Early Pregnancy Loss

sadAbortion is defined pregnancy loss occurring before 20 weeks. When most people hear the word they think the elective procedure but a Spontaneous Abortion happens without any intervention. In the medical world, we refer to a miscarriage as a spontaneous abortion. We also refer to this as Early Pregnancy Loss or EPL. Early pregnancy loss is a lot more common than you may think, 1 in 4 women will experience EPL in their lifetime. Many times this will happen before the woman misses a period and realizes that she is pregnant.

Today I am going to discuss early pregnancy loss occurring in the first trimester. More than 80% of pregnancy loss will occur in the first 12 weeks of pregnancy and 30% of pregnancies end in EPL.

What causes pregnancy loss

In most cases, EPL is caused by chromosomal abnormalities. There is nothing you did wrong or could have done differently to prevent the loss. There was a disruption when the sperm and egg met up and the DNA didn’t line up quite right, therefore there was no chance that the pregnancy could go on.

With that being said, there are factors that will increase your risk of having an early pregnancy loss. These risks includes

  • Advancing age (this is the biggest factor)
  • Previous pregnancy loss
  • Smoking more than 10 cigarettes a day
  • Alcohol and cocaine use
  • Medications or substances that are harmful to developing fetus (teratogens)
  • Super big amounts of caffeine (like lots of freaking Starbucks)
  • Being underweight or overweight (according to your BMI)
  • Endocrine diseases such as PCOS, thyroid disease, and uncontrolled diabetes
  • Autoimmune disorders such as Lupus
  • Uterine anomalies (such that the uterus is shaped in a way or so scarred that it can’t hold a fetus)

I know that I listed previous pregnancy loss as a factor. But remember, 1 in 4 women have miscarriage in their lives. And the majorities go on to have babies.  But the more losses you have the bigger the chance that there is an underlying issue causing these losses. Make sense?

What can you do for a miscarriage

If a woman is miscarrying in the first trimester, there is really nothing that can be done. The fetus is not capable of living outside of the womb yet and there is nothing we can do to keep it there. For women experiencing bleeding and cramping early in pregnancy, some providers will recommend bed rest. But at this point if you are miscarrying you are going to lose the pregnancy. There are basically 3 options if you are miscarrying.

  1. Expectant management. This means that we wait and watch, allowing the pregnancy to pass on its own.
  2. Medical management. This is where you would take a medication such as cytotek to help your uterus expel products of conception more effectively and quickly.
  3. Surgical aspiration. This is the surgical emptying of the uterus, many know this as a D&C. A D&C may still be needed after both expectant and medical management if the products do not expel completely.

Your medical provider can help you choose which option is best for your circumstance. In some cases it is best to let this happen naturally and in other instances you may need to finish miscarrying sooner than later.

If you have experienced EPL, know that you are not alone. Rather the pregnancy was planned or unplanned, desired or not this is a loss and you will grieve it in you own way. You may deal with a sense of guilt (for instance if you did not want to be pregnant in the first place). Or you may wonder if it was that one cigarette or glass of wine you had before you knew you were pregnant. It wasn’t! Your feelings of ambivalence did not will this loss into reality.

If you are desiring pregnancy, make sure you are as healthy as possible. Lose that extra weight, stop smoking,  and start taking prenatal vitamins now. Visit your OBGYN or WHNP to discuss a plan. Give yourself 3 or 4 months and then try again.

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Here are a couple of online support groups:

https://www.miscarriageassociation.org.uk/

https://www.dailystrength.org/group/miscarriage

 

 

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