Overcoming the grief of miscarriages
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By Lee hye-jun
“I should’ve stayed in bed night and day...”
This was the first thing the distraught woman said, sobbing when she heard the news. Her baby’s heart had stopped beating at 7 weeks.
“Is it because of what I’ve been eating?” “It must’ve been because I walked around too often...” Is it really the mother’s fault when an unborn child is lost?
Miscarriage is a very common event. But sometimes people don’t even realize when it happens. After a sperm penetrates an egg and fertilization successfully occurs, 30 percent of embryos fail to implant in the uterus. The other 30 percent become unviable even before it is known and a woman’s period begins. Among the remaining 40 percent of women who actually find out they’re pregnant, 12 to 15 percent of them experience miscarriage between 4 and 20 weeks and only 25 percent of them actually get to hold their babies in their arms.
Why do most pregnancies end in miscarriage? Overall, 50 to 75 percent of miscarriages result from chromosomal abnormalities in the embryo. The human body makes mistakes producing babies and spontaneous miscarriages of abnormal babies are considered part of natural selection process. Most of those chromosomal abnormalities occur by chance, although miscarriages are likely to be repeated if parents have chromosomal abnormalities which they may not know about.
The age of the mother is one of the biggest risk factors for chromosomally abnormal babies. As women grow older, more errors occur in the production of eggs. When women are under 35, only 10 percent of eggs are abnormal, after the age of 40, the proportion of abnormal eggs reaches up to 30 percent and more. Accordingly, the risk of clinically recognized miscarriages increases with age. Before the age of 30, only 10 to 15 percent of women suffer miscarriages and at ages 35 to 39, the risk doubles. Almost half of all pregnancies go wrong in women aged 40 and older. Biological age as well as chronological age matters. The lower ovarian reserve a woman has, the more abnormal eggs she produces.
Let’s suppose you experienced one miscarriage. What are the odds of having another in the very next pregnancy? This generally occurs in about 20 percent of cases. If you have two episodes, the risk increases to 40 percent. The rate of miscarriages increases with the number of previous pregnancy losses but rarely exceeds 40 to 50 percent, which means even if you unfortunately lose a baby another miscarriage will not necessarily follow.
There are unfortunate cases called recurrent pregnancy losses, defined as 3 or more miscarriages. Most doctors consider clinical investigation and treatment in couples with two consecutive spontaneous miscarriages. Causes of recurrent pregnancy losses include uterine abnormalities, immunologic disorders, thrombophilia, endocrine disorders, and infections. The treatment options vary from heparin to intravenous immunoglobulin. Sadly not all such cases are curable at the moment, but we all know researchers develop new technologies every day.
There’s not much one can do to prevent miscarriages. Here are two things you can do.
First, do try to get pregnant as young as possible when you still produce healthy eggs.
Second, if you happen to have a miscarriage, don’t let that one episode stop you from trying again. The desperation and guilt of mothers is sometimes so intense that they fear ever getting pregnant again. But the truth is it probably occurred due to bad luck. You will be lucky next time. If it happens again, we are here to help you.
Back to the first story, after 5 months, the woman became pregnant for a second time. At first, she was overcautious about every move she made and even considered quitting her job. I tried to reassure her, but she wouldn’t listen. At 8 weeks she gradually overcame her fear. She continued working until 2 weeks prior to the due date and took a regular walk with her husband three times a week. She delivered a beautiful baby girl last week.
The writer is a doctor at Maria Fertility Hospital in Seoul. For further questions, send an email to the writer at hyejunlee@mariababy.com, or call the hospital’s English-speaking coordinator at 82 (Korea country code) 2 (Seoul area code) 2250-5577, or visit the hospital’s Website, https://eng.mariababy.com/.