Miscarriage is the most common type of pregnancy loss and according to the American College of Obstetricians and Gynaecologists, 10-25% of all recognised pregnancies end in miscarriage and about 80% of all pregnancy loss occurs in the first trimester. Unrecognised pregnancies, which are also known as ‘chemical pregnancies’ account for 50-75% of all miscarriages, where the pregnancy is lost shortly after implantation, where bleeding occurs around the time of the woman’s expected period. Charlene Yared West unpacked the topic with Dr Francis Maleka from Life Mercantile Hospital. “In short, miscarriage is more common than we think,” he says.
Why does miscarriage happen?
“Not every miscarriage has a clear cut reason and often the cause isn’t identified. Women will ask themselves why – and often blame themselves, but the truth is, there is very little you can do to prevent a miscarriage,” says Dr Maleka. Reasons include chromosomal abnormality, hormonal problems, infections, maternal health problems, maternal age, maternal trauma, lifestyle (smoking, drugs, malnutrition) and implantation of the egg that does not occur properly. “Things that do not cause miscarriage are sex, working outside of the home and moderate exercise,” he adds.
Men – the forgotten grievers
Women are the ones who have to cope physically and emotionally after the loss of a baby. Often, the grief men experience goes unacknowledged. According to research carried out in 2014 by Dr Petra Boynton at the University College London, dads said they felt happy, excited, thrilled or delighted about the pregnancy before the miscarriage – and 55% of those men had already picked out a name for the baby. After the loss, many fathers reacted with feelings of sadness (85%), grief (63%) and shock (58%), but nearly a quarter didn’t share their feelings with their partner, usually for fear of upsetting her more or saying the wrong thing. “I encourage couples to talk about what happened and also to see a therapist if they find it difficult to access those emotions,” says Dr Maleka.
Getting pregnant after miscarriage
Deciding to have another baby after miscarriage can cause mixed emotions for both parents. “On one hand they want a baby, but the next time around is often fraught with fear of another loss. We have to pay special attention to the next pregnancy even more carefully,” says Dr Maleka. Parents may choose to delay falling pregnant again due to surgery from the miscarriage, a delay in menstrual cycles, genetic testing and autopsy reports, and emotional issues and readiness. “Seek support from family and friends, as well as your doctor or midwife and professional support groups, to help you heal after miscarriage,” he says. “Remember that you are still grieving the loss of your baby while attempting to get pregnant again. Be gentle on yourself.”
A case study: “How I moved forward”
We fell pregnant for the first time in 2011 and were so excited. We decided not to wait until the 12 week time period to share our news with friends and family – as for us, a life is a life and we told everybody! I had all the pregnancy symptoms; sore breasts and bouts of nausea. Then I was at work one day and started bleeding heavily. The doctor confirmed the miscarriage and we were distraught. I was so heartbroken and this heaviness weighed down on me for weeks. My husband and I went away on a relationship workshop weekend camp and for me that was the turning point. The camp was situated in a beautiful place in nature, which brought me a lot of comfort. There was also a small chapel there that my husband and I would visit. In the quiet of this tranquil place, I came to the realisation that I had to give her a name as I sensed she was a girl and that I needed to somehow name her. So, we named her Faith and I think just the act of giving her a name gave me such a sense of relief. I was much better afterwards and fell pregnant soon after… and gave my baby the second name of Faith, so that I would never forget the first little life that came to me. I think a lot of people after miscarriage tend to want to close it off and not talk about it – and try their best to forget about it. I somehow embraced the experience as painful as that was and named her, letting myself to feel the loss that occurred. This is what gave me closure. We have two daughters now, but have never forgotten baby Faith.