- Women's Health
Trying to Understand Miscarriage
Miscarriage, or the loss of a baby during pregnancy is a hard thing for families to deal with. Often times there is no cause given leaving a mother confused as to why it was her baby and what she did wrong. Very few miscarriages are the result of a mother doing wrong and statistics show that miscarriages happen in about 15-20% of pregnancies and affect lots of families.
Causes of Miscarriage
Chromosomal Abnormalities. One of the most common (especially in the first trimester) reasons for a miscarriage is chromosomal abnormalities. Chromosomes are the messengers that tell our systems how to work, how to look, and how to develop. While a baby (often referred to as a fetus at this stage) is developing the chromosomes are replicating themselves over and over again to build new cells and to complete development. This gives lots of chances for mistakes to be made. Some Chromosomal abnormalities cause little damage, while others can cause a miscarriage.
Chances of chromosomal abnormalties increases with age making pregnancies over 35 higher risk for complications and miscarriages. This doesn't mean that you can't have a baby over 35, just that there is a higher risk of problems.
Collagen Vascular Diseases. Collagen vascular diseases are those that cause a person's immune system to attack its own tissues. The woman's immune system often makes antibodies to attack her own tissues including the baby. The most common are Lupus (systematic lupus erythematous) and APLS (Antiphospholipid Antibody Syndrome).
Hormonal Imbalances. There are several issues with hormonal imbalances that can lead to miscarriage. Hormones work in favor of the developing baby, but if they are off they can work against it. Cushing's Syndrome, thyroid disease, and Polycystic Ovarian Syndrome can all lead to miscarriages due to hormonal imbalances.
Illness. Many types of illnesses in the mother can cause miscarriages. Most commonly uncontrolled diabetes (either type 2 or gestational) can cause miscarriage. Sometimes the problem lies in not managing it well and other times it is not identified as a problem before the miscarriage.
Infections. A number of bacterial infections can cause miscarriages. Sometimes these merely infect the mother and increase her risk of miscarriage, and at other times they infect the baby or the placenta and cause a miscarriage. Common infections that can cause a miscarriage include (but aren't limited to) Listeria, rubella, and herpes simplex.
Problems with the Uterus and or Cervix. Abnormalities in the female anatomy can make it difficult to carry a baby. Most are problems that the woman is born with, some which can be corrected by surgery if identified and others which can not.
One such problem is a tissue wall that separates the uterus into cavities (known as septate uterus or uterus septum). This isn't present in most women, however if the fertilized egg implants into this wall it may not receive enough blood. Similarly fibroid tumors can cause implantation and blood supply problems as well.
Cervix issues. Some women have a "incompetent cervix" that isn't capable of holding the baby's weight as it grows. This causes the baby to be born way to early (often in the beginning of the second trimester). Once recognized it can be helped with bed rest and supporting stitches to help hold the baby and cervix in place.
Problems with the Sperm. Most problems that envolve the sperm are put under the chromosome issues. This is because genetically there can be something wrong with the baby because of the sperm just as easily as with the egg. However, it should be noted that these issues do happen because of the sperm.
Lifestyle Factors That Increase the Risk of Miscarriage
The following is a list of things that have been known to increase the risk of miscarriage. Miscarriages can't usually be pinpointed to any of these things and blaming yourself is a bad idea. While these things can increase your risk, it is likely that it isn't the only thing that is going on.
Smoking. Smoking can double the chances of a miscarriage as well as cause low birth weight and health issues in young babies. A mother should quit when she starts trying to get pregnant or she finds out she is pregnant. Additionally there is an increased risk of miscarriage if the partner or other household members smoke. This is due to the toxicity of second hand smoke and while it isn't as large of a risk it is still a good idea for all members of the household to quit.
Alcohol and Drug Consumption. Women are told to avoid alcohol and drugs during their pregnancies for a reason. The invasion of chemicals in the body can increase the risk for miscarriage. This doesn't mean that you should be overly concerned with what you did before you knew you were pregnant, but once you find out you should stop alcohol and drug consumption. With my first pregnancy I drank heavily one time about three weeks into my pregnancy (about two weeks before finding out we were pregnant). I had a healthy and full term pregnancy. A friend of mine did drugs for the first three weeks of her pregnancy before finding out she was pregnant. She also had a healthy and full term pregnancy.
Caffeine Consumption. There are mixed results about caffeine and pregnancy. Some doctors say to avoid it at all costs, while others think that caffeine in moderation is good for pregnancy. The studies that show it isn't are often for large doses of caffeine in the four cups of coffee (8 ounce), four bottles of soda (20 ounce), or twelve cups of green or black tea (8 ounce) every day. All in all, keep an eye on your caffeine consumption and know what you are drinking.
Medication. While talking to your doctor about what medicines is always important, it is also important to talk to your doctor about the over the counter medicines and supplements you use. One common type of medication that can cause an increased risk of miscarriage is many over the counter pain relievers including ibuprofen and aspirin (also found in many headache specific medications including Excedrin). Avoid over the counter medications unless you have talked to your doctor about what is safe and what isn't.
Stress. This is one of those, don't want to mention it because it can cause it types of response. However, some studies have shown that stress, or more specifically the hormones associated with stress can increase the risk of miscarriage. Doctors don't completely understand how it works and are continuing to do research, but so far it seems that regular every day stress doesn't affect the development of a baby or the placenta. Only extreme cases of stress and those with poor managing techniques seem to be affected by this. Take a hot bath, do some relaxation techniques, and avoid whatever situations you can that cause you stress.
With most of these, there is a link in the increased risk of a miscarriage. These don't usually cause miscarriages and for them to do so it usually takes a lot of them and not a few.
Rumored Miscarriage Causes
Because miscarriage is something that doesn't affect everyone and isn't something that most people know about, there are a lot of rumors out there. They often come in the form, "I heard that .... causes miscarriages" or "Did you do ....., because it can make you loose a baby." Most of these have no supporting evidence and some have even been proven to be false.
Diet and Vitamins. Everyone tells you that you have to eat right and remember your prenatal vitamin. This is true and helps the developing baby, but a poor diet or forgetting your vitamin isn't going to cause a miscarriage. Often times a woman's diet isn't the best in the first trimester due to morning sickness and there are times that remembering a vitamin, especially if you aren't used to taking one, can be hard. But this won't cause you to miscarry. Women around the world give birth, many in underprivalaged areas where food is scarce and malnutrition common.
Exercise and or sex. Neither exercise or sex will cause a miscarriage. Both of these are common place during pregnancy and as long as your doctor doesn't tell you otherwise are good for you and your well being during pregnancy. Exercise is also a way to make delivary easier and is usually encouraged during pregnancy.
Work or Heavy Lifting. Unfortunately many women have to work while pregnant. Our society is such that two incomes are often needed to survive in this world and that means working. While some will say that continuing to work while pregnant increases the chances of miscarriage this isn't true. Additionally lifting heavy objects and other children will not cause a miscarriage.
Accidents. Some believe that accidents such as getting hit in the stomach, falling, car accidents, and other sorts of accidents cause miscarriages. While these situations can indeed cause a miscarriage it is only when serious damage has been done to the mother. In most cases, the baby is well protected in layers of tissue and fluid. It doesn't get harmed during mild injury to the mother.
Unfortunately, most women don't receive a clear answer as to why their baby died. Most miscarriages aren't investigated until at least two sometimes three miscarriages have happened in a row. Many women struggle with the fact that they don't know and they feel guilty. This is normal. Remember you are not alone! For more information, help, and support check out Facts About Miscarriage.