Dr. Rony Elias, an assistant professor of obstetrics and gynecology and of reproductive medicine at WCM, spoke to Bride magazine about the difficult topic of miscarriages. Read the complete article here.
As many as 20–25% of recognized pregnancies end in a miscarriage, according to Dr. Elias. And while they are physically and emotionally devastating, it’s important to know the facts, reasons, and resources that might help to navigate through such a difficult time.
What is a miscarriage?
By definition, Dr. Elias explains, a miscarriage is, “the unintentional arrest of a pregnancy before 20 weeks. Most physicians call a miscarriage a pregnancy that arrests any time from when it was first detected on ultrasound, and around 20 weeks. However, many pregnancies (up to 50% of all pregnancies) arrest much earlier, between the date a period is missed and up to one week later. These are called chemical pregnancies.”
Some miscarriages may occur at home, when bleeding or other signs/symptoms of miscarriage become apparent. Others may be discovered at a doctor’s appointment and are considered “missed miscarriages,” meaning the pregnancy has ended but the body did not yet recognize it. In very early miscarriages, the woman may not even know she was pregnant and experience what she believes to be a typical period.
Depending on the type and timing, miscarriages may be treated medically (with medication to help pass the tissue at home) or surgically (with a procedure to remove the tissue). Sometimes, there may be no need for assisted intervention, but of course your doctor should always be contacted as soon as you feel something is wrong.
Why do they happen?
According to Dr. Elias, “most miscarriages are due to abnormal chromosomes in the fetus. This is very rarely genetic (parents carry a specific chromosomal rearrangement), and most cases are sporadic or random. The incidence of this increases as the woman’s age increases.” Aside from chromosomal or fetal abnormalities, there are other causes, too. “In a patient who experiences two to three miscarriages, other causes should be ruled out," says Dr. Elias. "Most commonly, anatomical problems like inflammation and fluid in the fallopian tube, polyps, fibroids, or acquired thrombophilia disorder, commonly known as clotting disorder can cause miscarriages as well."
Though worry, grief, and even guilt are common (and normal) feelings often experienced by couples going through a loss, Dr. Elias says: “It is very important to reassure the couple that nothing the mother or couple does early on in pregnancy can change the outcome. No specific item, intercourse, or special food can cause or prevent a miscarriage. This is probably true for everything except smoking, drugs, or excessive alcohol." He also finds it important to inform couples how common miscarriages truly are.
“I usually tell my patients that having one or even two miscarriages mostly tells us one thing—they can get pregnant," he says. "It doesn’t mean that every future pregnancy will result in the same outcome.” Yet, it is important to acknowledge the potential causes with your doctor, which can often be treated relatively easily with good chances of live births following treatment.