While pregnancy is usually a joyous event, sometimes a devastating loss can occur. Miscarriage can happen all too often in about 20% of pregnancies. From the first moments of learning about your pregnancy, the excitement and joy and bonding begin with the baby. These wonderous thoughts are real and do not change in proportion to the size of the baby or length of time that you have been pregnant. Most pregnancy losses occur early in the first trimester. Well-meaning family and friends sometimes downplay the significance of an early loss in their attempts to console you, but the loss is as real and important in the early part of pregnancy as it is later. It is normal to be sad and grieve as with any other significant loss.
Early pregnancy losses are most frequently due to chromosomal mishaps and not due to some misbehavior on the part of the parents. While it is normal human nature to want to assign blame to yourself for the loss, please understand that is most situations it is out of your control. Usually, these chromosomal mishaps are random events and not the type which tend to recur. If you choose to attempt pregnancy again in the future, it is helpful to know that your chance for success is similar to most others of a similar age, even if you have experienced 1 or 2 pregnancy losses.
For those with recurrent pregnancy loss, which means 3 or more previous losses, an evaluation for possible causes is generally initiated. Some causes include obesity, advanced maternal age, smoking or drug use, autoimmune disorder, thyroid disease, hormonal abnormalities, and poorly controlled diabetes.
In 70% of cases, no abnormality is identified. The good news is that most of these situations continue to have a good chance of success with further attempts. If an abnormality is identified, then that issue can be managed to optimize the health of the woman which may, in turn, help to have a successful pregnancy.
Approximately 5% of pregnancy loss occurs after the first trimester. The etiology of these losses is different than those in the first trimester. Cervical or uterine abnormalities play an increasing role, as do fetal abnormalities, drug use and smoking, hyperemesis, preterm labor, infections, poorly controlled diabetes and hypertension, and autoimmune disorders. Many of these issues are modifiable or treatable.
Discuss your situation with Dr Richey and he will help to develop a plan to move forward.