What is a miscarriage?

A miscarriage is the spontaneous pregnancy loss before 20 weeks of pregnancy. (After 20 weeks, the loss of a baby is referred to as a still-birth).

It is estimated that some 20% of unknown pregnancies end in miscarriage. Early pregnancy loss most commonly results from a problem in the developing pregnancy.

The loss of a baby, whether early or late in a pregnancy is usually a sudden and unexpected experience resulting in many different emotions.

Parents feel shocked, confused and distressed by the sense of having no real control over the pregnancy, particularly when they believe they were doing their best for the baby.

Common feelings include emptiness, anger, disappointment, sadness and a sense of isolation.

Attachment to an unborn baby is unavoidable so grief is inevitable when that baby dies.

There is no greater intimacy than that between a mother and her baby. This intimacy creates an indelible imprint in the mind of the mother. In her memory is stored the individual characteristics of the child.

Parents need to grieve the loss of one child and recover part of themselves that they invested in that baby before they can get to know a subsequent child.

There is still a great deal not known about the many possible reasons for miscarriage and it is usually difficult to identify a cause.

The main causes are thought to be:-

Genetic: About half of all early miscarriages occur because of chance chromosome abnormalities

Hormonal: Women with hormonal irregularities may find it harder to conceive and, when they do, are more likely to miscarriage

Infection: Minor infections like colds are not harmful, but a very high temperature and some specific illnesses or infections, such as German measles, may cause miscarriage.

Anatomical: If the cervix (neck of the womb) is weak, it may start to open as the uterus (womb) becomes heavier in later pregnancies and this may lead to miscarriage. An irregular-shaped uterus can mean that there is not enough room for the baby to grow. Large fibroids may cause miscarriage later in pregnancy.

Ectopic pregnancy: An ectopic pregnancy is a pregnancy which is growing outside the cavity of the uterus. About 1 in every 100 pregnancy is ectopic. Around 95% of ectopic pregnancies occur in one of the fallopian tubes. Most ectopic pregnancies can grow to around 8 weeks, but beyond this the tube is likely to burst.

Signs of a ectopic pregnancy may be acute pain, usually on one side of the abdomen, preceded by a dull ache. If an ectopic pregnancy is suspected, a scan will be done to see whether the pregnancy is in the normal space. It may be possible to save the Fallopian tube but not the pregnancy.