11 Causes Of Miscarriage That Actually Are Not The Mother's Fault

Pregnancy is a period filled with hope and joy for every couple. However, some pregnancies can lead to unexpected causes of miscarriage.

According to the portal of the Ministry of Health Malaysia (MOH), the majority of miscarriage cases, about 80%, occur before the 13th week, while 20% occur before 22 weeks.

Causes of Pregnancy Miscarriage

Losing a pregnancy, commonly referred to as a miscarriage, is a bitter experience for most mothers. Miscarriage occurs when the natural process of pregnancy cannot continue, and the fetus does not develop properly. Although most miscarriages occur in the first trimester of pregnancy, there are cases where miscarriages occur in the second trimester.

Before we delve into the causes of miscarriage, it is important for prospective parents to understand what miscarriage is.

What Is Miscarriage?

Miscarriage occurs when a baby accidentally loses its life in the womb before reaching the 20th week of pregnancy. If the baby dies in the womb after the 20th week, the term used is stillbirth. Miscarriage can happen naturally (spontaneously) or through medical interventions such as the use of pills or surgical procedures to terminate the pregnancy.

Spontaneous miscarriage usually occurs within the first 20 weeks of pregnancy. More than half of spontaneous miscarriages occur within the first two weeks after conception. Miscarriages that occur after this period are usually known as late miscarriages.

Here are 11 common causes of miscarriage that most mothers experience:

Miscarriage during pregnancy can be caused by various factors. Some common causes of miscarriage include:

1. Chromosomal Issues

What is meant by chromosomal problems? Each person has 23 pairs of chromosomes, and sometimes, during the process of cell division and duplication of the fetus's chromosomes, the quantity may be excessive or insufficient. When this happens, the cause of miscarriage occurs. This first issue accounts for 60% of major miscarriage causes and usually occurs during the first trimester.

2. Thyroid Problems in the Mother

The next cause of miscarriage is thyroid issues. If someone suffers from hypothyroidism (underactive) or hyperthyroidism (overactive), it can lead to fertility and miscarriage problems.

Hypothyroidism causes the mother's body to produce more hormones, hindering the ovulation process. On the other hand, hyperthyroidism disrupts estrogen, a crucial hormone for embryo implantation in the mother's uterus. Usually, thyroid issues in the mother lead to miscarriage in the second trimester

3. Uterine Shape and Cervix Issues

Some women are born with uncommon uterine shapes, such as bifurcated uterus. When a mother has such a uterus, embryo attachment to the uterus becomes challenging.

Even if attachment occurs, there is a likelihood of miscarriage. Uterine shape problems account for 10% of miscarriage causes among mothers.

Besides uterine shape, the condition of the mother's cervix can also lead to baby loss. A weak cervix causes miscarriage at second trimester because it cannot support the growing baby.

4. Uncontrolled Diabetes

Poorly controlled diabetes also increases the potential for miscarriage among pregnant women. This is because the diabetes condition makes the mother's uterine environment unfriendly to the growing fetus. It leads to the fetus not thriving and ultimately miscarrying from the womb. This miscarriage problem usually occurs in the second trimester.

5. Excessive Caffeine Intake

If you are a coffee or caffeine-containing beverage enthusiast and are pregnant, you need to be cautious. According to NHS UK, exceeding 200mg of caffeine per day doubles the likelihood of causing a miscarriage.

Studies indicate that consumed caffeine interferes with the placenta and hinders fetal growth. To give you an idea, a cup of tea has approximately 75mg of caffeine, and a cup of coffee has 100mg of caffeine. The total caffeine intake can also increase if you consume soda, chocolate bars, and energy drinks on the same day.

Other Causes of Miscarriage

• Immunological Disorders: Some immune system disorders can be a damaging cause of miscarriage, such as antiphospholipid syndrome.
• Infections: Miscarriage is also linked to infections in the reproductive system, such as uterine or sexual infections, increasing the risk of miscarriage.
  Infections like toxoplasmosis, rubella, cytomegalovirus, or chlamydia can endanger the developing fetus.
• Age Factor: The risk of miscarriage tends to increase with the mother's age. Women over 35 years old have a higher risk than younger women.
• Early Pregnancy Medical Disorders: Some medical conditions, such as uncontrolled diabetes, autoimmune diseases (like lupus), blood clotting disorders, or other chronic diseases, can increase the risk of miscarriage.
• Environmental and Lifestyle Factors: Exposure to harmful chemicals, high radiation, use of certain medications, alcohol consumption, smoking, and unhealthy lifestyles can be causes of early pregnancy miscarriage.

It is important to remember that most miscarriages are not caused by the actions of the mother or partner. Many miscarriage causes occur due to unavoidable genetic disorders.

Signs of Miscarriage

The signs of miscarriage can vary from individual to individual and from each pregnancy. However, there are some common signs that may indicate a potential miscarriage. Here are some signs of miscarriage that you may notice:

• Vaginal Bleeding: Heavier or more substantial bleeding than usual menstruation, especially if accompanied by clots.
• Severe Abdominal Cramps: Severe abdominal cramps, similar to menstrual cramps, can be a sign of miscarriage.
• Pelvic Pain: Pain in the pelvic or lower abdominal region.
• Increased Vaginal Discharge: Discharge that changes color to brown or dark red.
• Change In Blood Pressure and Heart Rate: Changes in blood pressure and heart rate may occur.
• Release of Tissue or Fluid from the Uterus: Release of tissue resembling clots or fluid from the vagina.
• Changes in Pregnancy Test: Pregnancy test showing a negative result after previously showing a positive result.

Miscarriage Signs Without Bleeding

Miscarriage is usually marked by vaginal bleeding, but in some cases, miscarriage can occur without bleeding or with very mild symptoms. The medical term used to describe miscarriage without bleeding is "missed miscarriage" or "silent miscarriage."

Symptoms of miscarriage without bleeding include:

1. Reduced Pregnancy Symptoms: Experience a decrease in pregnancy symptoms such as relief from nausea, vomiting, breast enlargement, or a decrease in the frequency of urination.
2. Decreased Fetal Heart Rate: If you have had a Doppler or ultrasound scan and were previously able to hear the fetal heartbeat, you may no longer hear it or may not detect a measurable fetal heart rate on subsequent examinations.
3. Feeling that Something Is Wrong: Some women may have an instinctual
   feeling or a sense that something is wrong with their pregnancy, even though there are no clear physical symptoms.

Characteristics of Miscarriage Blood

Miscarriage blood is the blood expelled from the uterus during or after a miscarriage. Each woman has different characteristics of miscarriage blood, depending on

factors such as gestational age and the type of miscarriage. Some characteristics of miscarriage blood include:

• More or Heavy Bleeding: Blood loss may be more than during regular menstruation.
• Bleeding may last for several days or longer depending on the size of the miscarriage.
• Blood color may vary, including pink, dark red, or brown.
• In early miscarriages, blood may resemble normal menstrual blood.
• In some cases, miscarriage blood may be accompanied by blood clots.

How Long Does Blood Come Out After Miscarriage

The duration of bleeding after a miscarriage varies for each woman. Some women may experience bleeding for a few days, while others may have bleeding for several weeks. Generally, bleeding after a miscarriage will stop within 2 weeks.

What to Do If You Have a Miscarriage

1. Consult a Doctor: Immediately contact your doctor or local healthcare facility to discuss your condition. The doctor can provide guidance and help determine the next steps.
2. Medical Evaluation: The doctor may perform an examination to determine if there are any remnants of the pregnancy in the uterus and whether additional medical treatment is needed.
3. Monitor Symptoms: Keep track of symptoms such as bleeding, abdominal pain, or other changes in your body. If symptoms worsen or if you are concerned, consult a doctor promptly.
4. Rest and Recovery: Give your body time to heal. Adequate rest and maintaining overall health can aid the recovery process.
5. Emotional Care: Miscarriage can be an emotionally challenging experience. Talking to your partner, family, or friends can help manage grief and trauma. Support from mental health professionals can also be beneficial.

Effects After Miscarriage

Miscarriage can leave individuals feeling profoundly sad, affecting both their emotions and bodies. Here are some effects after miscarriage that can be observed in terms of feelings, physical health, and relationships:

Emotional Impact:

• Grief and Trauma: Most mothers feel deeply saddened and pained after a miscarriage, experiencing a sense of loss.
• Guilt or Self-Blame: Some mothers may feel guilty or blame themselves, even though miscarriage is not always caused by them.
• Anxiety and Sadness: Following a miscarriage, one may feel anxious about future pregnancies or continue to feel sad about the loss.

Physical Impact:

• Bleeding and Abdominal Pain: After a miscarriage, women may
  experience bleeding and abdominal pain, which is a part of the body's natural recovery.
• Hormonal Changes: Miscarriage can lead to hormonal changes that may affect your emotions and menstrual cycle.

Relationship Impact

• Strain in Relationships: Miscarriage can strain relationships, especially if partners handle their emotions differently.
• Perception of Pregnancy: Miscarriage can change how people view pregnancy, making them more cautious or anxious.

Effects of Uncleansed Miscarriage

Uncleansed miscarriage or Dilation and Curettage (D&C) is often misunderstood as a procedure to "cleanse" the uterus after a miscarriage.

The D&C procedure is actually a removal procedure, not a 'cleaning' process. In miscarriage cases, D&C is only necessary if an examination reveals the possibility that the contents of the pregnancy are not fully expelled.

Possible effects of an uncleansed miscarriage that may occur in some cases include:

1. Infection: If pregnancy tissue remains unremoved from the uterus, this can increase the risk of infection, leading to symptoms such as fever, pelvic pain, and other serious health issues.
2. Prolonged Bleeding: An uncleansed miscarriage can cause prolonged or uncontrolled bleeding, resulting in a drop in blood levels and a risk of serious health problems.
3. Uterine Health Complications: Residual tissue in the uterus after a miscarriage can lead to complications in the organ, including endometritis (inflammation of the uterus) or structural disruptions.
4. Menstrual Cycle Disturbances: Improperly treated miscarriage can also affect the menstrual cycle, leading to hormonal imbalances and difficulties in regaining fertility.

Recovery Period After Miscarriage

According to WebMD, physical recovery after a miscarriage can take 1 or 2 months. Your period should typically resume within 4 to 6 weeks. Avoid inserting anything into your body, including tampons, and refrain from sexual intercourse for
approximately 1-2 weeks.

The recovery period after a miscarriage may take longer emotionally, as mothers typically experience a range of different emotions, such as sadness and disappointment for several days.

Tisas Academy suggests that traditional advice recommends mothers who have experienced a miscarriage to observe a post-miscarriage confinement period of 44 days.

However, women with careers may find it challenging to adhere to the post-miscarriage confinement period, similar to postpartum confinement practices.

Healing Duration of the Uterus After Miscarriage

The duration for the uterus to heal after a miscarriage can vary. It depends on various factors, such as how long the pregnancy lasted and how the body responds.

• Early Miscarriage (First Trimester): Physical recovery typically takes a few weeks. Bleeding and abdominal pain may subside within a few days to weeks.
• Miscarriage in the Second or Third Trimester: Recovery may take longer, possibly several weeks to over a month.

Post-Miscarriage Confinement Practices

According to Malay tradition, the practice of consuming turmeric with warm rice for 40 days is believed to restore the body's vitality and heal internal wounds. Turmeric is also used as a drink to contract the uterus and cleanse the blood.

After Miscarriage: When Will Menstruation Return?

• Early Miscarriage (First Trimester): Menstruation usually returns within a few weeks to a few months after a miscarriage. Some women may experience their first period within 4-6 weeks after the miscarriage.
• Miscarriage in the Second or Third Trimester: If a miscarriage occurs in the second trimester or later, the time needed for menstruation to return may be longer. The body's recovery process after a later miscarriage can take more time.

Resuming Intimacy with Your Husband After Miscarriage

You can resume intimacy with your husband after a miscarriage when you feel ready. Typically, wives can engage in sexual intercourse after two weeks of a miscarriage. However, according to experts, it is advisable to wait for the cessation of bleeding to avoid the risk of bacterial infection.

Risk Factors for Miscarriage

Risk factors for miscarriage can vary among individuals, but some factors that may increase the risk of miscarriage include:

1. Mother's Age: The risk of miscarriage tends to increase with the mother's age. Women aged over 35 years have a higher risk than younger women.
2. Previous History of Miscarriage: Women who have experienced a previous miscarriage have a higher risk of experiencing it again.
3. Genetic or Chromosomal Issues: Genetic conditions or chromosomal abnormalities in the fetus can lead to miscarriage. It can be caused by inherited genetic disorders or random chromosomal abnormalities.
4. Mother's Health Issues: Certain maternal health conditions, such as uncontrolled diabetes, autoimmune diseases (like lupus), undiagnosed or uncontrolled thyroid disease, or blood clotting disorders, can increase the risk of miscarriage.

Activities That Can Cause Miscarriage

Certain activities do not directly cause miscarriage. Miscarriage usually occurs due to medical issues or genetic disorders unrelated to daily physical activities. Here are some activities to avoid during pregnancy:

• Smoking
• Alcohol consumption
• Drug use
•  Excessive exercise
• Excessive stress
• Rough sex or penetration too deep

Preventing Miscarriage

While most miscarriages are caused by genetic abnormalities that cannot be avoided, here are some tips to help prevent miscarriage:

1. Folic Acid Intake: Ensure you take at least 400 mcg of folic acid daily before or early in pregnancy.
2. Healthy Diet: Consume a healthy and balanced diet.
3. Manage Stress: Manage stress levels.
4. Maintain a Healthy Weight: Keep your weight within a healthy range.
5. Avoid Smoking and Secondhand Smoke: Do not smoke, and avoid exposure to secondhand smoke.
6. Limit Caffeine and Alcohol Intake: Limit caffeine intake to one to two cups of coffee per day and avoid excessive alcohol consumption.
7. Avoid Harmful Substances: Avoid exposure to harmful substances like arsenic, lead, formaldehyde, benzene, and ethylene oxide.
8. Protect Your Abdomen: Be cautious and ensure the safety of your abdomen during pregnancy.
9. Avoid Risky Sports: Avoid sports with a higher risk of injury, such as contact sports and skiing. Always wear a seatbelt.

Trying to Conceive After Miscarriage

Research indicates that as many as 70% of women successfully conceive within 3 months of trying again after a miscarriage. This is a reassuring statistic, offering hope and encouragement.

Considerations and general advice for conceiving again after a miscarriage include:

1. Waiting Period: After a miscarriage, the body needs time to recover physically and emotionally. Doctors usually recommend waiting at least one or two menstrual cycles before attempting to conceive again. This allows your uterus and reproductive system to fully recover.
2. Consultation with a Doctor: It's important to consult with your doctor or midwife before trying to conceive again. They will provide specific advice based on your situation and medical history. They may also conduct additional examinations to ensure you are healthy and ready for pregnancy.
3. Health Care: During the waiting period, it's crucial to take care of your overall health. Maintaining a healthy diet, regular exercise, managing stress, and avoiding unhealthy habits such as smoking or drinking alcohol are important to prepare your body for a healthy pregnancy.

It's important to remember that every pregnancy carries risks, including the risk of miscarriage. However, most pregnancies progress smoothly. In most cases, couples who experience a miscarriage the first time can successfully conceive and deliver a healthy baby.

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