A miscarriage is defined as an early termination of gestation. There are several types of miscarriage: early miscarriage when it occurs during the first trimester of pregnancy (the most frequent), late miscarriage when it occurs during the second or third trimester. In some cases, women may suffer repeated miscarriages. Repeat miscarriage occurs when there are at least 3 consecutive spontaneous gestations before 14 weeks' amenorrhea. There are many reasons for miscarriage: infections, genetic abnormalities, health problems... Often, no reason is given. Charline, a midwife, talks to us about miscarriage and the emotional impact it has on women and couples. Often passed over in silence, miscarriages are today a real taboo that isolates and places certain women and couples in great distress.
How many couples are affected by miscarriages?
It is estimated that around 10.8% of couples will suffer a miscarriage in their lifetime. It's also important to note that it's not uncommon to have one or two miscarriages (1-2%). Some women also suffer a third miscarriage (0.7%).
The Lancet has published a study carried out on a total of 4.6 million pregnancies in Europe and North America, which shows that 23 million miscarriages occur worldwide every year, representing around 15% of all pregnancies. 44 pregnancies are lost every minute, and 1 in 10 women will suffer a miscarriage in their lifetime.
What are the symptoms of miscarriage?
Most of the time, one of the warning signs of miscarriage is bleeding. However, this is not always the case, and some miscarriages are discovered during a follow-up ultrasound. Even s'you should always consult your doctor if you experience bleeding during pregnancy, but it's important to remember that many women experience bleeding during the 1st trimester, but only 50% of bleeding is a sign of miscarriage.
The causes of bleeding are sometimes unknown. Some doctors refer to periods anniversaries. Sometimes it may be due to a slight detachment of the placenta, but this does not endanger the pregnancy. The reason for the bleeding is not always obvious. In all cases, you should seek medical advice if you notice bleeding and are pregnant.
During a miscarriage, you may feel cramps in your lower abdomen. These cramps, similar to periods pains or labor contractions, are uterine contractions used to evacuate the embryo or fetus from the mother's uterus.
Another symptom of pregnancy termination is the sudden disappearance of signs of pregnancy, such as nausea and tense breasts.
How is a miscarriage managed?
Either the miscarriage is eliminated with the bleeding, or to speed up the process, medication can be taken to evacuate the pregnancy. When the pregnancy is at a more advanced stage, an aspiration or curettage is required.
There are several types of bleeding: there's the first bleeding, when people don't yet know they're having a miscarriage. At this point, some women may lose large clots, which may be the pregnancy (this is not systematic). In all cases, after a miscarriage, bleeding is systematic, whether or not a curettage has been performed. This bleeding, which is often abundant, evacuates the endometrium, i.e. the uterine mucous membrane that had developed to accommodate a pregnancy.
This bleeding generally lasts about ten days. Once the bleeding has stopped, it is perfectly possible to start planning a new pregnancy.
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What causes miscarriage?
The causes of miscarriage depend on the type of miscarriage: isolated or recurrent. The risk of miscarriage increases with age, rising from 12% at 25 to 50% at 42. Isolated miscarriages are often due to an abnormality in the development of the fetus, but most of the time, little research is done. The most likely hypothesis is that the fetus has chromosomal abnormalities that halt its development. In the case of recurrent miscarriages, it is necessary to carry out an assessment to determine the causes. Some of the most common are: uterine malformations, uterine cavity anomalies, hormonal disturbances, blood coagulation abnormalities and genetic abnormalities. Obesity, smoking, excessive consumption of alcohol, drugs or coffee, vitamin deficiencies or even exposure to pesticides can all contribute to miscarriage. However, it should be stressed that the cause of recurrent miscarriage is not systematically identified.
Post-miscarriage precautions
As previously stated, after a miscarriage, it is perfectly possible to start a new pregnancy project. In the case of early, non-recurrent miscarriages, gynecologists even recommend trying again fairly quickly, without waiting several months.
Miscarriage: the taboo of silent pain
Coping with a miscarriage can sometimes be complicated. Indeed, it's the loss of a pregnancy, in which many project themselves, that is often very difficult. There are no degrees of pain for everyone. No matter how far along the pregnancy is, there's still mourning to be done. It's perfectly normal to feel sad after a miscarriage. Don't hesitate to talk about it and express your sadness if you feel the need to, because miscarriages happen all the time, and not just to other people.
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