This is different from a stillbirth, which is when a baby dies prior to delivery at 20 weeks or more. There are a few types of miscarriage, each with their own unique causes and conditions: 

Ectopic pregnancy

This is when the embryo implants outside of the uterus, usually in one of the fallopian tubes. An embryo rarely survives an ectopic pregnancy, as it is unable to develop into a baby within the small fallopian tubes. In some cases, a pregnant woman may not even realise she has an ectopic pregnancy until a routine examination. However, most women will exhibit some kind of sign between 4 and 12 weeks of pregnancy – usually severe pain in the abdomen, vaginal bleeding, vomiting or shoulder-tip pain.

Molar pregnancy

A molar pregnancy is a type of pregnancy where the baby doesn’t develop from conception. There are no known causes for molar pregnancies, it’s simply that the cells that normally form a placenta fail to develop. Many women discover they have a molar pregnancy when they have their first scan. Others may find out when they miscarry. Unfortunately, molar pregnancies often need to be surgically removed, which can make the experience even more traumatic for the parents involved.

Blighted ovum

The last type of miscarriage is when a sac and placenta develops, but there’s no baby inside. This is also known as an ‘anembryonic pregnancy’. In most cases, a blighted ovum will end in a miscarriage around 7-12 weeks of pregnancy, when the body realises the pregnancy isn’t developing. Your doctor will discuss treatment options.

Common signs of miscarriage

Common signs include cramping stomach pain and vaginal bleeding. If you think you might be having a miscarriage, see you doctor immediately or go straight to your local emergency department. 

Why does it happen?

This is the most painful question for women who miscarry, and sadly, the answer is often unknown. While many women struggle with the possibility that it was their fault, the truth is that in most cases, a miscarriage is entirely unpreventable and has nothing to do with your actions. 

What we do know, is that miscarriages happen because the baby does not develop properly. It is simply the body’s way of dealing with a chromosomal abnormality – it’s a sporadic event, and is not something that is inherited or treatable.

There is, however, a small percentage of couples (approx. one per cent) who deal with recurrent miscarriages. This is defined as three or more consecutive losses, and in some cases these couples may have a unique, underlying cause. 

Occasionally, miscarriages may also be caused by hormonal abnormalities, medical conditions (thyroid problems or diabetes), major infections, or the shape of a woman’s uterus.

What next?

For some women, the miscarriage is swift. For other women, further medical attention may be required. Generally, there are three options for treating a miscarriage, all of which understandably take their own emotional toll:

Expectant management: when a woman miscarries naturally within 14 days of presenting symptoms. A re-scan is then performed two weeks later.   

Medical management: If a woman is clinically stable, she can be given medicine to speed up the miscarriage process and pass the pregnancy tissue naturally within a day or two.

Surgical management: In Australia, this usually involves a minor operation called a dilatation and curettage. It’s done under general anaesthetic and takes five to ten minutes in an operating theatre. 

Your doctor will talk to you about the safest treatment option for your condition.

Coping with feelings of grief and loss

Experiencing a miscarriage, or multiple miscarriages, can be a deeply traumatic experience. If you do find yourself struggling with the fallout of a miscarriage, it’s important that you find a way to express this loss with family, friends, or professionals – when the time is right for you. It can take a long time to talk openly about it, and that’s okay. What’s essential is that you know there are many support networks out there that can give you the information and understanding you might need. 

As for trying again – this is perhaps the most painful and scariest part for many women. Often the fear that a miscarriage will happen again can cloud a woman’s experience of falling pregnant. For most women, it’s safe to start trying again after their next period, but just be sure to talk to you doctor about the best timing for you.

If you’ve been affected by the loss of a baby, SANDS Australia offers support online or you can call their national, 24/7 phone line on 1300 072 637.

 

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