Already I had a Miscarriage. Will I have one again?

You are not more likely to have a miscarriage if you have had one in the past. In fact, your risk of miscarriage is exactly the same as if you had never had a miscarriage.

Miscarriages are extremely common, occuring in approximately 1 in every 5 pregnancies. That means that most women will have at least one miscarriage in their reproductive lives. The miscarriages are caused by one time, non-repeating genetic problems. These genetic problems are not inherited; they are caused by genetic defects that happened during the creation of the egg or the sperm, or a genetic problem that occurred at the time of fertilization. Therefore, they are restricted only to that pregnancy and have no impact on future pregnancies.

Of course, since the normal miscarriage rate is so high, some women will have two miscarriage, but the odds are small, approximately 1 in 25 or 4%.

back to Miscarriage FAQs

Types of Miscarriage

Missed miscarriage

Missed miscarriage (also called 'missed abortion') is usually early in the pregnancy and you may have no warning symptoms and discover through a routine scan that your baby has no heartbeat, the result of a non-viable foetus. If there is an empty foetal sac (called a 'blighted ovum') the egg was fertilized and attached itself to the uterine wall but unfortunately, even though it might have kept growing for a few weeks, no embryo ever developed.

Threatening miscarriage

Threatening miscarriage may be experienced for days or even weeks before you lose the baby. At this stage you could experience any of the following:

Light bleeding. Pain similar to period pain. Cramps The nausea and tender breasts associated with pregnancy may disappear. A sense of no longer 'feeling' pregnant. About 40% of bleeding episodes occur during early pregnancy, usually at 5 to 7 weeks, and is spotting (normally dark blood) at about the time your period would have been due. Sometimes a small amount of blood is lost when the placenta matures at about 7 weeks and takes over the progesterone production. This can be frightening but is quite common and in most cases your pregnancy will continue as normal without harming the baby at all. These situations only lead to a miscarriage in 20% of cases. Sometimes, if the corpus luteum is not functioning properly and is therefore not making adequate amounts of progesterone, you will miscarry.

Inevitable miscarriage

This is when the cervix opens and the placenta breaks free from the uterine wall. The most common signs are:

Pain is like bad period pain or birth contractions. Bleeding is heavy. Faintness and nausea. Passing pieces of placenta which look like blood clots or liver. You may see the foetus. If your miscarriage is due to an incompetent cervix, (from 16 weeks on) everything will happen very quickly and your baby may be born alive.

Incomplete miscarriage When some placenta remains inside the uterus you will need to be hospitalised for a few hours or overnight to have a dilation and curettage (D&C) operation. For this you will be given a general anaesthetic, your cervix opened and uterus emptied. Incomplete miscarriage occurs most commonly between 6 and 12 weeks of pregnancy.

Complete miscarriage Once the uterus is empty the cervix closes, the pain stops and the bleeding slows down and should stop by seven days. If you continue to bleed after that time, have a temperature, pain or there is an odour, check with your medical professional. You may have an infection and if not treated it can have an effect on future pregnancies. back to Miscarriage FAQs

Causes and Noncauses of Miscarriages

Miscarriage can be caused by one or more of the following reasons:

• Many miscarriages are due to chromosomal problems or genetic abnormalities (50%)and are by chance. Something goes wrong during or soon after conception and the part of the pregnancy that grows into the baby fails to develop. This is known as 'afoetal pregnancy' or 'blighted ovum'.
• Something may be wrong with the placenta.
• The fertilised egg may implant in the wrong place.
• Endometriosis, this can double the chances of miscarriage.
• Hypothyroidism, this has now been connected to late miscarriage but if known about or tested for it can be dealt with.
• Diabetes. The anti-diabetes drug 'Metformin' appears to reduce the likelihood of early miscarriage.
• 'Anti phospholipid syndrome' is an antibody that causes blood clots to form in the placenta, which causes repeat miscarriages. Treatment with Aspirin, Clexane or Heparin works in many cases. Subsequent pregnancies also require treatment.
  See http://www.abc.net.au/rn/talks/8.30/helthrpt/stories/s2035.htm
• 'NK' Cells. These are responsible for protecting us from invasion by bacteria, viruses and foreign bodies, and rejecting organ transplants. The foetus contains foreign genetic material coming from the father, but in normal circumstances it does not get rejected. However, in some women these NK cells may reject the foetus and cause a miscarriage either by being high in numbers or by abnormal hostile activity. This problem, as most autoimmune disorders, can switch on and off, therefore some of the women may have one or more normal pregnancy outcomes as well as recurrent miscarriages. Women with CD16/56 NK cells in excess of 12% or 0.2 absolute number are at risk of miscarrying. Seehttp://www.miscarriageclinic.co.uk/causes2.html
• The mother's immune system or hormone levels may effect the pregnancy. She may be sick, badly injured, under too much stress, have a deformed uterus, a weak cervix or still have an intrauterine contraceptive device (IUCD) inside the uterus, or an infection.
• Environmental pollution may be a cause.
• The consumption of alcohol, cigarettes and recreational drugs is linked to higher rates of miscarriage.
• A hard blow to the stomach.
• Given that women are born with their life supply of eggs, maturing at puberty, by 35 these eggs have become older and less viable.
• Under-nourishment at conception.
• Caffeine; The British Medical Journal linked caffeine to an increase of restricted foetal growth and the British Food Standards Agency added the risk of miscarriage.
  They rank caffeine with alcohol in its potential to harm unborn children. Pregnant women are being advised to cut their coffee intake to 2 mugs per day and are warned against ‘energy’ and ‘smart drinks’ (including soft drinks - American FDA) saying that these contained other ingredients beside caffeine which are not recommended for pregnant women. It also warns to be ‘cautious’ about herbal teas.
• Small fibroids may increase miscarriage risk;
  According to early findings from a pilot study done by researchers at the University of North Carolina at Chapel Hill, America, it appears the presence of fibroids is uniformly associated with and may increase miscarriage. (Fibroids are benign muscle tumours of the uterus.) It's estimated they affect more than one in five women of reproductive age, and early results indicate that women with small fibroids (more so than larger sfibroids) have a 55% increased risk of pregnancy loss.
• 'Slapped Cheek Disease' - parvovirus B19 infection (also known as Fifth Disease). This infection, though normally mild and self limiting amongst children, can cause a more serious illness among non-immune adults and may lead to miscarriage.

You can be certain your miscarriage was NOT caused by bending, stretching, carrying heavy weights, digging the garden, exercising or having sex, otherwise there would be many more.

Unfortunately most women never find out the cause of their miscarriage. There is nothing that can be done to save a non-viable pregnancy.

back to Miscarriage FAQs

What is Miscarriage?

Miscarriages are extremely common. Approximately 1 in 5 pregnancies will end in miscarriage. Many women wonder if there is anything they can do to prevent a miscarriage. For the vast majority of miscarriages, there is nothing you can do to prevent it from happening.

Most miscarriages are caused by one time, non-repeating genetic defects in the embryo. The egg might be abnormal, the sperm might be abnormal or the combination might be abnormal. This does not mean that either you or your partner has a genetic defect. Every woman has some abnormal eggs and every man produces some abnormal sperm.

An embryo that has one of these one time, non-repeating genetic defects is destined to miscarry from the moment of conception. That’s why there is nothing that you can do to prevent the miscarriage. At some point, the embryo will stop growing and developing and be expelled by your body.

If you’ve had a miscarriage, you don’t have to wonder if you did anything to cause it. Nothing you can do can cause a miscarriage. It is true that doctors sometimes recommend bed rest for women who have bleeding in early pregnancy. However, all medical studies show that bed test cannot prevent a miscarriage.

There is a small group of miscarriages that can be prevented. These miscarriages are causes by a progesterone deficiency (luteal phase defect). Progesterone is needed to support the growth of a pregnancy. In the early weeks of pregnancy, the mother’s body produces the progesterone. By about 8-9 weeks of pregnancy, the placenta usually takes over the production of progesterone. Women who don’t produce enough progesterone in the early weeks of pregnancy may have repeated miscarriages. These miscarriages can be prevented by progesterone supplements.

Only a small percentage of women have a progesterone deficiency. The most common symptom of progesterone deficiency is a menstrual cycle that is less than 26-27 days long. A progesterone deficiency can be diagnosed by tests done before you get pregnant. Women who do not have a progesterone deficiency will not benefit from progesterone supplements.

Measuring progesterone levels at the beginning of pregnancy may show dropping levels of progesterone before a miscarriage. However, it seems more likely that levels drop because the pregnancy is no longer growing, not because the dropping levels cause the miscarriage. Therefore, taking progesterone supplements will not prevent the miscarriage.

The bottom line is that in the vast majority of miscarriages, you could not have caused the miscarriage, and you could not have prevented it.

back to Miscarriage FAQs