If you lose a baby before 24 weeks of pregnancy, it is called a miscarriage. If this happens in the first 3 months of pregnancy, it is known as an early miscarriage. Unfortunately, early miscarriages are common, with 10 20 in 100 (10 20%) pregnancies ending this way. Late miscarriages, after 3 months of pregnancy but before 24 weeks, are less common: 1 2 in 100 (1 2%) pregnancies end in a late miscarriage. When a miscarriage happens three or more times in a row, it is called recurrent miscarriage. Recurrent miscarriage affects 1 in 100 (1%) couples trying to have a baby.

Why does recurrent miscarriage and late miscarriage happen?

Sometimes there is a reason found for recurrent and late miscarriage. In other cases, no underlying problem can be found. Most couples are likely to have a successful pregnancy in the future, particularly if test results are normal.

There are a number of factors that may play a part in causing recurrent and late miscarriage:

Age, the older you are, the greater your risk of having a miscarriage. If the woman is aged over 40, more than 1 in 2 pregnancies end in a miscarriage. Miscarriages may also be more common if the father is older.
Antiphospholipid syndrome (APS- a syndrome that makes your blood more likely to clot) is uncommon but is a cause of recurrent miscarriage and late miscarriage.
Thrombophilia (an inherited condition that means that your blood may be more likely to clot) may cause recurrent miscarriage and in particular late miscarriages.
Genetic factors, about 2 5 in 100 couples (2 5%) with recurrent miscarriage, one partner will have an abnormality on one of their chromosomes (the genetic structures within our cells that contain our DNA and the features we inherit from our parents). Although this may not affect the parent, it can sometimes cause a miscarriage
Weak cervix is known to be a cause of miscarriage from 14 to 23 weeks of pregnancy. This can be difficult to diagnose when you are not pregnant. It may be suspected if in a previous pregnancy your waters broke early, or if the neck of the womb opened without any pain.
Developmental problems of the baby may lead to a miscarriage but are unlikely to be the cause of recurrent miscarriage.
Infection that makes you very unwell can cause a miscarriage. Milder infections that affect the baby can also cause a miscarriage. The role of infections in recurrent miscarriage is unclear.
An abnormally shaped uterus may contributes to recurrent miscarriage or late miscarriages. However, minor variations do not appear to cause miscarriage.
Diabetes and thyroid problems can be factors in miscarriages. They do not cause recurrent miscarriage, as long as they are treated and kept under control.
It has been suggested that some women miscarry because their immune system does not respond to the baby in the usual way. This is known as an alloimmune reaction. There is no clear evidence to support this theory at present. Further research is needed.
Are there any other risk factors?

Being overweight increases the risk of miscarriage. Smoking and too much caffeine may also increase the risk. Excessive alcohol is known to be harmful to a developing baby and drinking five or more units a week may increase the risk of miscarriage.

The chance of a further miscarriage increases slightly with each miscarriage. Women with three miscarriages in a row have a 4 in 10 chance of having another one. This means that 6 out of 10 women (60%) in this situation will go on to have a baby next time. 

Why are investigations helpful?

Finding out whether there is a cause for your recurrent miscarriage or late miscarriage is important as your doctor will be able to give you an idea about your likelihood of having a successful pregnancy. In a small number of cases there may be treatment available to help you.

What investigations might be offered?

Blood tests:

For APS- APS is diagnosed if you test positive on two occasions 12 weeks apart, before you become pregnant again.
For thrombophilia- If you have had a late miscarriage you should be offered blood tests for certain inherited thrombophilias.
To check you and your partner s chromosomes for abnormalities. You may be offered this test if your baby has been shown to have abnormal chromosome
Tests for abnormalities in the baby You should be offered tests to check for abnormalities in your baby s chromosomes. This is not always possible but may help to determine your chance of miscarrying again. If you have had a late miscarriage you may also be offered a postmortem examination of your baby. This will not happen without your consent and you will have the opportunity to discuss this with your health team beforehand.

Tests for abnormalities in the shape of your uterus. You should be offered a pelvic ultrasound scan to check for any abnormalities in the shape of your uterus. If an abnormality is suspected, further investigations may include a hysteroscopy (a procedure to examine the uterus through a small telescope which is passed through the vagina and cervix) or a laparoscopy (a procedure in which a surgeon uses a fine telescope to look inside the abdomen and pelvis).

Tests for infection. If you have had a late miscarriage, tests such as blood samples and vaginal swabs may be taken at the time to look for any source of infection.




What are my treatment options?

Treatment for APS

If you have APS and have had recurrent miscarriage or a late miscarriage, treatment with low-dose aspirin tablets and heparin injections in pregnancy increases your chance of having a baby. Aspirin and heparin make your blood less likely to clot and are safe to take in pregnancy.

Having APS means you are at increased risk of complications during pregnancy such as pre-eclampsia, problems with your baby s growth and premature birth. You should be carefully monitored so that you can be offered treatment for any problems that arise.

Treatment for thrombophilia

If you have an inherited tendency to blood clotting (thrombophilia) and have had a miscarriage between 12 and 24 weeks of pregnancy, you should be offered treatment with heparin. At present there is not enough evidence to say whether heparin will reduce your chance of miscarriage if you have had early miscarriages (up to 12 weeks of pregnancy). However, you may be still offered the treatment to reduce the risk of a blood clot during pregnancy.

Your doctor will discuss what would be recommended in your particular case.

Referral for genetic counselling

If either you or your partner has a chromosome abnormality, you should be offered the chance to see a specialist called a clinical geneticist. They will discuss with you what your chances are for future pregnancies and will explain what your choices are. This is known as genetic counselling.

Monitoring and treatment for a weak cervix

If you have had a miscarriage between 14 and 24 weeks and have a diagnosis of a weak cervix, you may be offered an operation to put a stitch in your cervix. This is usually done through the vagina at 13 or 14 weeks of pregnancy under a general or spinal anaesthetic. Your doctor should discuss the surgery with you.

If it is unclear whether your late miscarriage was caused by a weak cervix, you may be offered vaginal ultrasound scans during your pregnancy to measure the length of your cervix. This may give information on how likely you are to miscarry. If your cervix is shorter than it should be before 24 weeks of pregnancy, you may be offered an operation to put a stitch in your cervix.

Surgery to the uterus

If an abnormality is found in your uterus, you may be offered an operation to correct this.

Hormone treatment

Taking progesterone or human chorionic gonadotrophin hormones early in pregnancy has been tried to prevent recurrent miscarriage. More evidence is needed to show whether this works.

Immunotherapy

Treatment to prevent or change the response of the immune system (known as immunotherapy) is not recommended for women with recurrent miscarriage. It has not been proven to work, does not improve the chances of a live birth and may carry serious risks (including transfusion reaction, allergic shock and hepatitis).

What if no cause is found?

Where there does not appear to be a cause for recurrent miscarriage or late miscarriage, there is currently no evidence that heparin and aspirin treatment reduces the chance of a further miscarriage. For that reason this treatment is not recommended in these circumstances.

What does this mean for us in the future?

You and your partner should be seen together by a specialist health professional. Your doctor will talk to you both about your particular situation and your likelihood of having a further miscarriage and a successful pregnancy. If a cause has been found, possible treatment options will be offered to you to improve your chance of a successful pregnancy.

For couples where no cause for recurrent miscarriage has been found, 75 in 100 (75%) will have a successful pregnancy with this care. It is worth remembering that the majority of couples will have a successful pregnancy the next time even after three miscarriages in a row.

Recurrent And Late Miscarriage - Tests & Treatment For Couples!

Natural therapies are a great option to support your body and prepare it for pregnancy. As with any approach trying to decrease the chance of miscarriage, these steps will help to nourish and support the body, inviting a healthy pregnancy to occur.

Preparing ahead of time for your pregnancy is also important for decreasing the chance of a miscarriage, these steps must be practiced for at least 3 months before you become pregnant again. If you are currently experiencing a miscarriage contact your doctor or midwife right away.

Prepare for conception: The first step is to prepare your body with fertility cleansing. Fertility cleansing helps you to support the liver in cleansing the body of old toxins and excess hormones while encouraging the uterus to cleanse itself of  old  contents, increasing uterine circulation and tone.

Eat a nutrient dense fertility diet: The next step is to nourish and build up your body to be a healthy, baby friendly body. This can be done through eating a well balanced and nutritious diet. What you eat has a strong impact on:

The health of your eggs
Your hormonal balance
Creating a healthy placenta
Decreases chance of a miscarriage
Building nutrient storage for baby
Creating a healthy reproductive system
Build a healthy foundation: One of the major foundational steps to increase your chance of having a healthy pregnancy is to take some basic vitamins, minerals, and EFA s. There are specific vitamins and minerals that are necessary for a healthy reproductive system, hormonal balance, and ovulation. Essential fatty acids are also extremely important for miscarriage prevention.

Recurrent Miscarriage - How Can It Be Avoided?

For a mother, a miscarriage is the last thing she would want to hear. It can pin her down psychologically, leading to trauma and stress in unfathomable measures. To understand miscarriage better: it is a condition wherein there is a loss of pregnancy within the first 22 weeks of getting pregnant. The primary symptom of a miscarriage is bleeding from the vagina. So if you experience vaginal bleeding during this phase, then consult a doctor for further guidance.

Why do they occur?
There are many reasons as to why a miscarriage may occur and no study has been able to put a finger on any one specific cause. Having said that, miscarriages are mainly caused due to the presence of unusual chromosomes in the baby. Chromosomes are genetic material that directs the growth and development of a baby. Chromosomes present in either excess numbers or less can hinder the development of the baby. If the miscarriage occurs during the second trimester (14th to 26th week), then it can be accrued to a health anomaly in the mother. A miscarriage may also occur because of a weak cervix as a weak cervix will not be able to hold a pregnancy. This condition is called cervical insufficiency and occurs when the woman is in her second trimester.

Is it possible to prevent them?
In most cases, miscarriages cannot be prevented. For women who have suffered multiple miscarriages, multiple medications might be required to help with their subsequent pregnancies. Following a healthy lifestyle is recommended as it can minimize the risk of a miscarriage. One must abstain from smoking and substance abuse and limit consumption of alcohol in order to keep the body in optimal condition. It is advised to maintain optimal weight levels and eat a well-balanced diet.

Post miscarriage
A miscarriage is a very traumatic experience for a mother to be; it can be emotionally debilitating. That is the reason counseling can help in times such as these. Start planning for a baby only once the symptoms have subsided and you have also had a period post the miscarriage. It is important to make sure that you are physically and emotionally ready to have a baby. Remember, a miscarriage doesn t mean the end of the world. One can enjoy a fully healthy and a successful pregnancy even after a miscarriage.

Miscarriage - Why it Happens?

For some women, having their own children is not as easy as it seems. Suffering from more than two or more miscarriages is known as recurrent miscarriage. This experience affects every aspect of a woman s life from her mental and emotional health to her physical health and social well-being. 

It is important for a woman undergoing this experience to keep in mind that she can still give birth to a healthy baby even after recurrent miscarriages.

Look after your health: Miscarriages are not very uncommon and in many instances are a result of the woman s body not being able to take the strain if a growing fetus. Hence, pay attention to your health to prepare your body for future pregnancies. Avoid smoking, alcohol, caffeine and exposure to toxins that can cause fertility problems. Eat healthy food and start taking a multivitamin with folic acid on a daily basis. Exercise regularly, but avoid strenuous activities that involve heavy lifting or dangerous contact sports. Yoga is great for pregnant women or women planning a family as it tones your body keeps your stress levels low.
Talk to people: A miscarriage can affect your emotional health and self-image, but you must remember that you are in a way responsible for the miscarriage. Talk to other women who have had a similar experience and share your feelings with them. Men and women cope with a miscarriage in different ways and hence work on communicating your feelings with your partner. Do not suppress your feelings, but acknowledge them and work through them. You may also find it beneficial to talk to a counsellor or get involved with a support group.
Give yourself a break: It s ok to not attend your friend s baby shower when you ve recently suffered a miscarriage. Instead of surrounding yourself with your friend s babies and children, take a break and pay attention to yourself. Develop a hobby or find something to keep yourself busy. Take a holiday with your partner and find ways to reconnect with them. Find your own way of acknowledging the pregnancy. This could be in the form of writing about it, naming the baby or planting a tree in memory of the baby.
Get proactive: Don t sink into despair because of your miscarriages. Educate yourself about the various reasons you may have miscarried the baby by reading books or talking to medical professionals. This can help prevent future miscarriages.

Recurrent Miscarriage - How to Deal With It?

Miscarriage is the early loss of foetus within 20 weeks of pregnancy. It is also known as  spontaneous abortion . According to research, about 8-20% of the pregnancies end in miscarriage. Out of the total number of miscarriages, 80% of them end within 12 weeks of pregnancy.

Types of Miscarriages and their Symptoms 

Threatened Miscarriage   As the term suggests, in this condition the process of miscarriage might have begun. This is the initial stage of the process. In threatened miscarriage, there is slight bleeding accompanied by cramps and pain in the lower back, which is usually mild. The cervix (the lower part of the uterus) remains closed. 
Inevitable and Incomplete Miscarriage   In these conditions, there is bleeding along with an open cervix. When there is dilatation and thinning of the cervix, miscarriage is inevitable. In incomplete miscarriage, part of the tissue comes out and a part remains inside the uterus. In inevitable and incomplete abortions, the bleeding and cramps are more severe. 
Complete Miscarriage   Complete miscarriage is when the embryo has completely emptied from the uterus. The pain and bleeding reduce once the foetus is expelled. This can be confirmed through ultrasound. 
Missed Miscarriage   In Missed miscarriage, there is no sign of the life of the embryo and there is no expulsion of the embryo. It can be detected from the absence of heartbeat of the embryo found on ultrasound. 
Recurrent Miscarriage   It happens when there are two or three miscarriages one after the other. It affects about 1% of the pregnancies. 
Risk Factors 

Increased maternal age i.e., women above 35 years. 
Excess or insufficient chromosome in embryo. 
Placenta is the organ which links mother and the baby for blood supply. Problem in the development of placenta can cause miscarriage. 
Excessive smoking and drinking during pregnancy. 
Obese women have higher risk of miscarriage. 
Long-term health conditions like high blood sugar, high blood pressure, liver disease etc.
Infections like rubella, malaria etc. 
Weakened cervix, which is the result of previous injury or surgery, can also result in miscarriage. 
What are the symptoms of a miscarriage? 

Bleeding or spotting can be one of the symptoms of miscarriage. It should be kept in mind that not all pregnant women who suffer from spotting or bleeding, end in miscarriage. 
Lower backache starts before or right after bleeding, which can be persistent or you could have cramps which may be mild or sharp and can feel like more of pelvic pressure. 
Missed miscarriages are detected through ultrasound when the doctor finds that there is no heartbeat of the embryo or when the uterus is not growing. 
What are the treatment options in miscarriage? 

Medical   In most of the cases, there are no specific drugs to stop a miscarriage from occurring. In some cases, certain hormonal preparations help. There is no point in prescribing medicines for prevention of miscarriage if there is heavy bleeding. 
Surgery   Dilatation and evacuation (D&E) is a simple operation which is done under general/local anaesthesia. In this operation, the cervical canal is dilated and contents present in the uterus are evacuated. There is no cutting involved as it happens through the vagina. The process needs only five to ten minutes, but the patient has to stay in the hospital for about 3-4 hours. 
This process is opted when: 

There is heavy bleeding. 
The patient suffers from missed miscarriage. 
What can you do to prevent miscarriage? 

Nothing much can be done to prevent miscarriage in most of the cases. However, following supportive measures may help: 

There should not be overexertion during pregnancy. Moderate amount of physical activity is permissible. 
One should have a well-balanced diet. Studies have shown that a diet loaded with fruits and veggies helps in overall well-being during pregnancy. One should limit the consumption of caffeine. 
Avoid smoking, alcohol and certain drugs to prevent miscarriage. 
Avoid stress and anxiety. 
Report to Doctor (preferably Obstetrician) as soon as any symptom related to miscarriage appears.

Miscarriage - Symptoms, Treatment and Prevention

Being a mother is the greatest gift to womankind. Every woman dreams of bearing a child. The feeling of being a mom is beyond any description. For some women, conception becomes a long and painful struggle. The fetus requires a complete 28 weeks to mature. Women who are unable to hold fetus or where fetus ceases to grow to suffer complications. Abortion is a term used for medical termination of pregnancy. It can be induced by drugs or surgery. However, complications can arise within any trimester causing a miscarriage. Miscarriage refers to the loss of a fetus before 20 weeks of pregnancy. A miscarriage is medically known as spontaneous abortion that may occur due to fetal or maternal complaints.

The symptoms of a spontaneous abortion are severe pain, cramps or heaviness in abdomen, fluid or tissues passing from the vagina or vaginal spotting or bleeding. These are warning signs and immediate gynaecologist attention is required in case of any such symptoms.

Let s look at some of the causes of miscarriage:
Faults in the genetic makeup of the fetus or chromosomal abnormalities can cease fetal growth.
Immune system disorders
Infection such as syphilis, rubella, poliomyelitis can lead to fetal death
Trauma and injury due to accidents may cause loss of fetus
Lifestyle factors such as excessive smoking, drinking, drug abuse can lead to fetal death.
Women with fibroids, cysts, menstrual issues or uterine abnormalities have a tendency for recurrent abortions.
Women with hormonal imbalances also tend to suffer miscarriages.

Homeopathy, with its holistic systems approach, provides highly individualised treatment for recurrent abortions. This all natural treatment targets the symptoms of the disease in totality. Homeopathic treatment of miscarriages goes beyond treating complications in conception and aims to restore uterus health and hormonal balance. It also deals with psychological symptoms like mood swings, irritability, anger, depression and fear that become associated due to recurrent failures in pregnancy. Morning and evening sickness can also be effectively managed through homeopathic medication.

Apart from this, homeopathy effectively combines a preventive and curative approach to treatment. It ensures that the patient is treated for the miscarriage and her health be restored for further conception.

Arnica is a well-known remedy for miscarriages in case it happens due to falls, lifting weights or violent concussion. If given in time, it may reduce the chance of miscarriage.
Caulophyllum: deals with the tendency of miscarriage due to weakening of uterine tissues.
Crocus Sativa: Deals with the tendency of abortion in Ist or 2nd month and issues like mood swings, violence, repentance and sadness.
Erigon: effective remedy for irritability, abortion due to exercise and profuse bleeding.
Sepia: Deals with morning sickness, depression, the tendency to abort in 5th to 7th month.

These and many other remedies are available for effective and long term treatment. Remember to consult a qualified homeopathic doctor for the same.

Homeopathy Remedies to Restoring Fertility After Miscarriage

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