Experiencing the loss of a pregnancy can be heart-breaking, and it can often lead couples to wonder what happened. A natural miscarriage is defined as the early loss of a pregnancy without intention or medical intervention. It happens most often during the first trimester, which is before 14 weeks gestation, but also can occur up to the 20th week. However, a pregnancy loss can unfortunately occur throughout the entire pregnancy. According to both the American Pregnancy Association (APA) and the American College of Obstetricians and Gynecologists (ACOG), 10 to 25% of all clinically recognized pregnancies will result in a miscarriage. Therefore, it is more common than most realize, yet it can still feel isolating when it happens to you.
What Are the Signs of a Natural Miscarriage?
The signs and symptoms of a natural miscarriage may differ from woman to woman and can vary depending on how far along you are in your pregnancy. Here are some signs to look out for:
- Cramping or severe pain in the abdomen and/or back
- Vaginal bleeding, spotting, or passing of blood clots
- Other fluid passing from the vagina
In any of these cases, or if you’re simply not feeling right or you’re just concerned, you should feel comfortable calling your doctor and discussing any of these symptoms immediately. While it’s entirely possible to have any of the above and not be having a natural miscarriage, it’s better to alert your physician as to what you’re experiencing so that he or she can monitor you closely and hear your concerns.
It’s also important to note that in some cases, a natural miscarriage may take place so early and so quickly that it may happen even before you know you’re pregnant. In addition, there may also be no signs of a miscarriage until your next doctor’s appointment when an ultrasound may find there is no heartbeat.
What Causes a Natural Miscarriage?
There are many different causes of natural miscarriage, but sometimes we do not know exactly what caused the miscarriage. While many couples who have experienced a miscarriage may blame themselves, there actually are very few causes of miscarriage that are preventable. About half of all first trimester miscarriages are due to a chromosomal abnormality in the baby. While we know that the chance of having a pregnancy with a chromosomal abnormality increases with a woman’s age, we also know that they happen for women of all ages, and it´s difficult to prevent a spontaneous pregnancy from being affected with a chromosomal abnormality.
In addition, we also know that a woman’s health is important with regard to risk for miscarriage, as having certain untreated health conditions may increase your risk to have a miscarriage. Your embryo will be implanted, and it will grow in your uterus, so this place must be in the best conditions to allow and maintain the pregnancy, unhealthy endometrial microbiota (abnormal uterus bacteria flora) could be a cause for natural miscarriages. Also, it is important to know that chronic infections, especially those sexual and urogenital as Chronic Endometritis could promote spontaneous miscarriages. It is recommended to meet with a physician before you plan a pregnancy to optimize your own health and therefore attempt to reduce this risk.
If you experience a miscarriage, it is also recommended to speak with a physician regarding options for genetic testing on the products of conception (POC) or other tests that may be done to help provide you with more information about the cause of the miscarriage. Sometimes, however, we unfortunately do not know what causes a miscarriage.
Can You Prevent A Natural Miscarriage?
While natural miscarriages can never be entirely prevented, there are some steps that can be taken to reduce the possibility of miscarriage. Because about half of all first trimester miscarriages are due to chromosomal abnormalities, one way to reduce the risk of miscarriage would be to undergo In Vitro Fertilization (IVF) with Preimplantation Genetic Test for aneuploidy (PGT-A). PGT-A A is able to test for chromosomal abnormalities in embryos prior to implantation. PGT-A can improve the chance of a healthy pregnancy by selecting embryos that appear to be chromosomally normal to transfer into your uterus. This would significantly decrease the chance of miscarriage.
It is important to discard general or urogenital infections before getting pregnant, you can consult to your physician in order to run different blood, urine, vaginal and endometrial (internal uterine lining where the embryo has to implant) tests.
You can also speak with your doctor about any other risk reducing options available to you based on your own medical history. Another test you can ask your doctor about is called Products Of Conception (POC) testing. POC testing is done on tissue from the lost pregnancy and evaluates the chromosomes to help provide insight into what has caused the miscarriage. This can provide helpful information to couples regarding if there might be an increased risk for having another miscarriage in the future due to a chromosomal abnormality, and it can provide some closure for the couple if a cause for the miscarriage was identified.
Once you’ve gone through the emotional pain and physical experience of a natural miscarriage, it’s understandable to be anxious in a future pregnancy about symptoms that may arise. Sometimes it may help to share your feelings and experiences with others who have also experienced a pregnancy loss. You also can discuss these experiences with your doctor and other healthcare providers, who may be able to provide additional support. Know that you are not alone in this experience, and there is a team ready to support you as you continue to take steps toward building your family.