Miscarriage is hard. It's just very hard, no matter WHAT the circumstances! It's usually unexplainable, and the doctors don't seem to have anything comforting to say, because there really is no comfort in the loss of a baby.

Take the story of a relative of mine who miscarried 6 times in the first 5 years of her marriage. They thought they were never going to have children, and just as they were looking into adoption, she became pregnant with the first of their 5 healthy, beautiful children.

Then there are the people who miscarry often, and never even realize that they're pregnant, until after they lose the baby. That's the kind of shock that is an after effect, and STILL causes distress and mourning.

But what about those who get pregnant, FINALLY, after months and even years of infertility treatment, and lose their babies? The total cost of my miscarriage? $2500. And we'll have to do it all over again when we're emotionally not ready to try again.

So, how do we deal with this unexpected, traumatic, unexplainable loss? It's certainly not by paying the doctor off. It's by reaching out to others, who care about you. It just happens that you have several friends who have miscarried recently, and amazingly enough, they've lost their babies after years of infertility treatment! So, you never will feel alone!

Adoption's not out of the question, and it's not the end of the world to wait a few years to think about it.

Self-acceptance, and peace, come when we discover that it really isn't our fault. Yes, it will take time - some longer than others - but it WILL heal.


How to deal with Miscarriage after infertility treatment:

Spontaneous abortion (SAB) or miscarriage is the term used for a pregnancy that ends on it's own, within the first 20 weeks of gestation.

Spontaneous abortion (SAB) gives many women a negative feeling so lets say is Miscarriage. Miscarriage is the most common type of pregnancy loss. Studies reveal that anywhere from 10- 25% of all clinically recognized pregnancies will end in miscarriage.

Estimations of chemical pregnancies or unrecognized pregnancies that are lost can be as high as 50-75%, but many of these are unknown since they often happen before a woman has missed a period or is aware she is pregnant.

Most miscarriages occur during the first 13 weeks of pregnancy.
The reason for miscarriage is varied and most often, the cause can not be identified. During the first trimester, the most common cause of miscarriage is chromosomal abnormality-meaning that something is not correct with the baby's chromosomes.

Most chromosomal abnormalities are the cause of a faulty egg or sperm cell or due to a problem at the time that the zygote went through the division process. Other causes for miscarriage include (but are not limited to):

Hormonal problems, infections or health problems in the mother
Lifestyle (i.e. smoking, drug use, malnutrition, excessive caffeine and exposure to radiation or toxic substances)
Implantation of the egg into the uterine lining does not occur properly
Maternal Age
Maternal trauma
Factors that are not proven to cause miscarriage are sex, working outside the home (unless in a harmful environment) or moderate exercise.


What are the chances of having a Miscarriage?
For women in childbearing years, the chances of having miscarriage can range from 10-25%, and in most healthy women the average is about 15-20% chance.

- An increase in maternal age changes the chances of miscarriage
- Women under the age of 35 yrs old have about a 15% chance of miscarriage
- Women aged 35-45 yrs old have a 20-35% chance of miscarriage.
- Women over the age of 45yrs old can have up to a 50% chance of miscarriage.
- A woman who has had a previous miscarriage has a 25% chance of having another (only a slightly elevated risk than for someone who has not had a previous miscarriage)

What are the Warning signs of Miscarriage:
If you experience any or all of these symptoms, it is very important to contact your doctor or get to a medical facility as soon as possible:
- Mild to severe back pain (often worse than normal menstrual cramps)
- Weight loss
- White-pink mucus
- True contractions (very painful happening every 5-20 minutes)
- Frequent bowel movements
- Brown or bright red bleeding or spotting with or without cramps (20-40% of all pregnancies can experience some bleeding in early pregnancy, with about 50% of those resulting in normal pregnancies)
- Tissue with clot like material passing from the vagina
- Nausea
- Decrease in signs of pregnancy or loss of breast tenderness

The different types of Miscarriage:
Miscarriage is often a process and not a single event. There are many different stages or types of miscarriage. There is also a lot of information to learn about healthy fetal development so that you might get a better idea of what is going on with your pregnancy. Understanding early fetal development and first trimester development can aide you in knowing what things your health care provider is looking for when there is concern of a miscarriage occurring.

Most of the time all types of miscarriage are just called Miscarriage, but you may hear your health care provider refer to other terms or names of miscarriage such as:
 

Threatened Miscarriage: Some degree of early pregnancy uterine bleeding accompanied by cramping or lower backache. The cervix remains closed. This bleeding is often the result of implantation.

Inevitable or Incomplete Miscarriage: Abdominal or back pain accompanied by bleeding with an open cervix. Miscarriage is inevitable when there is a dilation or effacement of the cervix and/or there is rupture of the membranes. Bleeding and cramps may persist if the miscarriage is not complete.
 

Complete Miscarriage: A completed miscarriage is when the embryo or products of conception have emptied out of the uterus. Bleeding should subside quickly, as should any pain or cramping. A completed miscarriage can be confirmed by an ultrasound or by having a surgical curettage performed
 

Missed Miscarriage: Women can experience a miscarriage with out knowing it. A missed miscarriage is when embryonic death has occurred but there it not any expulsion of the uterus. It is not known why this occurs. Signs of this would be a loss of pregnancy symptoms and the absence of fetal heart tones found on an ultrasound.

Recurrent Miscarriage (RM): Defined as 3 or more consecutive first trimester miscarriages. This can affect 1% of couples trying to conceive.
 

Blighted Ovum: Also called an anembryonic pregnancy. A fertilized egg implants into the uterine wall, but fetal development never begins. Often there is a gestational sac with or without a yolk sac, but there is an absence of fetal growth.

Ectopic Pregnancy: A fertilized egg implants itself in places other than the uterus, most commonly the fallopian tube. Treatment is needed immediately to stop the development of the implanted egg. If not treated rapidly, this could end in serious maternal complications.
 

Molar Pregnancy: The result of a genetic error during the fertilization process that leads to growth of abnormal tissue within the uterus. Molar pregnancies rarely involve a developing embryo, but often entail the most common symptoms of pregnancy including a missed period, positive pregnancy test and severe nausea.
 

Treatment of Miscarriage:
The main goal of treatment during or after a miscarriage is to prevent hemorrhaging and/or infection. The earlier you are in the pregnancy, the more likely that your body will expel all the fetal tissue by itself, and will not require further medical procedures. If the body does not expel all the tissue, the most common procedure performed to stop bleeding and prevent infection is a dilation and curettage, known as a D&C. Drugs may be prescribed to help control bleeding after the D& C is performed. Bleeding should be monitored closely once you are at home and if you notice an increase in bleeding or the onset of chills or fever, it is best to call your physician immediately.
 

Prevention of Miscarriage:
Since the cause for most miscarriages is due to chromosomal abnormalities, there is not much that can be done to prevent them. One vital step is to get as healthy as you can before conceiving to provide a healthy atmosphere for conception to occur.
- Exercise regularly
- Eat healthy
- Manage stress
- Keep weight in healthy limits
- Take folic acid daily
- Do not smoke
 

Once you find out that you are pregnant, again the goal is to be as healthy as possible, to provide a healthful environment for your baby to grow in:
- Keep your abdomen safe
- Do not smoke or be around smoke
- Do not drink alcohol
- Check with your doctor before taking any over-the-counter medications
- Limit or eliminate caffeine
- Avoid environmental hazards such as radiation, infectious disease and x-rays
- Avoid contact sports or activities that have risk of injury

Emotional Treatment:
Unfortunately, miscarriage is not prejudice in whom it touches. It can affect any couple or family. Often women are left with unanswered questions regarding their physical recovery, their emotional recovery and trying to conceive again. It is very important that women try to keep the lines of communication open with family, friends and health care providers during this time.