The Fact Is....
A significant proportion of all pregnancies end in miscarriage, mostly before a woman is aware she is pregnant
AND
About 15 percent of all known pregnancies miscarry.
The most common cause of miscarriage is from foetal death due to abnormalities
Other causes include infection, hormone factors, immune problems and disease in the mother
Exercise and intercourse do not cause miscarriage
The risk of miscarriage is higher for women over 35
A D & C operation (Dilatation and Curettage) to clean the uterus is recommended after some miscarriages, but may safely be avoided in certain circumstances.
Medical intervention is available for some women with recurrent miscarriages
What Is A Miscarriage? A miscarriage is when a foetus aborts before 20 weeks of pregnancy. It is also known as spontaneous abortion.
It is a common problem. About 15 percent of all known pregnancies end in miscarriage. About half of all conceptions are also believed to be lost, normally before the mother is aware she is pregnant.
Most miscarriages occur before the 13th week of pregnancy. Thirty percent of miscarriages that occur before the 8th week have no embryo inside the sac.
Most women who have miscarriages have a high chance of having a healthy baby when they get pregnant again. However, about one percent of women will have repeated miscarriages and need medical intervention to identify the reasons for this.
Women who have had two miscarriages in a row have a 35-40 percent chance of having another miscarriage.
What Are The Symptoms of Miscarriage? The first sign of a miscarriage may be stomach cramps (similar to period pain) and a small amount of bleeding. This is known as a threatened miscarriage and in many cases the symptoms will settle. A scan may confirm that all is well.
Women who do have a miscarriage will experience heavy bleeding, blood clots, nausea and painful cramps. The foetus may be seen and if more than four months pregnant, it could be alive.
Many miscarriages are incomplete and some placenta will still be inside the uterus. In these cases women are given a dilatation and curettage (D & C), to remove any remaining tissue.
The cause of a miscarriage usually goes undetected in the majority of women, mainly because up to 90 percent of women who have just had one miscarriage will go on to have a healthy baby.
Women with recurrent miscarriages can have an extensive medical examination involving blood testing to identify genetic problems, and hormone levels in the mother.
The uterus will be tested for infections and the structure of the uterus can be examined with a CAT scan or MRI.
In many cases the cause is not identified. Up to two thirds of recurrent miscarriages will be for unknown reasons.
What Are The Causes of Miscarriage? The most common cause of miscarriage is foetal death due to genetic abnormalities that occur when the foetus is developing. Sixty percent of all miscarriages in early pregnancy are due to genetic defects.
In some cases a fertilised egg does not attach itself to the wall of the uterus, or attaches itself to the wrong place.
Bacterial infections in the uterus may also be responsible for some miscarriages. However, infections can also be present in women who also have successful pregnancies.
Abnormalities in the uterus can also cause miscarriage. Fibroid tumours in the uterus and other structural problems can stop a foetus from implanting properly.
Women's own immune system may also have a role in pregnancy loss. It is believed some women's immune systems actually attack the placenta, instead of allowing it to help grow the foetus.
Alcohol, smoking and some medications may increase the risk of miscarriage.
Drugs to treat malaria, acne and cancer have been linked to a higher rate of miscarriage.
Other problems such as diabetes and thyroid disorders are also linked to miscarriage.
What Are The Myths about Miscarriage? There are many myths about miscarriage which have never been scientifically proven.
There is no evidence that exercise, working or intercourse increase the risk of miscarriage.
There is no evidence that working at a computer screen increases the risk of miscarriage.
There is no evidence that hair spray or hair dye increases the risk of miscarriage.
What Can be done to Help? Women who have a miscarriage are usually given a dilatation and curettage (D & C) immediately after the pregnancy loss. This is to remove any remnants of the pregnancy.
Rest is important for women have just had a miscarriage because they are likely to feel physically unwell and emotionally upset.
The bleeding will slow after a complete miscarriage or D & C, and completely stops after one week. Do not have sexual intercourse while you are bleeding or this could cause an infection.
It is recommended to have at least one period before getting pregnant again. It is possible to conceive just two weeks after a miscarriage.
Many women will feel grief after a miscarriage and they should express these feelings. Fathers may also feel grief. A funeral or a farewell ceremony can be helpful for some couples.
Treatment for recurrent miscarriage will depend on the cause. Assessment is usually done in specialised units.
Couples who have a genetic defect which may be causing the miscarriages may need counselling to come to terms with the issues.
Surgery is an option for women with abnormalities in the uterus, but this has no guarantees for a successful pregnancy in the future.
Women whose immune system is believed to be reacting against the pregnancy can take medication to help control this.
Getting Help Your doctor, midwife, or local hospital will be able to help.

Read "The Thing About Miscarriage is You Go To Pieces" - a moving account of the numbing effect of recurrent miscarriages
For more information take a look at our section on Miscarriage.
The Miscarriage Association is an excellent source of help, support and information.
December 2006
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