Understanding Miscarriages
Medically known as a "spontaneous abortion," for most couples a miscarriage normally happens only one time. The cause is usually an isolated chromosomal abnormality that occurs when fertilization involves a randomly defective egg or sperm. The condition, known as a blighted ovum, means the embryo is simply too weak to survive. When this type of conception occurs, all the usual hormonal activity associated with pregnancy takes place, causing the body to feel and act as if a normal gestation is in progress. But while the placenta begins to grow, making you "feel" pregnant, the defective embryo does not.
Usually, within the first twenty weeks after conception, the body recognizes that something is wrong. The placenta begins to shrink, which in turn causes a rise in prostaglandin, a body chemical linked to inflammation. When this occurs, cramping, staining, and bleeding, which are the classic signs of miscarriage, can also begin, and the pregnancy is lost.
While sometimes the now-useless placenta gets reabsorbed by the body, other times it remains an empty sac inside the uterus, in which case it must be removed, usually by D&C, a procedure that either scrapes the inside of the uterus or uses suction to "vacuum" but what remains of the placenta.
Under most circumstances, the next attempt at conception is healthy and normal. In fact, because reproductive hormones are often at their peak just before a miscarriage you should try for another pregnancy as soon as one month following your loss. Most find this second conception faster, easier, and healthy.
For some prospective parents, however, pregnancy loss is not an isolated event. A growing number of couples are continually plagued with what is medically "called "habitual abortion," losing every conception that occurs. These couples are, in fact, considered to be infertile, unable to bring their pregnancy to term.
In the past, recurring miscarriage was thought to be caused by just one of two problems:
1. Structural abnormalities within the mother's body, such as a blockage or deviation in the uterus, or weakness in the cervix or,
2. Chromosomal abnormalities within either partner's body. Here, chronically defective genetic material present in either the egg or the sperm allows a pregnancy to occur, but ultimately results in miscarriage.
Now, however, much has changed. Although both structural and chromosomal abnormalities still account for a good number of recurring miscarriages, we now know there are also a significant number of other reasons why pregnancy loss occurs. These include biological factors in the mother, such as hormone imbalance (particularly a shortage of progesterone), endometriosis, stress, diabetes, and infection
Additionally, the older you are when you get pregnant, the greater your risk of pregnancy loss. Women aged twenty to twenty-nine, for example, have a normal miscarriage rate of just 10 percent, while for those over age forty-five the risk can jump to nearly 50 percent. If you had difficulty conceiving, if you have a history of premature labor or premature birth, or if you have had four or more abortions, you might also be at higher risk for miscarriage. Other factors that increase your risk include a history of PID (pelvic inflammatory disease), repeated bouts with STDs (sexually transmitted diseases), recurring UTIs (urinary tract infections), or if your mother took DES when she was pregnant with you.
