Miscarriages are devastating, no matter when they occur in pregnancy.
I’ll never forget mine. It was my first pregnancy, and it was right around eight weeks’ gestation. It was also the weekend of my sister’s wedding. It was heartbreaking and it was traumatic, and it definitely took some time to get over.
Months later even, I remember wondering what I could have done differently to prevent the miscarriage, or what I could have done to have caused it, but the painful truth is, the answer to both questions was nothing.
Abnormal chromosomes in the fetus cause most spontaneous miscarriages, just more than 50 percent of them, and most miscarriages occur during the first trimester with the risk decreasing as pregnancy progresses. After 15 weeks gestation, the chance of having a miscarriage is less than 1 percent.
Although they’re widely recognized as common, it’s difficult to know exactly how often miscarriages occur because many women experience them before they even realize they’re pregnant, said Dr. Lily Hahn, an OB-GYN with St. Elizabeth Physicians.
“A lot of women will have one right around the fourth or fifth week when they don’t even know their period is late yet,” she said. “They’ll just have a heavy, late period and won’t even know it was a miscarriage.”
Miscarriages are characterized by bleeding during pregnancy or pelvic pain, although they can be asymptomatic, as well, and not revealed until the time of the first ultrasound. They also can be difficult to diagnose because bleeding in early pregnancy can be normal in up to a third of pregnancies.
The fail-safe plan, Hahn advised, is if you have a positive pregnancy test and then experience bleeding or pain, call your physician for an evaluation. Ultrasounds are available at six weeks gestation.
And although there is nothing you can do in early pregnancy to prevent a miscarriage, it’s worth checking to see if you have an increased risk.
The biggest risk factor for miscarriage is pregnancy in a woman who is 35 or older, Hahn said, but the frequent use of pain relievers such as ibuprofen or aspirin during the first trimester carries a higher risk, as well, as does heavy smoking or drug use ““ specifically cocaine use ““ or previous miscarriages.
“If you’ve only had one miscarriage, you probably don’t have a higher risk than the general population for a subsequent miscarriage,” Hahn said, “but once you have two or three, your risk for miscarriage goes up exponentially.”
As agonizing as miscarriages can be, physicians typically don’t order diagnostic testing to look for a possible cause until a woman has experienced three early-pregnancy losses.
