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Pregnancy Loss FAQ’s

How early is too early to have a baby?
A baby born before 20 weeks has a low chance of survival. There are reports of babies born as early as 21 weeks who survived. At this age, the baby typically weighs less than a pound. Babies born prematurely, between 20 and 37 weeks, require special care and help with breathing and eating.

Is vaginal bleeding always a sign of pregnancy loss?
Not always. A miscarriage can occur with no initial symptoms. Vaginal bleeding may be benign, caused by implantation, sexual intercourse, or pelvic or urinary tract infection. Or it can signal something more serious, such as a problem with the placenta or an ectopic pregnancy. Be sure to contact your doctor right away if you notice any bleeding or spotting.

How common is early miscarriage?
Also known as a spontaneous abortion, miscarriage in the first trimester, or before 12 weeks, is very common. It has been estimated to occur in 40 percent of conceptions, although that number could be higher. It can happen to any woman, but the risk increases with age. A 40-year-old woman’s risk of miscarriage is estimated to be about 33 percent, whereas a 20-year-old’s risk is about 15 percent. Check out more signs of a miscarriage.

Is a miscarriage ever the mother’s fault?
No, a miscarriage is usually nature’s way of ridding the body of a defective embryo or fetus that would not have survived. The exact cause is often not identified but may be because of a chromosomal or genetic abnormality, environmental factor, infection, poor implantation, or other unknown reason.

How common is late miscarriage?
Miscarriage between the end of the first trimester and week 20 is estimated to occur in 1 in 1000 pregnancies. It is usually related to the mother’s health, the condition of her cervix or uterus, her exposure to certain drugs or other toxic substances, or to problems of the placenta.

Could a medical condition be causing my repeated miscarriages?
There could be a medical reason for having repeated miscarriages. After three miscarriages, a physical examination and testing are recommended. Certain conditions, such as antiphospholipid syndrome, diabetes mellitus, and polycystic ovary syndrome, increase the risk of miscarriage.

What is vanishing twin syndrome?
When one fetus of a twin birth dies and “disappears” in the uterus. The nonviable fetus is partially or completely absorbed into the mother’s body. A vanishing twin is usually discovered by ultrasound early in pregnancy. It does not cause symptoms in the mother or harm the remaining fetus.

Can a molar pregnancy result in a birth?
Sadly no, a molar pregnancy, also known as hydatidiform mole, is the result of a chromosomal error at the time of conception. A benign tumor develops in the uterus, and the placenta grows into mass of cysts. Fetal tissue, if present, is not viable. All molar pregnancies end in miscarriage. However, women who have had a molar pregnancy are not likely to have another one.

What is a stillbirth?
Fetal death in the uterus after 20 weeks of gestation, stillbirth, is estimated to occur in about 1 in 160 pregnancies. You may suspect that something is wrong when you don’t feel your baby moving for several hours or more. Your doctor may not be able to find a heartbeat.

What are the most common causes of stillbirth?
Undetected infection and placenta problems (the most common being placental abruption) cause the majority of stillbirths. Poor fetal growth increases the risk of stillbirth. Birth defects, maternal chronic disease (such as diabetes or high blood pressure), and umbilical cord accidents are other well known, less common causes.

Can anything be done to prevent a stillbirth?
There is not much a pregnant woman can do to prevent a stillbirth. You can make sure you are providing the best environment for your baby by taking care of yourself, by not smoking or abusing drugs, and by avoiding activities associated with the risk of infection (eg, foreign travel).

How do women cope with the loss of a baby in late pregnancy?
Loss at any time during pregnancy is very difficult. A period of sadness and grieving is normal and helpful for recovery. Support from your partner, family, and friends is important. The healing process is different for every woman. For some women, trying to conceive again is a good way to move on. For others, joining a support group or seeing a counselor can be beneficial.

Can eclampsia cause pregnancy loss?
Eclampsia is life-threatening to the mother, although maternal deaths are quite rare now because of better monitoring and treatment of preeclampsia (high blood pressure and significant amounts of protein in the urine of a pregnant woman). The baby of an affected mother is at risk for premature birth.

How likely is vasa previa to result in pregnancy loss?
Vasa previa is a very rare condition in which fetal blood vessels run outside the umbilical cord and along the membrane over the cervix. Rupture of these vessels can occur during labor and cause harm to the fetus. In most cases, vasa previa is diagnosed before labor and the baby is delivered by cesarean section, which prevents any harm to the fetus.

What causes cholestasis in pregnancy?
The cause of cholestasis is unknown but may be related to pregnancy hormones. Severe itching is usually the only symptom, most often occurring in the last trimester. The risk of fetal distress, preterm birth, and stillbirth increases when a buildup of bile acids in the liver (caused by slowing of the normal flow of bile in the gallbladder) spills into the bloodstream.

Any advice for the parent who experiences the loss one twin?
The loss of one twin comes with conflicting emotions, happiness for the twin that survives and sadness. You may feel a sense of punishment or guilt. Why a twin dies is often not known, but it is nothing you did that caused the loss. While is it disappointing that you will not be a parent of multiples, it is important to celebrate the birth of your remaining child and grieve for your loss.

In what situations would pregnancy reduction become necessary?
Pregnancy reduction may be necessary when the survival of one of the fetuses is compromised, possibly because of malformation; when the ailing fetus endangers the health of the remaining fetus; or when a multifetal pregnancy becomes life-threatening to the mother and her fetuses.

Is lactation suppression painful after a baby dies?
Yes, it can be painful emotionally, as a reminder of the baby you lost, and physically, as a result of breast engorgement. Treatment of breast engorgement includes ice packs and pain relievers. Wearing a supportive bra and expressing milk can alleviate discomfort until engorgement resolves in a few days.

Should we try again after a pregnancy loss?
The decision to try conceiving again after a miscarriage is a personal one that only you and your partner can make. Some practitioners recommend waiting 3 months before trying again. It is important to not push yourself. You will need to heal physically as well as emotionally. Most women who have experienced pregnancy loss go on to have normal pregnancies and healthy babies.

[Page updated June 2015]