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Things Fall Apart
Learn to cope with the trauma of losing a baby
By Christina Ching and Georgina Hersey
Most women suffering one miscarriage can expect to have a normal pregnancy the next time.
For many women who’ve had a miscarriage, sharing their experience is a turning point. Often, there is nothing anyone can say to take away the pain, but it’s important that there is someone who understands, and doesn’t judge you. You may need someone who can let you express how you feel, and be sad or angry about what has happened.
MISCARRIAGE: THE FACTS
Sadly, miscarriages are common - one in five pregnancies end this way. It can happen at any time until week 28 (after this, the loss of a baby is called a stillbirth). Although it’s often traumatic, most women who have a miscarriage go on to have a successful pregnancy. And having a miscarriage doesn’t make it any more likely that you’ll have a second. In fact, most women suffering one miscarriage can expect to have a normal pregnancy the next time. Only an estimated 20 per cent of women who miscarry will suffer recurring miscarriages. Even after three consecutive miscarriages, the chances of a successful pregnancy are still over 70 per cent for a woman under 36.
Do remember that many women experience spotting or bleeding in early pregnancy - and most don’t miscarry. Some women may get spotting when the embryo implants in the womb lining, while others have small hormone-related bleeds around the time of their missed period. While it’s important to get any bleeding checked by your gynae, it’s also helpful not to automatically fear the worst.
WHY IT HAPPENS
One of the worst things about having a miscarriage is not knowing why it happened.
It’s important to know that it’s extremely unlikely to be anything you did. About half of all miscarriages are thought to be caused by chromosome abnormalities in the embryo. Women who suffer from polycystic ovaries (a condition which can cause fertility problems and affects up to one in 10 women) may find it difficult to conceive and are also more likely to miscarry, but treatment is available to reduce the risk.
There are other causes as well. According to Mother & Baby expert Dr Christopher Chong, a consultant obstetrician, gynaecologist and urogynaecologist at Gleneagles Medical Centre, this includes auto-immune disease (where the body produces antibodies to reject the foetus), an incompetent cervix or womb abnormalities.
“Often, a reason cannot be found for the miscarriage,” Dr Chong notes. “Most of the time, it is due to the foetus or the placenta not being well. It is rarely anyone’s fault.”
All you can do to prevent a miscarriage is to be in the best of health before trying for a baby, he advises. That means correcting or stabilising any medical problems, avoiding smoking and drinking, building up your immunity with multi-vitamins, taking folic acid two months before you try for a baby, and staying active and healthy.
COPING WITH MISCARRIAGE
Whether or not there is a known reason for a miscarriage, most women go through similar emotions as they try to come to terms with losing their baby. For many women, their baby is a real person from the moment they see that line on the pregnancy test. So even if you miscarry when you’re “just” a few weeks pregnant, the emotional impact can be devastating.
“Grief after a miscarriage can be very complicated. You grieve for your lost baby, for the lost pregnancy, and the loss of your plans, hopes and dreams for the future, both in the short term and in the long term,” says Ruth Bender Atik, national director of The Miscarriage Association in the UK. “Because miscarriage is not generally perceived as an important loss, those around you may not understand your emotions. This can make you feel very alone and you may start to wonder if your emotions are normal.”
It’s also a unique kind of grief because you know very little about the person you’re grieving for. You may feel that the baby was part of you, and as if you’re grieving for a lost part of yourself.
Everyone reacts differently to a miscarriage and some women recover more quickly than others. Common feelings are shock, a strong sense of loss and emptiness, anger that it’s happened, and guilt that it may somehow have been something you’ve done. You may feel vulnerable and depressed for a time. As you recover, you’re likely to have good days and bad ones, and there may be certain times - such as the baby’s due date ? which you find particularly difficult.
MOVING ON
For many women who’ve had a miscarriage, sharing their experience is a turning point. Talking about it makes it a shared event, rather than a purely private one. Often, there is nothing anyone can say to take away the pain, but it’s important that there is someone who understands, and doesn’t judge you. You may need someone who can let you express how you feel, and be sad or angry about what has happened. If necessary, get in touch with a counsellor. Whatever emotions you go through, remember that a miscarriage is a devastating blow, but most women do go on to become mothers.
Forget Me Not
Men need emotional support as well ? here’s how.
When a woman has a miscarriage, she tends to be the focus of most of the support. Men often find that people ask them how their wives are, without asking how they feel themselves. Your husband may also feel he must hide his feelings for your sake, however upset, helpless and angry he is. It may help him to:
• Talk about his feelings with someone he trusts
• Read information about what has happened
• Let people know that he’s grieving too
In The Know
How to spot and manage a miscarriage.
Q What are the symptoms of a miscarriage?
A Usually vaginal bleeding and abdominal pain or cramps, but this can vary.
Q How is a miscarriage treated?
A There are three ways of managing miscarriages, depending on the stage of the pregnancy, what the hospital offers, and the woman’s preference:
1. Natural Miscarrying naturally, usually at home. If you suspect that you’ve miscarried, see your gynae, stresses M&B expert Dr Christopher Chong, a consultant obstetrician, gynaecologist and urogynaecologist at Gleneagles Medical Centre. “He will ensure that the womb is cleared of the dead foetus and placenta ? the medical term is products of conception (POC) ? to prevent bleeding and infection,” he explains. Your gynae will monitor the level of the pregnancy hormone HCG in your blood. If it remains high, an evacuation of uterus (see 2 below) is usually necessary, he adds.
2. Surgical treatment Your gynae will perform a minor procedure called an evacuation of uterus. He inserts a suction tube into the cervix to remove the POC, before using a curette (a type of scraper) to scrape the womb lining clean of any remaining POC, Dr Chong notes. Your gynae may also prescribe medication (oral pills or a vaginal pessary) to soften the cervix before carrying out the evacuation so that he won’t need to open the cervix physically. This is to reduce the risk of cervix damage, he explains.
3. Induction of labour Women who miscarry after 14 weeks may need to have labour induced. This is to prevent the mother from dealing with the psychological trauma of having her gynae remove the big foetus part by part in a uterine evacuation. “Big foetuses are difficult to suck out,” Dr Chong explains. “On top of that, bigger wombs are softer and there is an increased risk of rupturing the womb in the evacuation process.” |
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