Baby Loss Awareness Week is held annually from 9 to 15 October. It’s a special opportunity to mark the lives of babies lost in pregnancy or at or soon after birth and also to raise awareness amongst the public and even healthcare professionals of the key issues affecting those who have lost a baby: the emotional impact of loss, the quality of care, pregnancy after loss and so on. The week also gives people an opportunity to talk openly about the subject of and raise awareness of baby loss and pregnancy loss, a topic that is rarely discussed openly.
This brings us to the topic of miscarriages.
What is a miscarriage?
A miscarriage is an event that results in the loss of a fetus during early pregnancy. It’s also called a spontaneous abortion. It usually happens during the first trimester, (first three months), of the pregnancy. Statistics show that 10-25% of all clinically recognized pregnancies end in miscarriage.
There are different types of miscarriages, and they are classified depending on the cause of the miscarriage and the stage of the pregnancy.
Threatened miscarriage
This is usually characterised by vaginal bleeding early in pregnancy. There may also be some abdominal pain, however the neck of the womb remains closed and so the pregnancy is able to continue.
There is rarely anything that can be done to protect the pregnancy. In the past, bed rest was recommended, but there is no scientific proof that this helps at this stage.
Inevitable miscarriage
Inevitable miscarriages can come after a threatened miscarriage or without warning. There is usually a lot more vaginal bleeding and strong lower stomach cramps. During the miscarriage the cervix opens and the developing fetus will be passed from the womb through the vagina as clumps of tissue and sometimes large amounts of bleeding.
Complete miscarriage
A miscarriage is said to be complete when all the pregnancy tissue has left the uterus. Vaginal bleeding may continue for several days. Cramping pain much like labour or strong period pain is common – this is the womb contracting to empty. This can happen at any time and the best way to confirm if a miscarriage was complete is to have a check-up with a doctor or midwife and get a scan done.
Incomplete miscarriage
Sometimes, after a miscarriage some pregnancy tissue will remain in the uterus. Vaginal bleeding and lower abdominal cramping may continue as the uterus continues trying to empty itself. This is known as an ‘incomplete miscarriage’.
In such cases, there may be need for a short procedure called a ‘dilatation of the cervix and curettage of the uterus’ (popularly known as a ‘D&C’) is necessary to remove any remaining pregnancy tissue. This is an important medical procedure and should ideally be done in an operating theatre by an experienced and qualified gynecologist.
Missed miscarriage
In some cases, the fetus dies but stays in the uterus. This is known as a ‘missed miscarriage’. There may be no obvious symptoms. Some of the symptoms of pregnancy, such as nausea and tiredness, may fade. There may be a brownish vaginal discharge. Usually a missed miscarriage is detected on ultrasound scan. Treatment for this depends on how far along the pregnancy is and also the patients preference.
Miscarriages occur for a variety of reasons, some of which cannot be explained and most of which are unavoidable. The loss of a pregnancy, for whatever reason, regardless of the stage, can have great physical, emotional and psychological effects on the woman and the family. It is important to acknowledge loss and not be dismissive just because the baby died while still in the womb.
