What Is a Miscarriage? Impact on Body and Mind

Miscarriage is a distressing situation that affects the mental and physical health of the woman experiencing it as well as her family. The most common definition of miscarriage is associated with the loss of a potential pregnancy before the 20th week of the gestation period.

Most miscarriages often happen in the first trimester, although there are isolated cases of miscarriages later in the gestation period too. Another term associated with miscarriages and often used synonymously is 'spontaneous abortion'. There are several explained and idiopathic reasons for pre-term miscarriage, the most common being chromosomal abnormality.

Let us delve into more details regarding miscarriages, their physical symptoms, causes, and the difficult emotional impact they may have on the mother experiencing the loss.

What is a miscarriage? What may cause a potential miscarriage?

It is the question that haunts every pregnant woman. Pregnancy is a very volatile time in the life of a woman. While it is associated with joy and happiness, it also poses several complications to the health of both the mother and the baby. Thus, it is natural to feel fear about the safety of the fetus.

Losing a fetus before the 20th week of pregnancy can be called a miscarriage. Miscarriages are very common, affecting around 10-20% of pregnant women, without any preconceived causes. It may occur during different stages of pregnancy, especially in the first trimester.

The physical and emotional impact of miscarriages on pregnant women is largely dependent on how far along the pregnancy is. There are several types of miscarriages you need to be aware of:

The symptoms of a miscarriage may vary from one pregnant woman to another. It may also depend on the stage of pregnancy. Sometimes, miscarriages can happen without any warning signs. However, recognising the common symptoms of miscarriage is crucial for diagnosis and treatment. The most common signs of a miscarriage are as follows:

• Sudden vaginal bleeding (ranging from light spotting to heavy bleeding)
• Abdominal cramps during early pregnancy
• Passage of tissue or fluid from your vagina
• Mild or severe back pain
• Lack of pregnancy symptoms such as tender breasts, or nausea

In some cases, pregnant women may experience mild spotting which does not lead to miscarriage. So, reach out to a medical professional if you experience any of the symptoms above to prevent a potential miscarriage. However, it is to be noted that some women do not experience any of the common symptoms of a miscarriage before it happens. 

Of course, it is difficult to distinguish between the symptoms of a normal pregnancy and those of a miscarriage. The line between them is often blurred and confusing. For example, light spotting or vaginal bleeding in pregnancy is common for some women. But, it can be mistaken as a symptom of a miscarriage.

Additionally, abdominal cramps during the early stages of pregnancy are fairly common in most women as their uterus expands. However, this is also one of the most common symptoms of an early miscarriage. It is often difficult to distinguish between the discomfort of pregnancy and symptoms of miscarriage when they are mild, so we recommend seeking out immediate medical attention to be safe.

Numerous underlying factors can cause miscarriages. In some cases, the exact causes might be left unknown, however, understanding what causes miscarriages is crucial for preventing and treating future pregnancies. The most common causes generally involve genetic or chromosomal abnormalities, maternal health conditions, environmental factors, and lifestyle choices. Read the following points to understand what may cause a miscarriage:

• Incompetent cervix (your cervix begins to open too early in pregnancy)
• Exposure to TORCH diseases
• Severe kidney disease
• Congenital heart disease
• Diabetes that isn't managed
• Thyroid disease
• Radiation
• Certain medicines, such as the acne drug isotretinoin (Accutane®)
• Severe malnutrition
• Lifestyle choices including smoking, drinking alcohol, having excessive caffeine, and consuming narcotics can increase the risk of miscarriage.

Around 50% of miscarriages that occur in the first trimester are due to chromosomal abnormalities. If there is an error in the structure and number of the chromosomes during conception, it leads to improper fetal development. These abnormalities occur randomly and cannot be predicted. However, these issues are more common in geriatric pregnancies, especially those over the age of 35.

Every developing fetus gets a pair of chromosomes from its father and mother. The chromosomal abnormalities are as follows.

1. Trisomy: It occurs when there is an extra chromosome in a set. The most common chromosomal abnormality is Trisomy21 which can cause Down syndrome.
2. Monosomy: It happens when a chromosome is missing from a set.
3. Triploidy: When an embryo has three complete sets of chromosomes instead of two, it results in 69 chromosomes instead of the normal 46 chromosomes.
4. Translocations: Translocations refer to broken chromosomes attached to other chromosomes. It leads to a structural abnormality that may cause a miscarriage.

Usually, these abnormalities occur during cell division, during the formation of an egg, or early fetal development.

Apart from these genetic issues, other risk factors of miscarriages also include chronic health conditions like uncontrolled diabetes, high blood pressure, autoimmune problems, and thyroid disorders.

Bad lifestyle choices like smoking, drinking, and drug use can also lead to pregnancy loss in the early stages. Additionally, exposure to environmental toxins can be a major cause of miscarriage.

Unchecked stress, hormonal imbalance, and physical trauma can impact the healthy growth of your fetus. So, managing these risk factors can also help you overcome unexpected miscarriages.

Treatment for miscarriage depends on the person's health and the type of miscarriage. The treatment mainly includes the complete expulsion of pregnancy tissue. Additionally, it involves the physical and mental recovery of the patient along with preventing any kind of infections.

It is important to note that the expulsion of the pregnancy tissue is a must for a complete miscarriage. The treatment and management of miscarriages include non-surgical treatment, where the inviable fetus is expelled without surgery, and surgical treatment where surgery is necessary to remove the fetal tissue.

For some cases, like missed miscarriages and incomplete miscarriages, non-surgical management is enough to complete the process. Non-surgical treatment attempts to regulate the natural passing of the miscarried fetus through the vagina. This process will take typically a few days to a week. It involves taking oral medications such as Misoprostol, which helps in inducing uterine contractions and expelling the fetus.

Women undergoing this treatment may experience heavy vaginal bleeding, abdominal period cramps, and symptoms that occur during a heavy period. If the bleeding is excessive or prolonged, patients must consult their healthcare advisor.

If the removal of the fetal tissue cannot be completed naturally or if you are experiencing heavy bleeding, then you need to consider surgical interventions. The most common process in surgical management is D&C (Dilation and Curettage).

Generally, in a D&C, the cervix is dilated and the leftover fetal tissue is removed. After the completion of the surgical treatment, patients may experience light vaginal bleeding for several days.

Miscarriage is a traumatic event that requires both physical and mental recovery. Women who go through a miscarriage can experience guilt, sadness, grief, depression and PTSD.

A miscarriage, especially after a long-awaited pregnancy in the third trimester, is an incredibly devastating loss, making it challenging for a woman to regain a sense of normalcy. Even with early-stage miscarriages, the grief can be profound, though some may find it easier to recover emotionally.

Many women experience feelings of guilt, inadequacy, or the belief that they did something wrong. Healing from such a loss is deeply personal, and it takes time for each woman to find her way through it.

Emotional support is crucial for women who have experienced this traumatic loss. However, there are many options for support and healing available. This includes connecting with communities or support groups of others who have been through pregnancy loss. Focusing on internal health is also equally important.

Many women wonder how to support their bodies after a miscarriage, including how to help the uterus heal. Physical recovery involves eating nutritious foods and staying well-hydrated. It's common to have questions, such as "When will my period return after a miscarriage?" but the priority is to feel better emotionally.

For personalised guidance and clarity, it's always best to consult your healthcare provider.