Multiple Miscarriages

A miscarriage is always devastating to parents who have been trying to conceive. While experiencing one miscarriage can be distressing, having to go through two or more can be overwhelmingly traumatic for a couple. Suffering multiple miscarriages is a good indication that you need to see a fertility specialist. Recurrent pregnancy loss is often a sign of an underlying fertility problem that requires treatment before a successful pregnancy can occur.

Miscarriage: The Facts
It is not unusual, nor necessarily worrisome from a medical point of view, for a woman to experience one miscarriage. It is thought that 15% to 20% of all pregnancies end in miscarriage. Of these, approximately 75% of the miscarriages will occur during the first 12 weeks of pregnancy. A woman’s risk of miscarriage decreases after the first miscarriage. However, after a second pregnancy loss, the risk of miscarriage rises and continues to rise with each subsequent miscarriage.

It is generally accepted that the main cause of miscarriage in the first trimester is due to a chromosomal abnormality, usually a one-off occurrence that will not affect future pregnancies. It has been estimated that as much as 50% to 60% of all miscarriages that happen in the first trimester are due to a chromosomal abnormality. However, chromosomal abnormalities are not the only explanation for a miscarriage. There are other factors that can contribute to pregnancy loss, many of which can cause multiple miscarriages if left untreated.

Hormone Levels
It is always necessary for hormone levels to be at normal amounts for a successful pregnancy to happen. When these levels go out of whack, the repercussions can prevent implantation from occurring or inhibit proper development of the endometrial lining, making it difficult for the uterus to sustain a pregnancy. Women with thyroid or adrenal gland problems as well as diabetic women have an increased risk of miscarriage because their hormonal levels can be out of synch, especially if the disorder is not properly managed.

Uterine Factors
A healthy uterus will always help ensure a successful pregnancy. However, women who have a misshapen uterus, a septum dividing their uterus or some other problem with their uterine size or shape are more likely to experience a miscarriage. Although uterine problems can make it especially difficult to sustain a pregnancy, it does not mean that it is impossible to have a healthy pregnancy.

Infections
Certain infections, like herpes, chlamydia and German measles (rubella), can cause problems with your reproductive abilities. If left untreated, these infections can interfere with fetal development, thereby resulting in miscarriage.

Environmental Toxins
Regular exposure to harsh chemicals, including arsenic, benzene, ethylene, oxide, lead and formaldehyde has been shown to induce miscarriage in pregnant women. Minimizing your exposure to chemical toxins can help lower your chances of experiencing pregnancy loss.

Alcohol, tobacco, caffeine and marijuana are also considered to be environmental toxins and have been proven to affect fetal development. All have also been associated with an increased risk of miscarriage. However, you have control over these toxins and can limit the use of them or avoid them altogether.

Immunologic Problems
Although it is not fully understood, abnormal functioning of the immune system has been found to cause a small number of miscarriages. The most common immunological problem associated with miscarriage is antiphospholipid syndrome (APS). With APS, blood clots form and inhibit proper fetal development. In other instances, it is thought that the immune system views the developing fetus as a foreign invader. Rather than protecting the baby, it attacks the tissue in an effort to make the woman’s body "healthy."

Other Factors
There are a number of other factors that can contribute significantly to the increased likelihood of recurrent pregnancy loss. Age is an important factor when establishing a woman’s risk of miscarriage. After age 35, there is more potential for genetic problems to occur as well as an increased chance of miscarrying.

Exposure to DES (diethylstilbestrol) in the womb has also been found to increase a woman’s risk of suffering recurrent pregnancy loss. Additionally, fetal exposure to DES has also been associated with a weak cervix.

A weak cervix can make it difficult to almost impossible for a woman to have a successful pregnancy. As the fetus grows and becomes heavier, it puts more weight on the cervical opening. For most women, this is not a problem. But for the woman with a weak cervix, it is difficult for the cervix opening to stay closed. Pregnancy loss associated with a weak cervix will usually occur later in pregnancy, in the second trimester, or cause a woman to go into preterm labor.

If You Have A Miscarriage
Signs of an impending pregnancy loss include vaginal bleeding, often going from a dark brown to a more pink or red color; a decrease in breast size or sensitivity; and a lack of fetal movement or heartbeat. If you are actually experiencing a miscarriage, you will likely have cramps that grow increasingly worse along with heavy vaginal bleeding. You should call your health care provider immediately if you suspect you are having a miscarriage.

If it is possible, you should save any tissue that you pass when you miscarry. This tissue can then be analyzed in a laboratory to determine the reason for the miscarriage. This information can help you learn what, if anything, you can do to in order to have a successful pregnancy.

Pregnancy After A Miscarriage
Many women have had no problems having children after a miscarriage. Even women who have suffered recurrent pregnancy losses have been able to conceive and carry a healthy child to term. However, if you have had two or more miscarriages, it is important to see a fertility specialist. Through testing, the specialist can determine what, if any, underlying factors are contributing to your losses. For all the problems that play a part in causing pregnancy loss, there are many solutions and treatments that can significantly improve your chances of having a child.

However, experiencing multiple miscarriages can be very taxing to a couple emotionally as well as physically. Even though it may only take as little as month before your body is ready to have a child, it doesn’t necessarily mean that you are mentally ready for another pregnancy. It is important to take the time to grieve as you would with any other loss. Consider joining a support group where you can talk with other women and couples who have also experienced multiple miscarriages. If you feel it is necessary, then seek out a therapist for yourself or for you and your partner to talk with.

When you feel you are emotionally and physically ready to try for another child, then make an appointment with a fertility specialist who can help you overcome any fertility problems you may be experiencing.

Recommended Resources:
Pregnancy After Miscarriage (PAM) features resources and practical tools to help you cope emotionally during a subsequent pregnancy.
Pregnancy After Miscarriage (PAM) also features a listserv for couples who are trying or who are pregnant after experiencing a miscarriage.
Just send your e-mail to pam-requestion@fensende.com. Write "subscribe" in the body of your message (make sure not to include the quotes).

There is also a helpful e-book on this topic along with a list of other online support resources. Find out more out I Never Held You by Ellen DuBois

SPALS (Subsequent Pregnancy after Loss Support) is a very supportive environment where you can learn more and talk to other women who have experienced a pregnancy loss.

 

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