Courageous after miscarriage

Monique Rainford, HER HEALTH

As I thought about my first column for the new year, the word 'courage' came to mind. Throughout my years of practising medicine, I have seen many women act courageously and sometimes they do not give themselves credit.

The example that comes readily to mind has to do with pregnancy. I have treated a number of women who have lost a pregnancy and some more than once. The reaction is often the same - sadness, self-doubt about whether their actions caused it, and fear regarding their ability to conceive again. However, despite all this, many courageously try again.

But why does it happen? Why should any woman miscarry a baby? Almost 20 per cent of pregnancies result in miscarriages. If the loss is before 10 weeks of pregnancy, it is usually caused by an abnormality of the developing foetus's chromosomes or genes. However, when a woman loses a pregnancy at about 18-20 weeks, it is often caused by problems with the cervix or the uterus.

Cervical incompetence

Women may have a condition called cervical incompetence, in which the cervix painlessly opens and can lead to the loss of the baby. Some women may have abnormalities in the structure of their uterus. In some cases, uterine fibroids which grow in the lining of the womb can also lead to miscarriage. Fortunately, surgery can treat some of these conditions. For example, women with incompetent cervix can have a suture around their cervix which greatly decreases their chances of losing the baby.

Other causes of miscarriage include certain infections, excessive smoking, alcohol use, and having too much caffeine (more than two cups of coffee per day). Women with certain health problems such as diabetes and polycystic ovary syndrome (PCOS) may also be at higher risk of a miscarriage. However, if the blood sugar level of a diabetic woman is well controlled, she is no longer at a higher risk of losing her pregnancy. If women with PCOS are treated with certain medications, their risk can also be reduced.

Excess stress

Many women fear that excess stress may have led to their miscarriage. So far, there is no proof that stress can cause miscarriages in early pregnancy.

A woman who has a miscarriage and attempts to become pregnant again is certainly courageous. She does confront fear, sometimes pain, and definitely uncertainty. Fortunately, most of these women, even if they have had more than one miscarriage, will one day take home a beautiful healthy baby. Let us reward these women in their courage and never seek to trivialise their pain.

Dr Monique Rainford is a consulting obstetrician and gynaecologist; email: yourhealth@gleanerjm.com.