early-miscarriageAn estimated 15 to 20 percent of known pregnancies end in miscarriage, the loss of a pregnancy before the 20th week. The actual number is likely higher, because many miscarriages occur very early on, before a woman knows she is pregnant, and may simply seem to be a heavy period on or near schedule.

Most clinically recognized miscarriages occur between the seventh and 12th week after a woman’s last menstrual period. The chances of miscarriage decrease significantly once a heartbeat has been detected on ultrasound.

Bleeding
The first warning sign is usually bleeding. But not all bleeding means that you are going to miscarry, because it’s very common in the first trimester. In most cases, it’s simply a few spots of blood on your underwear. Miscarriage is more likely if the bleeding progresses from light spotting to something more like a normal period, if the colour is bright red rather than brownish, or if you are also feeling cramping.

What causes one?
Although it’s common for a woman to wonder if she has miscarried because of something she did or didn’t do, it’s important not to blame yourself. Miscarriage is not caused by moderate exercise, sex, or a small daily cup of coffee. The most common cause, according to American Pregnancy Association (APA), is a chance chromosomal or genetic abnormality in the embryo.

Other risk factors include:

– Drug use
– Smoking
– Excess drinking
– Listeria, a bacteria that may be present in undercooked meats, raw eggs, and unpasteurized dairy products
– Maternal trauma, such as a car accident
– Hormonal or structural abnormalities in the mother (such as low progesterone levels or uterine fibroids)
– Advanced maternal age (over 35)
– Infections such as Lyme disease or Fifth disease
– Chronic illnesses such as uncontrolled diabetes, lupus, or thyroid disease

What will happen after the miscarriage?
In most cases, a woman’s body will complete the miscarriage naturally. If this happens to you, you won’t usually need further treatment.

The bleeding is likely to tail off in a week to 10 days and will usually have stopped after two weeks or three weeks. You’ll be able to rest at home with painkillers and a hot water bottle, and, most important of all, someone to comfort and take care of you.

Your doctor may ask you to do a pregnancy test at home after your miscarriage, to confirm that the pregnancy has ended.

Can miscarriages be prevented?
In some cases, perhaps. A new Danish study published in 2011 followed over 100,000 women from the beginning of their pregnancies. The study identified a number of risk factors that may increase the risk of miscarrying, including binge drinking, drinking large amounts of coffee, smoking (but not nicotine replacement treatments—good news for those trying to quit!), being overweight or underweight before conception, and lower education. Some of the results were a bit surprising: Working night shifts and intense exercise were also risk factors, and so was the age of the baby’s father if he was 45 or older.