Miscarriages and Stillbirths:
Miscarriages are medically referred to as spontaneous abortions. This term is used to describe the loss of a fetus in the first half of pregnancy (before 20 to 24 weeks). After this time, if a baby dies in a mother's uterus on or after the 24 week mark, it is known as a stillbirth.
Both events can be devastating for prospective parents, so understanding the causes, what precautions can be taken and how to deal with the feeling of loss caused by a miscarriage or stillbirth is vital.
In this section we look at: the risks of miscarriage and stillbirths, possible causes, and what diagnosis can be given for miscarriages and stillbirths.
What Causes Miscarriages?
Women can miscarry for various reasons. Most of the early miscarriages occur when the embryo fails to attach to the wall of the uterus because the lining isn't prepared for implantation or because the embryo has severe chromosomal or developmental defects. The presence of an autoimmune disorder, severe infection or illness, or an abnormality in the shape of the womb may also occasionally lead to miscarriage. If the embryo is exposed to so-called 'teratogenic' substances (e.g. x-rays, certain medications or drugs) within the first two weeks of conception, then either a very early miscarriage will take place or the pregnancy will go ahead as normal and the child will not have been damaged. The cause of most miscarriages, however, is not known.
Later miscarriages can be caused by problems such as genetic or chromosomal defects; abnormalities of the uterus (for example, a subdivided/septate uterus) or of the placenta; severe illness; metabolic disease in the mother (diabetes or thyroid problems); bacterial or viral infections (e.g. toxoplasmosis and listeriosis); or incompetence of the cervix.
The chances of a woman miscarrying increase with age, and also (but less so) with the number of previous pregnancies. As miscarriage is common, affecting nearly 15% of clinically recognised pregnancies, many women may have a miscarriage if they have enough pregnancies. Thus, a history of miscarriage doesn't really make it any more likely that you'll go on and miscarry again. It's advisable, however, to wait at least three months before attempting to conceive after a miscarriage, as the uterus lining needs some time to recover.
Rarely, some women have what is known as recurrent miscarriage, but this refers to those with three or more consecutive miscarriages. This is sometimes due to a medical reason such as one of the parents carrying a predisposition to chromosome problems in the baby, or the mother having an autoimmune problem or an abnormally shaped uterus. The majority of women who miscarry go on to have a successful next pregnancy.
The most common symptoms of miscarriage are similar to those of a period and are bleeding (which occurs in 95% of cases), possibly with clots, and/or cramp-type pain.
Stillbirth/ Intrauterine Deaths:
Stillbirth is the delivery of a dead fetus in the last half of pregnancy. In Ireland, it is still defined as delivery after 24 weeks, whereas increasingly a definition of delivery after 20 weeks is used. Stillbirth is also sometimes referred to as late fetal death or intrauterine death.
Sadly, the exact cause of stillbirth remains unknown in over 30% of cases. In the rest of the cases, stillbirth may be due to poor fetal growth, severe fetal abnormality, placental problems, pre-eclampsia, uncontrolled diabetes, severe cases of Rhesus incompatibility, infections, antepartum haemorrhage and post-maturity. This is one reason why obstetricians usually recommend induction of labour at term (from 38 weeks) if there are problems in the pregnancy.
How common is it? The incidence of stillbirths in Westernised countries is fortunately declining, having fallen from around 2% in the UK in the 1950s to 0.3% in the early 1990s. Stillbirths tend to be more common in deprived communities, in older women and in women who receive poor care during their pregnancy.
What are the signs? If the baby has died movements stop, the uterus may also start to shrink and there is weight loss.
Stillbirth is often preceded by a reduction in fetal movements in the days or week before the baby dies inside the womb. For this reason, if you're over 30 weeks pregnant, it's important to report any major reduction in the frequency of movements over a period of a day or so to your healthcare professional.
Often when you feel no movements, your baby will be shown to be moving when tested in hospital. But some babies will show signs of distress, and can be saved by early delivery.
Try to familiarise yourself with your baby's movements and contact your healthcare professional without delay if you don't feel anything for six to eight hours.
Although labour will follow naturally within a few days to weeks after the death of the baby, in the majority of cases women prefer to have labour induced straight away. Caesarean sections are not normally carried out, so that the mother isn't subjected to an unnecessary operation. Counselling and support will be provided and every effort will be made to try and discover the cause.
Miscarriages are medically referred to as spontaneous abortions. This term is used to describe the loss of a fetus in the first half of pregnancy (before 20 to 24 weeks). After this time, if a baby dies in a mother's uterus on or after the 24 week mark, it is known as a stillbirth.
Both events can be devastating for prospective parents, so understanding the causes, what precautions can be taken and how to deal with the feeling of loss caused by a miscarriage or stillbirth is vital.
In this section we look at: the risks of miscarriage and stillbirths, possible causes, and what diagnosis can be given for miscarriages and stillbirths.
What Causes Miscarriages?
Women can miscarry for various reasons. Most of the early miscarriages occur when the embryo fails to attach to the wall of the uterus because the lining isn't prepared for implantation or because the embryo has severe chromosomal or developmental defects. The presence of an autoimmune disorder, severe infection or illness, or an abnormality in the shape of the womb may also occasionally lead to miscarriage. If the embryo is exposed to so-called 'teratogenic' substances (e.g. x-rays, certain medications or drugs) within the first two weeks of conception, then either a very early miscarriage will take place or the pregnancy will go ahead as normal and the child will not have been damaged. The cause of most miscarriages, however, is not known.
Later miscarriages can be caused by problems such as genetic or chromosomal defects; abnormalities of the uterus (for example, a subdivided/septate uterus) or of the placenta; severe illness; metabolic disease in the mother (diabetes or thyroid problems); bacterial or viral infections (e.g. toxoplasmosis and listeriosis); or incompetence of the cervix.
The chances of a woman miscarrying increase with age, and also (but less so) with the number of previous pregnancies. As miscarriage is common, affecting nearly 15% of clinically recognised pregnancies, many women may have a miscarriage if they have enough pregnancies. Thus, a history of miscarriage doesn't really make it any more likely that you'll go on and miscarry again. It's advisable, however, to wait at least three months before attempting to conceive after a miscarriage, as the uterus lining needs some time to recover.
Rarely, some women have what is known as recurrent miscarriage, but this refers to those with three or more consecutive miscarriages. This is sometimes due to a medical reason such as one of the parents carrying a predisposition to chromosome problems in the baby, or the mother having an autoimmune problem or an abnormally shaped uterus. The majority of women who miscarry go on to have a successful next pregnancy.
The most common symptoms of miscarriage are similar to those of a period and are bleeding (which occurs in 95% of cases), possibly with clots, and/or cramp-type pain.
Stillbirth/ Intrauterine Deaths:
Stillbirth is the delivery of a dead fetus in the last half of pregnancy. In Ireland, it is still defined as delivery after 24 weeks, whereas increasingly a definition of delivery after 20 weeks is used. Stillbirth is also sometimes referred to as late fetal death or intrauterine death.
Sadly, the exact cause of stillbirth remains unknown in over 30% of cases. In the rest of the cases, stillbirth may be due to poor fetal growth, severe fetal abnormality, placental problems, pre-eclampsia, uncontrolled diabetes, severe cases of Rhesus incompatibility, infections, antepartum haemorrhage and post-maturity. This is one reason why obstetricians usually recommend induction of labour at term (from 38 weeks) if there are problems in the pregnancy.
How common is it? The incidence of stillbirths in Westernised countries is fortunately declining, having fallen from around 2% in the UK in the 1950s to 0.3% in the early 1990s. Stillbirths tend to be more common in deprived communities, in older women and in women who receive poor care during their pregnancy.
What are the signs? If the baby has died movements stop, the uterus may also start to shrink and there is weight loss.
Stillbirth is often preceded by a reduction in fetal movements in the days or week before the baby dies inside the womb. For this reason, if you're over 30 weeks pregnant, it's important to report any major reduction in the frequency of movements over a period of a day or so to your healthcare professional.
Often when you feel no movements, your baby will be shown to be moving when tested in hospital. But some babies will show signs of distress, and can be saved by early delivery.
Try to familiarise yourself with your baby's movements and contact your healthcare professional without delay if you don't feel anything for six to eight hours.
Although labour will follow naturally within a few days to weeks after the death of the baby, in the majority of cases women prefer to have labour induced straight away. Caesarean sections are not normally carried out, so that the mother isn't subjected to an unnecessary operation. Counselling and support will be provided and every effort will be made to try and discover the cause.
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