Miscarriage: Understanding Pregnancy Loss

I miscarried at around seven weeks. I did everything right, even preparing myself prior to conception, and still I lost my baby. What causes pregnancy loss?

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ABOUT THE EXPERT

Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

Most mothers who have experienced pregnancy loss have the same question: "Why did this happen to me?" Only in a few circumstances can the care provider provide this information.

It is normal to question "why" or even feel responsible somehow, despite the fact that very few miscarriages are actually caused by some environmental factor or maternal activity.

The most common causes can be broken down into several categories:

Genetic: About half of all early miscarriages occur because of random chromosomal abnormalities. Chromosome imbalance caused by the absence or duplication of chromosomal material most often results in loss of a baby. There may be an alteration in chromosome numbers or a defect in chromosome structure itself. Some maternal genetic blood factors that produce conditions such as Factor V Leiden or Factor C may also be responsible for early pregnancy loss. Unfortunately, such factors may not be looked for until a woman has experienced two or more losses. Thereafter, it is best to seek out the services of a genetic counselor through the National Society of Genetic Counselors.

Anatomical: A defect in the connective tissue of the cervix may be responsible for "incompetence" occurring in the late first or early second trimester. An abnormality in the shape or capacity of the uterus may be responsible. Scar tissue may inpede implantation or development and larger myomas (fibroids) may cause improper implantation or may draw blood flow away from the developing embryo.

Hormonal: Women with hormonal abnormalities may experience infertility and when they do conceive, they are more likely to miscarry. Women with short post-ovulatory phases of the menstrual cycle may experience repeated miscarriages. And unfortunately, the incidence of miscarriage increases with age, from 15 percent at ages under than 25 years to 35 percent after age 38.

Immunological: Some infections or a specific immunity factor, such as "anticardiolipin antibodies" or antiphospholipid syndrome, may cause miscarriage. A medical professional would investigate such causes and perform blood studies to rule out such causes.

Male factors: There are increased numbers of early pregnancy losses that seem to be associated with low sperm counts or with a high ratio of abnormal sperm.

Environmental: Research on environmental causes of early pregnancy loss are still ongoing. We know that to create a healthy womb environment, women should eat a healthy diet prior to conception and not smoke or use drugs or alcohol. But does this mean that women who use drugs or smoke or eat junk food cause themselves to miscarry? It is unlikely.

The vast majority of miscarriages have nothing to do with the activities of the mother. But regardless, it is normal to feel responsible, and to feel guilt. We search for answers and we often look to ourselves first.

Knowing the facts does not mean that you will grieve any less. Feel free to express all the emotions you feel. Ask for support, and don't be surprised when even your partner or best friends don't know what to say or do. Just keep the lines of communication open, talking about the loss, so you can more easily move through the stages of grief. With eventual acceptance, comes the energy to move on

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