Miscarriage – the early farewell

Hardly any other event concerns men and women as much as pregnancy and the upcoming birth. During the nine months of the new life, the parents-to-be go through an emotional roller coaster. Joy, fear, insecurity, dreams and wishful thinking go hand in hand with the mother’s physical changes. However, 10 to 30% of all pregnancies end in miscarriage: the child cannot be carried to term.

What is a miscarriage?

One speaks of a “miscarriage” (abortion) when the child is stillborn weighing less than 500 grams. Stillborn babies weighing more than 500 grams are called stillbirths. Depending on the course of the pregnancy, a distinction is made between an early miscarriage (up to the 12th week of pregnancy) and a late miscarriage (up to the 25th week of pregnancy).

 

Causes of miscarriage

There are several causes of a miscarriage:

  • Genetic defects of the embryo
  • Maternal factors such as infections or malformations of the uterus or placenta
  • Hormonal disorders (e.g. a luteal hormone deficiency)
  • Blood group incompatibilities
  • On the father’s side, abnormalities in the sperm and genetic disorders, among other things, can lead to an abortion.

More than half of early miscarriages are probably due to defective fruit systems. It is, therefore, a perfectly reasonable reaction of the body not to let this malformed embryo continue to grow.

Signs are often confused with menstrual bleeding.

A miscarriage can be recognized by vaginal bleeding and the onset of labour. However, the bleeding is also the reason why a large number of miscarriages in very early pregnancy are not recorded because they are regarded as delayed, hefty menstrual bleeding. The risk of a miscarriage decreases throughout pregnancy: While it is still around 15% in the first 6-8 weeks, it drops to around 3% by the 17th week of pregnancy.

 

types of miscarriages

Physicians distinguish between miscarriages primarily according to clinical aspects. However, the decisive cause can only be found in very few cases: bleeding has occurred in the event of an imminent miscarriage ( abortus imminent), but the pregnancy is still intact. In this case, everything will be tried to maintain the pregnancy. Bed rest, birth control drugs, and sedatives are often used for this purpose.

In the case of an incipient abortion, the miscarriage has already begun, the amniotic sac has ruptured, and labour has started. In this case, the miscarriage can no longer be stopped. Doctors try to end the birth without further complications for the mother.

In the case of an incomplete miscarriage ( abortus incompletes), there are still residues, such as the placenta in the uterus. The birth must also be completed as quickly as possible in the hospital.

Infant death in utero

In some cases, the baby dies in the womb without going into labour or bleeding. The mothers notice that the child is no longer moving or that infant death in the uterus is detected during a routine ultrasound check. In this case, the birth is often induced with drugs. As a rule, the mother gives birth to the dead child “naturally”, which is highly stressful for the woman concerned but helps her to cope with the miscarriage.

Bleeding during pregnancy is always a reason to visit your doctor or the clinic directly. If a miscarriage cannot be stopped, the birth that has started must be ended as quickly as possible so that the mother does not suffer any complications and, if necessary, the cause can be investigated.

Avoid more miscarriages

The success of further pregnancies depends crucially on the cause of the abortion. Nothing stands in the way of a successful pregnancy if these can be recognized and eliminated.

 

Investigate causes of abortion.

Since miscarriages are relatively common in early pregnancy, it is usually not necessary to investigate the causes in more detail. However, this can be the case, for example, with repeated miscarriages.

  • If the woman has already suffered several premature births, the embryo is usually examined to clarify the cause of its early death. In addition, whether the parents may have a hereditary disease must be clarified. There are special genetic consultations for this, which are usually carried out in university clinics.
  • In some cases, hormonal imbalances can be identified as the cause, which can be avoided if you become pregnant again. For example, if the body does not produce enough corpus luteum hormones, the uterus lining cannot develop properly, and the fruit cannot hold. A weakness of the corpus luteum can be determined by a blood test and treated before fertilization.
  • Vaginal infections can be detected in good time with the help of regular pH value tests. There are newly developed tests for this that can be carried out at home: the pregnant woman checks the pH value in the vagina with a disposable glove. If she finds an increased value, the gynaecologist should check whether an infection is present.

Allowing grief after miscarriage

Many women blame themselves for the miscarriage and torture themselves with allegations. In most cases, the exact cause of the miscarriage cannot be determined. Psychological support can be helpful. However, it should be taken into account that both parents suffer from the loss, often processing it very differently. Along with the guilt, this creates a potential for tension that can damage the relationship and complicate another successful pregnancy.

In any case, after a miscarriage, parents should open up to their grief and try to deal with it together. Visiting a self-help group and meeting parents who are also affected can be helpful.

Pregnant Again After Miscarriage?

In most cases, there is no medical reason to believe that another pregnancy will also end in miscarriage. Although women who have had two miscarriages are more likely to have another miscarriage, the reasons for the miscarriage can be different.

 

No time rules for getting pregnant again

There are no rules as to how quickly a woman should become pregnant again after a miscarriage. That depends on the woman and her way of processing the event. Some want to get pregnant again as soon as possible; others need months or years before they dare to take such a step again.

Counselling after a miscarriage

The advice centres of Pro Familia (including genetic advice), Caritas and Donum Vitae provide independent medical advice. The counselling centres also offer psychological care after a miscarriage, an abortion and during a renewed pregnancy. Human genetic examinations and consultations are possible through the relevant institutes at the university clinics. You should contact the nearest university clinic for this – if the forwarding has not already occurred via the treating gynaecologist.

Funeral after a miscarriage

For a long time, the distinction between “miscarriage” on the one hand and “stillbirth” on the other played a role when parents wanted to bury their dead child. In many places, the burial of “miscarriages” was not possible, but that of stillbirths was. In the meantime, it has become clear that parents who have lost their child through a miscarriage also need a place to mourn.

In most federal states, these children can be buried at the parents’ request, even if there are no relevant laws, only recommendations from the responsible bodies. The contact person responsible can be found at the local cemetery office.

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