Chapter 22, Page 7

Lifestyle of the woman

If the woman is regularly exposed to toxic fumes and chemicals (for example, workers in chemical factories or nurses and anesthetists in operating rooms) these could damage the developing fetus (which is very sensitive to poisons) and cause a miscarriage. Recent studies show that even men exposed to environmental toxins can cause their partner to miscarry a fetus (presumably because their sperm are damaged by the toxins). Smokers, alcoholics and drug abusers also have an increased incidence of miscarriages.

The Emotional Aspects

Human society still tends to dismiss miscarriage complacently; it is a subject which is rarely discussed. A foetus for most people is a non-person and a miscarriage is a non-event. But, to the would = be parents, the developing fetus is a baby with an identity, specially if they have seen it on the ultrasound screen and heard its heart beating with a Doppler. When the child is lost, it is a bereavement and the sense of loss, tinged with pain, anger, isolation and depression, can be profound especially when it follows a long period of infertility.

After a miscarriage, it is normal to experience a period of grief. Find support from each other and from others who have had a similar experience. Healing does take place in time. Focus on getting through the grieving rather than on the suffering.

Your next pregnancy

After a miscarriage, making the decision to go in for another pregnancy is difficult. Collect as much information as possible to try to find out the possible causes of the loss and whether they might influence a future pregnancy.If you have had 2 or more miscarriages, then tests are usually done to try to find a cause. These include the following:

  • Hysterosalpingogram or hysteroscopy to make sure there are no defects in your uterus (womb).
  • Blood tests, such as serum progesterone, to rule out a luteal phase defect.
  • Blood tests for antiphospholipid antibodies (lupus anticoagulant).
  • The VDRL (Venereal Diseases Research Laboratory) blood test, for sexually transmitted diseases.
  • Karyotype, for you and your husband, to rule out chromosomal abnormalities.

Often many doctors will perform what is called a "TORCH" test, but this test is a waste of money for most patients, since it provides little useful information.

When to start the testing depends upon you. While few doctors would investigate a woman after a first miscarriage (since her chance of having a healthy pregnancy even without tests and treatment is better that 85%), most would start a workup after two miscarriages. Often, nothing is found, and such a situation can be very frustrating to the doctor and the patient. But do remember that medical technology has it's limitations, and we still do not know a lot about the early embryo and its development.

Credits: How to Have a Baby: Overcoming Infertility