Miscarriages: What are the risks?

First, let’s talk about the generals of miscarriage, which is the spontaneous loss of a pregnancy before the 20th week (Mayo Clinic). After that 20-week mark, it’s called a stillbirth.

Most miscarriages occur in the first trimester before the 12th week, and the rate of miscarriage drops drastically after that in the second trimester (to 1-5%). It’s estimated that between 10-20% of all known pregnancies end in miscarriage, but the number of total pregnancies that end in miscarriage may be as high as 50%. The exact figure can’t be determined as so many miscarriages occur before the pregnancy is known and a miscarriage may appear as a typical period.

Miscarriage Risk Factors

Here are some things that may make you more likely to miscarry. If you’re early in your pregnancy now, making the choice to avoid some of these risk factors (smoking, drinking, etc) will improve your odds of having a “successful” pregnancy.

• Having had repeat miscarriages.

• Being 35 or older. At age 35, the risk is about 20%. At 40, it doubles 40%. And at 45, the risk doubles yet again to 80%.

• Smoking, drinking alcohol or using drugs. Each cigarette smoked per day equates to a roughly 1% increase in the risk of miscarriage. Even if you don’t personally smoke, second-hand exposure to smoking increases the risk of miscarriage by 11%. In terms of drinking, consuming any alcohol at all during pregnancy increases the miscarriage risk by 19%.

• Obesity. Studies have found a link between obesity and increased risk of not only just miscarriage, but recurrent miscarriages. Obesity also increases the risk of stillbirth.

• Preexisting diabetes. Hight blood sugar levels in early pregnancy have been linked to an increased risk of not only miscarriage, but birth defects. If you are trying to conceive and have type 1 or type 2 diabetes, be sure to speak with your physician about making your blood sugar management a priority.

Okay, but what about exercise or sex during pregnancy?

These are considered “routine activities” that don’t cause miscarriage. With exercise, pregnancy is not the time to begin a new strenuous routine, but you can continue with the physical activity you’re used to from pre-pregnancy.

As far as sex is concerned, baby is well protected inside the amniotic fluid in the uterus. If you have pregnancy complications like an incompetent cervix, however, make sure to speak with your OBGYN to know what’s best and safest for you and your pregnancy.

Causes of Miscarriage

Most miscarriages (roughly 50%) are caused by chromosomal abnormalities, such as having too many or too few. One study even estimates these abnormalities may be the cause of as many as 70% of all miscarriages!

Chromosomes contain baby’s genetic code, and typically each person receives 23 pairs of chromosomes. Each pair contains a chromosome from mom and a chromosome from dad. Not all chromosomal abnormalities are incompatible with life, however, such as with Down syndrome (which has a partial or full copy of chromosome 21).

Miscarriages can also be caused by problems with the uterus or cervix, including:

• Septate uterus: This is the most common type of congenital uterine abnormality , in which there’s muscle/tissue dividing the uterus into two pieces. This can also cause repeat miscarriages.

• Asherman syndrome: May cause repeat miscarriages before even knowing you’re pregnant, as this condition leaves scars/scar tissue that can damage the lining of the uterus. If you have Asherman syndrome, speak with your OBGYN prior to pregnancy about the possibility of a hysteroscopy to remove scar tissue.

• Fibroids: Fibroids can limit the baby’s space and also interfere with the baby’s blood supply. A surgery called myomectomy can remove them pre-pregnancy.

• Incompetent cervix: For some women, their cervix dilates (or opens) too early in pregnancy, and it’s usually without contractions or any other sign that there may be an issue, which can lead to miscarriage (usually in the second trimester) or a premature birth. In this case, your OBGYN may recommend a cerclage, which is a stitch put into the cervix to help keep it closed.

Another possible cause of miscarriage would be infection. Early testing and treatment for sexually transmitted infections are incredibly important during pregnancy. Additionally, an infection known as listeriosis (a kind of food poisoning) can cause miscarriage; if you have any concerns that you may have listeriosis, contact your OBGYN, and you may receive antibiotics.

Signs and Symptoms of Miscarriage

Some of the more common signs and symptoms include vaginal spotting/bleeding, pain or cramping in the abdomen or lower back, or fluid/tissue passing from your vagina.

However, spotting/bleeding and cramping can be experienced in the first trimester of a pregnancy that continues to term and results in a healthy baby. Because of that, be sure to speak with your OBGYN if you have any concerns!

Grieving Post-Miscarriage

It’s not uncommon to grieve a miscarriage. It’s the loss of a life—maybe the loss of a life you had been longing for years for, or maybe this “surprise” baby revealed some surprising emotions in you that you didn’t expect.

If you’re in need of support as you walk through a journey of grief, here are some resources for you:

Local grief support in the Modesto, CA area:

• Community Hospice: Grief Support Services

  • Community Hospice Grief Specialists are honored to walk beside you during your journey of grief. Allow us to provide a safe place to talk and share your stories, a place to receive resources, and a place to cry where your pain can be expressed. At Community Hospice, our services are free of charge to the entire community. We offer grief resources and individual grief support for anticipated grief or after loss has occurred.

• Jessica’s House

  • Jessica’s House provides support in a safe place for children, teens, young adults and their families grieving a death because no one should grieve alone. During a time of unimaginable loss, Jessica’s House peer support groups provide grieving children, teens, young adults and their families with moments of connection, expression through art and play, and opportunities to share and practice coping skills. These groups are provided at no charge to families thanks to generous private support from our community.

    Families attend group together and share a meal as they arrive. After dinner, each person in the family attends group with their peers. Each group session is 1.5 hours and facilitated by Jessica’s House staff and trained volunteers.

Virtual support available everywhere:

• Empty Cradle

  • Empty Cradle is a peer support group for parents who have experienced the loss of their baby due to miscarriage, stillbirth, TFMR, infant death, SIDS or SUID. Our goal is to offer bereaved families support via a resource parent network, through monthly meetings, written materials and partnership with the health care community. For information about our monthly meetings please visit our Support Meetings.

• Miscarriage Hurts

  • We are a team of men and women who understand that miscarriage is a painful experience, and that there are few places to go to find healing and support. Each of us has been touched by miscarriage in one way or another, and we have recognized the need for a place of healing. Miscarriage Hurts is meant to offer a safe place to share your story, help you better understand your own personal experience, and connect you to resources that can provide support for your specific needs.

• Sierra Pregnancy + Health

  • At Sierra Pregnancy + Health we recognize reproductive loss can have a significant effect on men, women, family members and loved ones. We want to change the culture of disenfranchised grief and offer a safe place for those grieving to find hope and healing. We offer faith-based and secular support through individual or group meetings and for those not in the greater Sacramento area, we provide remote support through confidential video conferencing.