HealthAgenda

Pregnancy & Birth

Coping with miscarriage

Losing a baby is heartbreaking. So common and yet so little talked about. It’s important to have the basic facts and to know where to get help.

Health Agenda
June 2017

The first few months of being pregnant can be an exciting, emotional, challenging, almost dizzying time. But mixed in with the joy is often the underlying fear that something could go wrong.

It’s a fear unfortunately borne out in statistics; up to 1 in 4 pregnancies ends in miscarriage (the loss of the baby in the first 20 weeks of pregnancy; after that it's called a stillbirth), impacting some 103,000 Australian families every year.

While common, it’s an emotionally painful experience – and perhaps because of this, it’s a subject that remains largely taboo. This silence can make it even harder to deal with.

Types of miscarriage

Rachel Bromley was 13 weeks into her first pregnancy when she miscarried. She’d told family and friends she was pregnant, feeling secure to do so after a 10-week scan had shown no abnormalities.

“I had what’s known as a ‘missed miscarriage’, meaning that I had no physical signs of miscarriage,” she says. “It wasn’t until I went for a scan at 13 weeks that there was no longer the heartbeat that had been there weeks earlier.”

Missed miscarriages occur where the foetus dies but remains in the uterus. They usually happen without any symptoms, which can make it even harder to deal with when the miscarriage is discovered, usually at a check-up or scan. It can be tough to accept what’s happened, especially if you’re still experiencing pregnancy symptoms.

Most miscarriages do come with warning signs. A ‘threatened miscarriage’ can indicate that you're at risk. Symptoms can include:

  • vaginal bleeding 
  • lower abdominal pain 
  • dizziness or fainting
  • fever or chills
  • diarrhoea.

Although these symptoms don’t always mean you’ll miscarry, if you experience them you should seek immediate medical advice.

A threatened miscarriage can lead to a complete miscarriage, where the foetus, placenta and gestational sac are expelled, or an incomplete miscarriage, where they’re only partially expelled. Every type of miscarriage requires medical attention.

Causes of miscarriage

In many cases a miscarriage occurs for reasons that are completely beyond your control. This could be because the baby hasn't developed properly or there are other problems with the pregnancy.

This includes ectopic pregnancy, where the embryo implants outside the uterus. Symptoms may include extreme abdominal pain, vaginal bleeding, vomiting or pain in the tip of one shoulder.

A molar pregnancy is when the fertilised egg doesn't grow properly; in full molar pregnancy, this means the foetus will not develop at all, while in partial molar pregnancy it won’t develop sufficiently to survive. Since all the symptoms of pregnancy are there, a molar pregnancy is often only picked up at the 12-week scan.

Other common causes include bacterial infection, a condition like polycystic ovary syndrome or problems with the cervix or uterus. Lifestyle factors like smoking, alcohol and poor nutrition, and environmental toxins like pesticides and second-hand smoke, can also play a part.

Regardless of the cause, the pain of losing the baby can be extremely acute. In Rachel’s case the miscarriage came as a shock and led her to worry about future pregnancies.

“I was devastated,” she says. “I hadn’t experienced any real sense of grief in my life at that stage and it was a very difficult time. Over the following weeks and months, that grief turned to fear. What if I couldn’t carry a child? What if I didn’t fall pregnant again? What if I miscarried again? My obstetrician, while very caring, was quite pragmatic, but I was caught in a wave of emotions and couldn’t be in that realistic mindset.”

Treatment

Unfortunately nothing can be done to prevent a miscarriage once it has begun and treatment will depend on your health and the type of miscarriage.

One form of treatment is known as ‘watch and wait’, where the pregnancy tissue passes from the womb naturally. Or you may need, or choose, to have a D&C (dilatation and curettage). If your case is more complex, such as an ectopic pregnancy, you’ll definitely need surgery.

Getting help

It’s important to give yourself time to grieve, and to reach out for support if needed. There are many sources of support for expectant mums, and their partners, who can sometimes feel a little overlooked. Organisations like Sands provide emotional care along with practical advice, education and support.

“I think some women suffer feelings of immense grief in silence, perhaps because they’re simply not able to, or feel uncomfortable, verbalising their feelings,” says Rachel, who now works as a volunteer parent supporter for Sands.

“I think we’re often expected to ‘get over it’ or ‘move on’ because ‘it just wasn’t meant to be’. These comments can come from a loving place but can feel incredibly painful for a mum who has lost a baby.

“Most times, that mum had been thinking about, planning and visualising how her life would be, and how her baby would be since that positive test result. Suddenly, she could be immersed in feelings of guilt, despair, sadness, or even relief. It’s such a difficult time.”

Rachel had two healthy daughters after her miscarriage, but experienced tragedy again in 2013 when her third daughter was stillborn. She decided to become a support worker to help those with similar experiences, and went on to have another healthy girl.

“I wanted to find a way to bring some positives from such a devastating period in my life,” she says. “I had previously used the Sands hotline, and started making some enquiries around becoming a volunteer parent supporter. I felt that if I could offer someone else the level of support and understanding I had, then it would be a comfort to me.

“I’ve always been lucky to have incredible support, but feel there is something reassuring about having the option to talk to someone confidentially, who you don’t know. To be able to say things, express feelings, tell your story. Sometimes there are things that you wouldn’t be comfortable saying to people within your personal support network and I find the peer-to-peer model that Sands use to be amazing for that.”

Hear more personal experiences of parents who’ve lost a baby before, or shortly after, birth on the HCF website. In these videos, parents talk about how their baby died and how they worked through their grief.

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MISCARRIAGE AND STILLBIRTH

Parents who've lost a baby before, or shortly after, birth talk about how their baby died and how they worked through their grief.

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