• How You Can Protect Your Early Pregnancy From Miscarriage

    It's hard to pinpoint what leads to a miscarriage, but there are factors that can lower your risks.
    by Ana Leah dela Cruz .
How You Can Protect Your Early Pregnancy From Miscarriage
PHOTO BY iStock
  • There’s nothing more life-changing than a pregnancy, except perhaps, a miscarriage. It’s one of the most common fears a woman has the moment she finds out she’s pregnant. Pregnancy loss has devastating effects on a woman — it can change how a mother looks at her abilities to raise a child and how she relates to her husband, too. There is a fear of judgment, not to mention the fear of it happening again.

    Most cases of miscarriage can't be prevented

    “[Miscarriages] are commonly due to abnormal chromosomes,” explains Dr. Josephine Carungay, an ob-gyn. There’s a possibility that the egg or the sperm had the wrong number of chromosomes, which prevented the fertilized egg from developing normally. Sometimes, a miscarriage can also occur when the egg doesn’t implant properly in the uterus, or the embryo had structural defects that prevented it from growing. 

    Dr. Siobhan Dolan, a medical advisor for the US-based non-profit organization March of Dimes, told Parents.com that most cases of miscarriage can’t be prevented. Most pregnant women do not undergo a full-scale checkup after a miscarriage, and even if they do, it’s hard to pinpoint what led to the pregnancy loss exactly.

    However, experts have already identified some risk factors when it comes to what causes miscarriages. It can range from having a weak cervix to being exposed to environmental toxins like lead and arsenic or harmful chemicals like formaldehyde, benzene, and ethylene oxide. Other risk factors include smoking, drinking, and using drugs. Chronic diseases and disorders like diabetes, lupus, and polycystic ovary syndrome can also increase the risk of a miscarriage. If you have previously experienced two or more miscarriages, chances are, it can happen again.

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    Your age can also be a factor — women over 35 have a higher risk of conceiving a baby with a chromosomal abnormality, while forty-year-olds are about twice as likely to miscarry than 20-year-olds. If there’s a history of birth defects or genetic problems in the family, it also increases your chances of having a miscarriage. You can also be more prone to pregnancy loss if you have a congenital uterine abnormality like a one-sided uterus. 

    On the bright side, once you reach six weeks and your baby’s heartbeat is within the average rate of 100 to 160 beats per minute, the chances of a miscarriage is lower.

    Bleeding isn't the only sign of a miscarriage

    Since a miscarriage can happen any time during the pregnancy, it’s hard to tell if you’re experiencing once. The most common symptom of baby loss is vaginal bleeding. It can vary from light red or brown spotting to heavy bleeding. However, not all bleeding means that you are having a miscarriage, as it’s prevalent in the first trimester.

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    miscarriage early pregnancy
    Other signs of a miscarriage include severe back and abdominal pain, which you may feel in your lower back and belly.
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    The early signs of miscarriage can also include white, pink mucus or a clot-like material discharge. Sharp and persistent pains, which might feel sharp and stabbing, could also be a sign of a baby loss. The pain can vary from a period-like pain to strong labor-like contractions. Some aches are normal, like leg cramps and rib pain, mainly because your growing uterus is pushing other organs out of the way to make room for your baby.
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    The symptoms that would manifest may also vary depending on the kind of miscarriage that you are experiencing. According to Pregnancy Birth & Baby, a miscarriage can be classified as threatened, inevitable, complete, incomplete, missed, and recurrent.

    A threatened miscarriage is when your body shows signs that you might miscarry, which includes a little vaginal bleeding and lower back pain that can last for days or weeks. The pain and bleeding may either go away on its own, and you continue to have a healthy pregnancy, or it can get worse and lead to a miscarriage.

    “Inevitable miscarriage” happens without warning. There is a lot of bleeding, and the pain is severe. During this kind of miscarriage, the cervix opens, and the baby comes away with the bleeding.

    If and when you feel any of the symptoms mentioned, it’s best to call your doctor immediately so he or she can manage the bleeding and check how your baby is doing. 

    Obstetrician Dr. Alison Barrett told Today’s Parent that pregnancy isn’t over until it’s over. “Sometimes you have symptoms that seem pretty scary, and yet the pregnancy continues.” That’s why it’s absolutely essential to call your doctor if you ever feel any of the early symptoms. Getting an ultrasound can provide the best confirmation of whether a miscarriage is inevitable or not.

    Your body after a miscarriage

    What happens to a mother’s body after pregnancy loss is not often discussed as extensively as what happens to it while she’s pregnant, but it’s as important. After a baby loss, you might still experience some bleeding, which differs from woman to woman. Some may experience light spotting, some a heavy-period like bleeding, while some may not experience bleeding at all.

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    You may also experience some abdominal cramping caused by contractions in the uterus as it goes back to its average size. The pain can range from mild to an extremely uncomfortable one, but it will lessen over time. 

    If your pregnancy lasted for more than 12 weeks, you might experience tender breasts and milk supply. Since your body has already prepared itself for breastfeeding, it does not go away instantly. If you don’t express the milk regularly, the supply will gradually come to a stop.

    While some of these are normal, you need to see a doctor if any of these symptoms don’t go away on their own after a month.

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    The truth about sex and miscarriage

    It’s a common pregnant woman question: can sex cause miscarriage? The short answer is no. Doctors will tell you that as long as you have a healthy pregnancy, you can have sex as many times as you and you/partner husband desire. You can keep doing it right up until your water breaks! So where did Pinay moms get the idea that sex during pregnancy can cause a miscarriage?

    It’s one of those popular pregnancy myths that has been passed on from generation to generation but has been proven wrong by medical experts and recent studies. Having sex with your husband while your pregnant is okay and perfectly normal, especially if you have a low-risk pregnancy. The American College of Obstetricians and Gynecologists (ACOG) found that there is no known link between sex and miscarriage. A high percentage of loss before the 13th week of pregnancy happen because the embryo is not healthy enough to fully develop.

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    It’s also not true having sex will hurt your baby or cause a miscarriage.
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    During sex, the male’s penis only penetrates the vagina and even the tip of the cervix during deep penetration — it will never reach the uterus or your baby. If anything ever goes wrong with your pregnancy, it’s not because you had sex with your hubby.

    Your body also knows to protect your little one as it creates layers of protection while your child is in your womb. Your mucus plug seals your cervix and protects your unborn child from bacteria and infections, semen included. Don’t worry about any thrusts and bumps during sex, too, because the amniotic sac acts as a cushion.

    If you’re wondering about whether or not orgasms and sexual stimulations can trigger contractions and pre-term birth, Elizabeth Stewart, MD., a professor of obstetrics and gynecology at Harvard Medical School will tell you that it doesn’t. You will feel these contractions more intensely because your uterus is swollen and you have increased blood flow in your system, but it’s completely normal and usually goes away after a few minutes. However, if you continue to feel contractions after having an orgasm, it’s best to call your doctor. 

    Ultimately, every pregnancy is different. If you’re unsure about whether or not you can have sex while you’re pregnant, talk to your doctor about it. If your doctor gives you the go signal, you might want to try these safe positions, but if your doctor warns you against it, seek other ways to remain intimate with your hubby.

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    When will you get your period again after a miscarriage?

    Experts from the National Health Service in the United Kingdom say it will usually take four to six weeks before your period comes back after a pregnancy loss, and it won’t immediately be a regular cycle especially if you’ve always had an irregular period. 

    In an interview with Aszani Stoddard, a certified nurse-midwife in the US, for The Bump, she said the woman’s body treats a miscarriage as though it’s a period. However, if your period hasn’t returned after at least four weeks and your cycle was regular before you got pregnant, you need to consult with your ob-gyn immediately. Your doctor will run some tests to find out why your period hasn’t come back yet.

    Health experts also say your first period after a miscarriage will depend on the levels of hCG in your body and the length of your pregnancy. Human chorionic gonadotropin (hCG) is a hormone that your body produces when you’re pregnant. The hCG is made by cells formed in the placenta, which nourishes the fertilized egg. After a miscarriage, the hCG levels go down until it reaches a non-pregnant range.

    If you experienced pregnancy loss during your second trimester, it could take up to two to three months before your period returns. The time varies the farther along you were in your pregnancy. 

    The first period after a miscarriage varies for every woman. Some may experience a steady flow with cramping or blood clots, while some experience a lighter flow. You may also experience premenstrual syndrome (PMS), which includes intense mood swings, a change in libido, difficulty sleeping, joint or muscle pain, and fatigue.

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    How long your first menstruation after a miscarriage lasts isn’t definite, too. It can be heavy and long or short and light — it will take several months before you go back to your regular cycle.

    If you’re wondering when you can try to get pregnant again after a miscarriage, the World Health Organization recommends that you wait at least six months before getting pregnant. Most doctors also suggest you wait for at least one regular monthly cycle before you and your husband try again. 

    It’s important to note that ovulation can happen two weeks after a miscarriage, which means it’s also possible to get pregnant before the first period begins.

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    Can you prevent miscarriage from happening again?

    The last thing you want to think about when you first learn that you’re pregnant is the possibility of a miscarriage. In a perfect world, everything will go according to plan, but that’s not how it is most of the time. It’s better to make sure you’re prepared for anything that can happen. 

    Research by Ava, a company that makes a fertility tracker wearable devicerevealed that more than a quarter of women in the United States who have had a miscarriage believe they may have done something wrong, which is often not the case. Thinking it’s your fault is one of the most common pregnancy myths that most women believe. (The survey also showed that 32% of women were not satisfied with the care they received from their doctor when they miscarried.) 

    The survey also showed that 32% of women were not satisfied with the care they received from their doctor when they miscarried. This called the medical community into action, to provide more support for women who have had a miscarriage. 

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    There is no "how to prevent a miscarriage" manual, and there is little you can do to stop it from happening — you can only lower your risks. Almost 80% of miscarriages are caused by genetic abnormalities and are lost before 12 weeks.

    Most moms rely on hearsay and old Filipino myths, which can often lead to more problems. It’s always best to consult your doctor. You also need to make sure you have what experts call a pre-conception checkup. You should schedule a checkup with your obstetrician-gynecologist three months before trying to have a baby. This way, your doctor can check if you have pre-existing conditions or risks that may affect your pregnancy. 

    After your checkup, your doctor might prescribe prenatal vitamins like folic acid. This will help prepare your body for pregnancy. Make sure you take your vitamins regularly. Experts have found out that women who are prone to miscarriage do not have enough folic acid or vitamin B12 in their body. 

    It’s also essential that you watch your weight before you decide to get pregnant. Obesity can increase the risk of miscarriage. Controlling your weight gain can also help reduce the chances of other pregnancy complications like stillbirth and gestational diabetes.

    Another common myth about miscarriage that women have believed from decades now is about how miscarriages are caused by intense exercise and lifting heavy objects — all of which have been proven by data and research to be false. But since every pregnancy is unique make sure you ask your doctor so she can help you make choices that would be good for you and your child.

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    Although extensive daily stress can be bad for anyone, let alone a pregnant woman, there has been no evidence that links stress to miscarriage. However, Baby Center notes that extreme stress can affect a developing baby’s health, putting you at higher risk of stillbirth, premature birth, and low birth weight. If you ever feel stressed and anxious during (or because of) pregnancy, talk to your partner about it or seek professional help.

    Psychologist Dr. Nicole Highet, founder and executive director of the Centre of Perinatal Excellence (COPE), says there are ways to minimize the impact of stress on your developing baby. “Sometimes just recognizing you cannot control everything in itself can play a big part in helping you retain perspective and take the pressure off yourself,” she said.

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    Your pregnancy after miscarriag is considered high risk

    The National Institute of Child Health and Human Development defines a high-risk pregnancy as one that threatens the health or life of both the mother and the child. Most, if not all of the time, it requires specialized care from trained providers. 

    Several factors can lead to a high-risk pregnancy. Obesity, for example, can increase the risk of high blood pressure, preeclampsia, gestational diabetes, stillbirth, and neural tube defects. Obesity can also increase your child’s chances of developing heart problems at birth by 15%. Apart from obesity, a mother’s age can also affect the pregnancy, with teens and women age 35 or older being more at risk for preeclampsia and gestational high blood pressure. 

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    Some women can have increased risks for complications even before they get pregnant, while some women become high-risk as the pregnancy progresses. But if you've had a miscarriage and you are planning to change doctors for your next pregnancy, it is vital that you let your new doctor know of your pregnancy loss.

    Once you experience several issues during your pregnancy like premature labor, your doctor can consider it high-risk. Multiple pregnancies also put you in the high-risk category as it can increase the risk of early labor and pregnancy-induced high blood pressure. So does placenta previa where the placenta covers the cervix and eventually cause bleeding especially if a woman has contractions. If the placenta is still covering the cervix during delivery, your doctor may schedule a cesarean section to reduce the bleeding risks. If you have Polycystic Ovarian Syndrome (PCOS), you also have an increased risk of developing complications during pregnancy.

    Look out for vaginal bleeding, severe headaches, pain or cramping in the lower abdomen, watery vaginal discharge, and regular or frequent contractions. Decreased fetal activity, pain, and burning sensation during urination, as well as a blurred vision,  can also be signs of a high-risk pregnancy.

    Dr. Maynila Domingo of ManilaMed notes however that not all high-risk pregnancies result in adverse outcomes. A patient can be considered high-risk but didn’t have any complications. "There is a good chance that a high-risk pregnancy results in a good outcome,” Dr. Domingo said.

    Try not to panic or be scared when your doctor tags your pregnancy as high-risk, especially if you've experienced a miscarriage. Being tagged high-risk allows your doctor to be more aware of any possible complications.

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    Doctors would also monitor your pregnancy more closely. They might also recommend that you undergo a few prenatal screening tests.

    Specialized or targeted ultrasound, for example, is a type of fetal ultrasound that targets a suspected problem like an abnormal fetal development. Another ultrasound for cervical length may also be required by your doctor, which aims to check if you’re at risk of preterm labor. Amniocentesis is another common procedure where a sample amniotic fluid is withdrawn from the uterus to identify specific genetic conditions or any serious abnormalities of the brain or the spinal cord.

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    What to do if you have a high-risk pregnancy

    The key is to eat a balanced diet before and during your pregnancy. It’s true that you need more calories when you’re pregnant, but remember that whatever you eat, you’re baby eats, too, so make a conscious effort to keep your choices healthy. Keep away from people who may be sick and stay away from hazardous environments. Avoid using products with harmful or toxic chemicals and ask your doctor about medications like antibiotics before you take any of them.

    You need to be as healthy as possible — eat right, get plenty of sleep, reduce your workload, and exercise, unless you’ve been advised not to. Make sure you also work closely with your healthcare provider. Be diligent when it comes to attending your checkups and follow all your doctor’s instructions. Have the tests that your doctor recommends and make sure you take all the medications prescribed. Feel free to ask questions, too. It’s essential that you are honest with your doctor about how you feel so she knows what to do correctly.

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    Dr. Highet also emphasized the importance of self-care, saying it’s essential that you nurture your body with good quality food, incorporate gentle exercise in your life, and rest when needed.

    To heal physically and emotionally after a miscarriage is possible. Give your body the time to adjust and give your mind the space to understand what happened. The moment that you feel overwhelming guilt talk to your partner about it. A loss like this is not something you have to deal with on your own.

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