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If you lose a baby before 24 weeks of 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 APS- a syndrome that makes your blood more likely to 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 neck of the womb opened without any 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.
- Smoking and too much 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 ultrasound scan to check for any abnormalities in the shape of your uterus. If an abnormality is suspected, further investigations may include a vagina and cervix) or a abdomen and 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 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 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.
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.
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 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.
When you’re ready to take the plunge into parenthood, there’s no way to predict exactly how soon you’ll see a positive pregnancy test. If you’re in pretty good health, and having regular sex without birth control, you should expect to conceive in your first year of trying. In general, about half of couples will get pregnant within 6 months, and about 70%-80% will get pregnant within 1 year. But you and your partner can boost your odds of being parents-to-be by knowing the dos and don’ts of fertility. Set yourself up for success with these guidelines.
Him: Keep Tabs on Your Health
There’s a big connection between your overall health and your reproductive health, so making time for a quick health check can go a long way for your fertility.
Good diet, regular exercise, a healthy body weight, better sleep patterns, less stress -- all those things have been correlated with semen quality. Your doctor can help you make any changes you might need to be your healthiest self, as well as address any issues that might be a barrier to baby-making. Avoid hot baths and saunas- The testicles are a few degrees cooler than the rest of the body, because that's a better temperature for sperm production, so anything that warms them up can potentially be an issue. It takes your body 2-3 months to make new, mature sperm. Another heat source to watch out for: laptops.
Her: Learn How to Read the Signs
All pregnancies start when egg meets sperm. So they need to be in the same place at the same time. To help that happen, you can keep track of when your ovaries release an egg, called ovulation, and have sex during that time frame.
If your cycle is regular (with periods coming 26 to 32 days apart), that may just mean having sex on days 8-19 after your period. If you have irregular periods, you may not be able to rely on the calendar alone to know when you’re ovulating. However, there are other ways your body tells you it’s go-time.
To start, take note of your daily discharge. Cervical mucus increases and becomes very thin, stretchy, and clear as you approach ovulation. Watch for a consistency like egg whites.
You can also track your basal body temperature (BBT), which is your body’s temperature when it’s fully at rest. A rise of 0.6 degrees or more for over 10 days is a sign that you’ve ovulated. But your most fertile time is 2-3 days before that boost. When you track it for a few months, you’ll get an idea of when you might ovulate on your next cycle. For a more precise measure of those pre-ovulation days, you can buy an ovulation predictor kit from the drugstore. It tests your urine for hormone levels that spike a few days before ovulation.
Watch your weight: extra pounds make you more likely to have irregular menstrual cycles, or to not ovulate at all. Losing even a small percentage of body weight can increase fertility and decrease health risks during pregnancy.
Being too thin impacts fertility, too. Not only are you more likely to have irregular periods if you’re underweight, you’re also at risk for preterm birth once you do get pregnant, and your baby is more likely to be born at a low birth weight.
It's fine to get in some moderate activity. But engaging in strenuous, vigorous and extreme exercise might impact your menstrual cycle, leading to infertility. So, pass on the marathon when you're trying to get pregnant.
Both: Timing of intercourse
Once you’ve got a handle on your fertile window, set a good schedule for sex. We recommend couples have sex about every other day from a few days prior to ovulation until a few days after. Doing it more often doesn’t hurt your odds, but there are some studies that show it may lower a man's sperm count.
Before trying to concieve, review your medications with your doctor to be sure they don’t affect your fertility -- or won’t cause harm to a future baby.
Birth control pills use these hormones to prevent pregnancy. But if you’ve recently stopped taking them, there’s no need to fret about a post-pill waiting period. Your body should be ready to conceive right away, even if you took them for years. The length of time you used any form of birth control doesn’t affect your ability to get pregnant. Taking a daily folic acid supplement not only helps prevent birth defects, it may increase fertility as well.
Benefits of breastfeeding
- Breast milk contains the right balance of nutrients for your baby. Breast milk is easier to digest than is commercial formula.
- The antibodies in breast milk boost your baby's immune system. Breastfed babies get fewer colds and sinus and ear infections. They also have less diarrhea and constipation and a decreased chance of having allergies.
- Helps to increase the bonding with your baby
- Helps to reduce the risk of breast cancer in the mother
- No frantic runs to the store. No bottle cleanup. Many moms just roll over (especially if their baby is in a co-sleeper) and nurse in a sleepy state. Breast milk is instantly available and delivered warm.
- If you mostly breastfeed, you save money on formula
- Breast-feeding might even help you lose weight after the baby is born.
Its tough in the begining
Consider a breastfeeding class while you're pregnant. Getting baby to latch on may not feel natural. Ask for help in the hospital. Those first days, you might feel what experts call extreme tenderness -- and what we call pain. But once your baby is properly latched, discomfort should diminish during each nursing session and go away completely with time. Don't ignore shooting pain; a knot in the breast accompanied by soreness and redness could be a plugged milk duct, which can lead to mastitis, a nasty infection that requires antibiotics.
Start by getting comfortable. Support yourself with pillows if needed. Then cradle your baby close to your breast rather than learning forward to bring your breast to your baby. Support the baby's head with one hand and support your breast with the other hand. Tickle your baby's lower lip with your nipple to encourage your baby's mouth to open wide. Look and listen for a rhythmic sucking and swallowing pattern.
If you need to remove the baby from your breast, first release the suction by inserting your finger into the corner of your baby's mouth. If your baby consistently nurses on only one breast at a feeding during the first few weeks, pump the other breast to relieve pressure and protect your milk supply.
You're the food supply, so mother yourself
The nutrient needs of a woman are at an alltime high during breastfeeding. Keep taking prenatal vitamins, get ample calcium. By weight, 88% of breast milk is water. Breast milk volume increases from as little as 50 ml on the first day, to as much as 750 ml a day, when breastfeeding is well established. So, the most critical nutrient needed for the production of ample breastmilk to meet a suckling baby s demand, is water. Aim to drink at least 1.5- 2 litres/day.
You'll also need to learn to relax, however you can -- stress might affect letdown (the start of your milk flow). Take a warm shower, sink into a chair, and remember to breathe as you help your squirmy baby latch on.
Select wholesome food such as wholegrains, fruit, vegetables, low fat dairy products, lean meat, fish, poultry, eggs, beans, nuts and seeds to maximise the overall nutrient quality of your diet.If you need medication (for anything from a cold to a chronic condition), check with your doctor. Most meds -- but not all -- are fine in breast milk.