WOMEN: MISCARRIAGE. RISKS, CONSEQUENCES AND EMOTIONAL IMPACT.
Can miscarriage be dangerous?
Sometimes miscarriage can be dangerous. The main risks are haemorrhage and infection as complications of incomplete abortion. When the uterus can’t contract properly because all or part of the placenta is still attached to its wall, haemorrhage can be severe. The uterus must be emptied (by suction or curettage) as quickly as possible. Rarely, transfusion may be needed if blood loss has been great.
When dead or dying products of conception remain in the uterus and the cervical canal is open, conditions are ideal for infection. Incomplete miscarriage complicated by infection is septic abortion. The infection can spread rapidly beyond the uterus to the tubes and other pelvic organs. Infection can also enter the mother’s bloodstream, resulting in septicaemia. Before the advent of antibiotics, septicaemia from septic abortion was one of the most common causes of maternal death. Happily for us, prompt treatment with curettage and today’s antibiotics can prevent or rapidly resolve the risks of infection from incomplete miscarriage.
What to do if you bleed
If you have any bleeding at any time during pregnancy, don’t wait to see what happens. Contact your doctor and remain within easy reach of medical care, as heavy bleeding sometimes develops very quickly. Camping trips to remote places are definitely unwise. Try not to worry too much: remember that half of those who have bleeding won’t miscarry. An important reason for reporting all bleeding in early pregnancy is that it may be the first sign of ectopic pregnancy.
What are the consequences of miscarriage?
There are usually no physical consequences from complete spontaneous miscarriage. The uterus returns to normal and the next menstrual cycle starts a few days after the pregnancy has been expelled.
Blood transfusion, though rarely needed, now prevents the prolonged illness and anaemia previously common after haemorrhage from incomplete miscarriage. Prompt use of antibiotics to prevent or treat septic abortion has reduced the chances of the tubes being damaged -with subsequent risk of subfertility – by spread of infection.
The emotional impact of miscarriage
The body generally recovers quickly from miscarriage, but the soul can take longer. In the past, treatment was aimed mainly at reducing blood loss and preventing infection, and the emotional needs mother tended to be neglected.
Miscarriage was regarded as a common event for many women that they would soon ‘get over’. Miscarrying women, often admitted to hospital as emergencies and not treated by their usual doctor, were often discharged as soon as all physical risks had been eliminated but while they still too shocked and upset to ask questions such as ‘Why did it happen?’ and ‘Is it likely to happen again?’.
Hospital staff now acknowledge that carriage is a physical and emotional loss that can have a profound impact on women and their partners. Many hospitals provide counsellors and support groups to help women and couples over the trauma of pregnancy loss. If you can talk your feelings over with an experienced counsellor you’re much more likely to come to terms with your fears and not suffer from depression, panic attacks and nightmares afterwards, as many women have in the past.
There is always a sense of sadness and disappointment. The more your pregnancy has advanced, the more time you’ll had to become emotionally attached to your foetus and the greater your grief when
your plans and dreams for your future with
the child are shattered by miscarriage.
If it’s your first pregnancy, the miscarriage may come as a complete shock – the last thing you expected. If you miscarry before reaching hospital, heavy bleeding can be very frightening and disposing of a recognizable foetus can be extremely distressing.
You may have feelings of uncertainty and guilt. Did you do something to cause the miscarriage, or could you have done something to prevent it? Almost certainly ‘No’ to both questions. Many women worry that sex, physical exertion or lifting heavy things may have been the trigger, but these activities don’t cause miscarriage. Is there something wrong with you? Very unlikely, but if there is it can be discovered and dealt with. Is it going to happen next time? Probably not. Most miscarriages are a ‘one-off’ event, and some causes of repeated miscarriage can be treated. However, anyone who’s ever had a miscarriage will know the anxieties of the early months of the next pregnancy. You never feel really safe until abut six months and after you’ve had some strong kicks from the foetus.
*185/31/5*
