Suffering a miscarriage is a heartbreaking experience, so it's natural that moms-to-be worry about it. Perhaps because it's such a scary subject, there's a lot of misinformation floating around. The good news: It's unlikely that your own actions or lifestyle would be responsible for this event. "There are few things women can do that might cause a miscarriage," says Sindhu Srinivas, M.D., assistant professor of obstetrics and gynecology in the department of maternal fetal medicine at the University of
Pennsylvania. In fact, up to 60 percent of first-trimester miscarriages are due to genetic causes such as chromosomal abnormalities, most of which are nonrecurrent. Knowing that fact will help you rest a little easier. To help relieve other fears, we've consulted the experts to dispel some of the most common misconceptions about miscarriage.
The chance of having a pregnancy loss the second time around is no higher than if you hadn't suffered a miscarriage before, says reproductive endocrinologist Joseph Hill, M.D., president and CEO of the Fertility Centers of New England. However, after having two miscarriages, the risk of experiencing another pregnancy loss does increase -- to 20 percent. After three miscarriages, that number rises to 30 percent, and after four, the risk goes up to 40 percent. But keep in mind that even if you've had four pregnancy losses, there's still a 60 percent chance that you'll carry your next pregnancy to term, Dr. Hill assures. When a woman does suffer recurrent miscarriages -- defined as three or more consecutive pregnancy losses -- it's important to get thoroughly checked out by a reproductive endocrinologist to find out what could be going on. Fortunately, many causes of miscarriage, such as hormonal irregularities, autoimmune disorders, or antiphospholipid syndrome (an immunological problem that causes blood-clotting issues), can be successfully treated with hormone therapy or over-the-counter medication such as low doses of aspirin. If anatomical problems in your uterus or cervix are to blame, corrective surgery may be an option.
It's understandable that you might worry about having these symptoms, but they're incredibly common during early pregnancy and usually nothing to worry about. "Bleeding in the first trimester occurs in up to 40 percent of all pregnancies -- and mild cramping is something most women experience as the uterus expands," says Laurie Gregg, M.D., the chief of obstetrics and gynecology at Sutter Memorial Hospital, in Sacramento, California. That said, it is important to let your doctor know if bleeding, spotting, or cramping occurs, so that he or she can be on the lookout for worrisome developments. And if you experience severe pain -- especially on either side of the pelvis -- report this to your physician right away, Dr. Gregg says. It could be a sign of ectopic pregnancy, a serious condition in which a fertilized egg implants in a fallopian tube, which is potentially dangerous for the mom and not a viable pregnancy.
A garden-variety cold, a sinus infection, or even a stomach virus isn't likely to affect your pregnancy. However, having a fever over 102?F could be cause for concern. "A high core body temperature can kill the fetus in the first eight weeks of pregnancy," Dr. Hill says. So if you do become ill and have an elevated temperature, take acetaminophen as soon as possible to safely bring your fever down -- and then call your doctor right away. If you have a bacterial infection, such as strep throat or a sinus infection, certain antibiotics are fine to use during early pregnancy. Food-borne illnesses involving Listeria, a form of bacteria that can contaminate cold cuts, hot dogs, unpasteurized milk, and soft cheeses, can also cause pregnancy loss, notes Jonathan Scher, M.D., an assistant clinical professor of obstetrics and gynecology at The Mount Sinai Medical Center, in New York City, and a coauthor of Preventing Miscarriage: The Good News. Indeed, The American College of Obstetricians and Gynecologists (ACOG) advises that women avoid eating most of these foods during pregnancy, along with raw or undercooked meat, poultry, and fish. Symptoms of listeriosis can resemble the flu, so call your doctor pronto if you develop a fever and the chills. She can test you for the bacteria and treat you with antibiotics if need be.
If you've had an abortion in the past, be sure your ob-gyn knows about it, even though having had one or two procedures shouldn't affect your ability to carry a baby to term. Nor does it matter whether yours was a medication-induced abortion or a surgical one, according to research from the University of California, Los Angeles. "Though there is very limited information, there is some suggestion that having had three or more terminations may compromise the integrity of the cervix," Dr. Srinivas notes. (There is also an increased risk of miscarriage if there's a very short interval -- less than three months -- between an induced abortion and a subsequent pregnancy, according to research from Denmark.)
There's no evidence that engaging in moderate exercise during pregnancy increases your risk of miscarriage. According to ACOG, most forms of exercise are safe during pregnancy. (Just steer clear of activities that present a risk of falling, like horseback riding or skiing, and contact sports such as soccer and basketball -- and be sure to drink lots of water and avoid becoming overheated while you work out.) In fact, exercise may actually provide a protective benefit: Researchers at the Columbia University Mailman School of Public Health, in New York City, found that women who exercised throughout pregnancy actually had a 40 percent lower chance of having a miscarriage. "It's good to continue exercising during pregnancy because it prevents excess weight gain," adds Dr. Gregg. "Plus, being physically fit can help women get through the work of labor."
Originally published in the June 2011 issue of Parents magazine.