What is a miscarriage?
‘A miscarriage is the loss of a pregnancy during the first 23 weeks. The main sign of a miscarriage is vaginal bleeding, which may be followed by cramping and pain in your lower abdomen. If you have vaginal bleeding, contact your GP or midwife. Most GPs can refer you to an early pregnancy unit at your local hospital straight away if necessary. You may be referred to a maternity ward if your pregnancy is at a later stage. However, bear in mind that light vaginal bleeding is relatively common during the first trimester (first 3 months) of pregnancy and doesn’t necessarily mean you’re having a miscarriage.’
‘There are many reasons why a miscarriage may happen, although the cause is often not identified. If a miscarriage happens during the first trimester of pregnancy (the first 3 months), it’s usually caused by problems with the unborn baby (foetus). About 3 in every 4 miscarriages happen during this period.
If a miscarriage happens after the first trimester of pregnancy, it may be the result of things like an underlying health condition in the mother.
These late miscarriages may also be caused by an infection around the baby, which leads to the bag of waters breaking before any pain or bleeding. Sometimes they can be caused by the neck of the womb opening too soon.
What is ‘normal’ fertility?
A lot of people will have the strong desire to conceive a child at some point during their lifetime. Understanding what defines normal fertility is crucial to helping a person – or couple – know when it is time to seek help and approximately 85% will achieve pregnancy within one year of trying, with the greatest likelihood of conception occurring during the earlier months. Only an additional 7% of couples and/or person will conceive in the second year. As a result, infertility has come to be defined as the inability to conceive within 12 months. This diagnosis is therefore shared by 15% of people attempting to conceive. We generally recommend seeking the help of a reproductive endocrinologist if conception has not occurred within 12 months. However, there are various scenarios where one may be advised to seek help earlier. These include:
- Infrequent menstrual periods – when a woman has regular menstrual periods, defined as regular cycles occurring every 21 to 35 days, this almost always indicates that she ovulates regularly. Ovulation of the egg occurs approximately 2 weeks before the start of the next period. If a woman has cycles at intervals of greater than 35 days, it may indicate that she is not ovulating an egg predictably, or even at all. Ovulation of the egg is essential for pregnancy. Therefore, we recommend an evaluation if menstrual cycles are infrequent or irregular in a couple attempting pregnancy.
- Female age of 35 years or older – for unclear reasons, egg numbers decrease at a rapid rate as women age. Furthermore, as aging occurs, egg quality, or the likelihood of an egg being genetically normal, decreases. Therefore we recommend a fertility evaluation if a couple has been attempting pregnancy for 6 months or more when the woman is 35 years of age or older.
- A history of pelvic infections or sexually transmitted diseases – sexually transmitted infections, such as chlamydia or gonorrhea, can cause inflammation and permanent scarring of the fallopian tubes. The presence of open tubes is essential for natural conception, as sperm must traverse the tubes in order to reach and fertilize the ovulated egg. We recommend immediate evaluation for a couple attempting pregnancy when the woman has a prior history of pelvic infection. As part of the fertility evaluation, we will perform an HSG, a test designed to evaluate if the fallopian tubes are open.
- Known uterine fibroids or endometrial polyps – Uterine abnormalities, such as fibroids that indent the endometrial cavity and endometrial polyps, can impair how the endometrium (the lining of the uterus) and embryo interact to lower implantation and pregnancy rates. These abnormalities can also cause irregular bleeding between menstrual cycles. Evaluation should be pursued by 6 months of attempted pregnancy in women with a known history of these abnormalities or a history of bleeding between menstrual cycles. The main approach to correcting or removing these uterine abnormalities is by hysteroscopy, a surgical method by which a narrow scope with a camera is placed within the uterine cavity. Instruments can be introduced through the hysteroscope, allowing the surgeon to remove or correct any anatomic abnormalities.
- Known male factor semen abnormalities – if a male partner has a history of infertility with a prior partner, or if there are abnormalities on his semen analysis, then we advise earlier fertility evaluation, ideally within 6 months of attempting pregnancy.
Loss comes in many forms and losing your baby is a loss you don’t anticipate – this blog is interviewing Katie-nan on her fertility experiences and the loss of her baby – Charlie – and what she’s doing to get through it.
If someone you love has experienced a pregnancy loss or miscarriage, it can be hard to think of the right thing to say. One in five couples will experience a miscarriage in their journey to start a family. While miscarriages are common, many people who experience pregnancy loss find it difficult to process their loss as well as open up to family and friends.
If you have experienced a miscarriage, you may be feeling a variety of emotions that make it difficult to explain your loss to those you love. If you are close with someone who has recently miscarried, there are a number of ways you can show your support that doesn’t require talking about their lost pregnancy. Some ways you can support your friend, partner or family member include:
- Listening – offer to lend an ear once they are ready to talk.Helping out with painful tasks – if your friend or family member had a late miscarriage, they may have an abundance of baby supplies they may no longer want.
- You can offer to hold on to these items until they are ready, return them, or donate them to families in need.
- Accompanying them out of the house – when grieving, it can be hard to leave the house. Offer to take your loved one out and let them know you’ll be there if they need a hand or shoulder to cry on.
They may feel any or all of the following:
- Overwhelming sorrow – it may seem that everything you had hoped for has been taken away at a stroke. I’ve experienced a miscarriage before and the whole situation was overwhelming.
- Confused – they may be desperately searching for answers. Unfortunately, for most miscarriages, a cause can’t be found.
- Anxious and out of control – grief can feel like fear. You may have butterflies in your stomach, feel sick or have an upset stomach. You may go off eating.
- Shocked and numb – you find it hard to concentrate or become withdrawn.
- Exhausted – you may feel tired, but unable to sleep. Or you may want to sleep all the time.
- Guilty – try to bear in mind that many miscarriages happen for no reason. It is very unlikely to have happened because of anything they did or didn’t do.
- Angry – sometimes with those close to them or with friends or other members of the family who are pregnant or who’ve had a baby.
Allow yourself to feel what you feel. Everyone’s experience of miscarriage is different and there is no right or wrong way to respond!
Miscarriage Association offer some advice on the subject.
Firstly, Katie-Nan I’d like to thank you for sharing your experiences and being so brave by talking about fertility and baby loss – have you felt it’s helped you heal and process? What has inspired you to talk and share your experiences online?
Thankyou for wanting to hear about my experience. I have always loved writing, it has often been my voice in times I couldn’t find it. When we lost Charlie it’s like this spark had been reignited inside of me, I wanted to share our story. People don’t talk about infertility and child loss enough, I wanted to change that. We have been so lucky to have such amazing support and I just thought about all of these men and women out there who would be on their own and decided I would share our story so others don’t feel alone. So yes, in a way it has given me something to focus on, to make sure our boys memory lives on and that we can take some goodness out of this truly awful time.
If a friend or family have lost their baby is there anything you can say or do to help them? What would you recommend for someone suffering a loss?
I don’t think there is ever the right thing to say, but if I could say anything it would be “I know…I know how much this hurts, how your life now works differently, you are no longer you, you are a alternate version of you. And that is ok!” However you grieve is ok, let it out, bottle it up, do what is best for you – don’t let anyone tell you different. Just take your time and be kind to yourself, don’t punish yourselves, we carry enough pain without that. If people don’t want to talk, walk away from them. If they can’t accept the new you they can say goodbye to the old you.
Your currently fundraising – what is this for? Has fundraising for the ward made you feel it keeps Charlie’s memory alive?
We have decided to raise funds for The Laurel Ward at the hospital, it is the women’s services ward and where any woman under 20 weeks, sadly, will go to lose a baby. They were amazing, so kind and thoughtful and cared not just for me and Charlie but also Rob. It has helped me to carry on our baby’s name and leave a legacy I hope he would be proud of. Fundraising all for charlie bean
What kind of a day has this been for you?
I have good and bad days, the bad unfortunately outweigh the good at the moment. Today has been an inbetween day, I cry everyday and sometimes it’s happy tears. Crying because the thought of how proud he would have made me makes me smile, other days I cry because
I catch sight of his name written down somewhere. It’s a rollercoaster.
I can’t imagine being in your situation. Would you like to tell me what this has been like for you?
Heartbreaking. I won’t sugar coat it this has been the worst time of our lives. Somedays I simply don’t know how my life will ever be ‘normal’ again. It has changed me in a way I never thought possible, I miss him. Everyday . Every single day I miss him!
In what ways are you feeling differently now, as compared to the past?
I feel stronger. I won’t let people walk all over me now. Life’s too short, I will be living everyday for myself and husband and most importantly for our boy.
What would you like people to know about your feelings right now?
That it’s ok to talk to me about Charlie. Please don’t rush me to not feel anymore just because you don’t know what to say or do. I’m still me, I’m still the woman I always have been. I did have a son, I am a mother. Just acknowledge that.
Who has been the most supportive to you, and in what ways were they helpful?
Other than Rob, who is amazing, my mum and best friend Amy. The thing that gets me the most is how much they love Charlie and aren’t afraid to show it. They talk about him and recognise him. They are always there with arms wide open, anytime, day or night.
In what ways has this been harder than you thought it was going to be?
I never would have ever liked to have dreamt what child loss would be like, who would? However, this has been beyond hard, the pain of knowing your baby isn’t there is the worst kind of pain. I miss him so much and feel a part of me has gone with him. It feels
like you kinda know how you’ll react before it happens to you, ‘oh i’d do this or that’, but it isn’t like that, you become a different person totally.
What are your experiences on infertility?
Myself and Rob struggled for two years to fall pregnant, I didn’t ovulate and it damn near killed me. Knowing it’s your body that wont give you a baby is devastating. We had tests and hospital visits all the time, everything becomes a chore. Even sex. Your sole purpose is to fall pregnant. It ruins part of you and that was only taken away when we found out Charlie was going to be in our lives. I was due to start fertility treatment, a drug, but not sure which as three days before I found out we were pregnant.
Infertility grabs you by the heart and doesn’t ever let go, even pregnant I read stories and my heart hurt for those men and women that craved their baby, I felt so blessed that finally we had our miracle. Charlie has been my hope from day one, he gave me hope when i thought I couldn’t fall pregnant and he will give me hope for the future, I love him!