Miscarriage

Overview of Miscarriage

Miscarriage, the spontaneous loss of a pregnancy before the 20th week, is a distressing event for many Australian families. It’s a common part of the reproductive journey, yet it’s often shrouded in silence.

Recognising and discussing the causes, risk factors, and emotional impact of miscarriage can help in providing support and understanding to those affected.

Statistics

In Australia, it is estimated that miscarriage occurs in up to 20% of recognised pregnancies, with the majority happening in the first 13-weeks. The actual number is likely higher as many miscarriages occur before a pregnancy is known.

As women age, the risk of miscarriage increases significantly, rising sharply in women over 35-years of age.

Miscarriage can occur for a variety of reasons, many of which are not within anyone’s control. The causes can be complex, and sometimes a specific cause cannot be identified.

  • Genetic Factors: The most common cause of early miscarriage is a genetic abnormality in the embryo that prevents it from developing normally. These are typically random, not inherited anomalies.
  • Anatomical Issues: Abnormalities in the structure of the uterus can contribute to miscarriage. Conditions such as a bicornuate uterus or fibroids can impede the normal development of the pregnancy.
  • Hormonal Imbalances: Issues such as insufficient progesterone levels, which are vital for maintaining the early stages of pregnancy, can lead to miscarriage.
  • Lifestyle Factors: Smoking, excessive alcohol consumption, and the use of illegal drugs are linked to an increased risk of miscarriage. Severe malnutrition and exposure to harmful substances can also be contributing factors.
  • Medical Conditions in the Mother: Health conditions such as uncontrolled diabetes, thyroid disease, and autoimmune disorders can increase the risk. Infections like rubella or listeriosis are also known risk factors.
  • Age: The risk of miscarriage increases with maternal age, particularly after the age of 35.

Couples who experience recurrent miscarriages (two or more consecutive miscarriages) should seek specialist advice. It’s also advisable for any woman who has concerns about miscarriage, particularly those with existing health conditions or those who have experienced previous pregnancy complications, to consult with healthcare professionals.

Evaluation and Tests:

  • Ultrasound Scans: To check for the presence of an embryo or foetus, and to assess the health of the pregnancy.
  • Blood Tests: To measure hormone levels and check for infections or autoimmune disorders.
  • Genetic Testing: Offered after recurrent miscarriages to check for genetic issues.


Support Services:

  • Counselling: Many hospitals and clinics offer counselling services to help cope with the emotional distress caused by miscarriage.
  • Support Groups: Organisations such as the Miscarriage Association and SANDS Australia provide valuable support and information.
  • Follow-Up Care: Follow-up appointments are important to assess the physical recovery and discuss future pregnancies.

The emotional impact of miscarriage can be profound. Feelings of grief, loss, and even guilt are common. It’s important for couples to seek support and allow themselves time to mourn.

Mental health support, whether through professional counselling or support groups, can be instrumental in navigating this challenging time.

Conclusion

Miscarriage is a deeply personal and often isolating experience, but it is also a relatively common and, in many ways, natural occurrence. A miscarriage is ‘nature’s way’ of dealing with a genetically abnormal embryo.

Understanding the potential causes and available support can help those affected to deal with their loss more effectively.

Dr Shree Mane is a Sydney Obstetrician and Gynaecologist, and Fertility Medicine sub-specialist with 30+ years of experience. She has achieved specialist registration in India, the United Kingdom and Australia.

She consults and operates across Western Sydney and offers Saturday appointments, as well as telehealth bookings.

If you have a question about a condition or treatment, or would like to book an appointment, please contact us and one of our friendly staff members will happily assist you.