Miscarriage and Stillbirth

Miscarriage and stillbirth are terms that refer to a pregnancy loss. Miscarriage, sometimes called spontaneous abortion, occurs when a fetus dies before the 20th week of the pregnancy. Stillbirth is the death of a baby after the 20th week—it usually is detected while the baby is still in the mother’s uterus but, occasionally, not until labor is underway.

Causes of Miscarriage and Stillbirth
Grieving
Deciding to Try Again

^ Top Causes of Miscarriage and Stillbirth

Miscarriage is a surprisingly common event—but the vast majority of miscarriages occur before the woman even realizes she’s pregnant. Studies done with extremely sensitive pregnancy tests show that almost half of all pregnancies miscarry before the fertilized egg implants itself in the uterus. After a pregnancy is clinically recognized (about 35 to 50 days into the pregnancy), the risk has decreased to 25 percent—and when the woman is eight weeks pregnant, the risk has decreased to just 10 percent. Once an ultrasound has been performed to confirm that the fetus is viable, the risk shrinks to just three percent.

The most common factors that can contribute to miscarriage include the following.

• Failure of the egg to implant in the uterus
• Multiple pregnancy
• The age of the mother—the risk rises when the mother is 39 or older
• Smoking—30 to 50 percent increased risk

Usually, however, no one knows why miscarriage occurs. It is important that you not blame yourself—miscarriage is almost never caused by something you did or did not do, but by chance.

There is about one stillbirth for every 115 births in the United States. It is not always possible to determine why a stillbirth occurs, but some of the identifiable causes include the following.

• Birth defects cause approximately one-fourth of stillbirths.
• Problems with the placenta or umbilical cord can interfere with the baby’s flow of blood, oxygen and nutrients, which can cause stillbirth.

There are numerous other, rarer causes of stillbirth. Again, stillbirth is only very rarely caused by something you did or did not do.

^ Top Grieving

When you have experienced a miscarriage or stillbirth, it is important to allow yourself to grieve for your loss. Some couples who have gone through a miscarriage or stillbirth suggest the following.

• Do not blame yourself. In the vast majority of cases, miscarriage and stillbirth cannot be prevented. Remember, these tragedies almost NEVER occur because of something the parents did or did not do.
• Give meaning to your loss. It is not always possible to determine why a miscarriage or stillbirth occurred—but if you can find out why, it may be easier to accept.
• Perform a ritual. Find a way to remember and grieve for the baby by performing a ritual such as planting a tree. Ask your pastor or religious advisor about a funeral service.
• Get help. Supportive friends and family are extremely important during this time. In addition, you may want to seek outside help through a counselor, pastor or support group. UT Medical Center offers pastoral care, which may be of help to you during this time.

^ Top Deciding to Try Again

It can be hard to decide when to try again after a miscarriage or stillbirth. Some couples wish to try again as soon as possible, while others prefer to wait. Most physicians suggest that you wait at least until you have had one menstrual period before trying again—but it is important to consult with your doctor first.

Once you decide to become pregnant again, it is natural to worry about having another miscarriage or stillbirth. Experts say that approximately one in 26 women will have more than one miscarriage, simply because it is a reasonably common occurrence. Women who have had a stillbirth have just a 3 percent chance of having another one. But remember—for most women, having one miscarriage or stillbirth does NOT increase the likelihood of having another.