Dealing with a Late Miscarriage
Every pregnant woman knows that in the first trimester, there is always the off chance that a miscarriage can happen. In fact, many women move into the pregnancy with a sense of caution that mimics walking through a pasture during a lightning storm. But for many women, miscarriage happens beyond the first trimester.
A late miscarriage is one that occurs during the second trimester or between weeks 14 and 24. After 24 weeks, a fetus is considered medically viable, which is why the term late miscarriage has been created. Beyond 24 weeks, losing a baby would be called a stillbirth and would require a full delivery.
Late loss in pregnancy is most often due to a chromosomal abnormality with the fetus. As the fetus develops and vital organs begin developing, many of these chromosomal abnormalities will occur causing an end to the life of a fetus. They also occur because of problems with the umbilical cord, genetic discrepancies, or structural problems within the major organs of the body. If a baby dies in utero, doctors can identify the cause and can even draw blood from the umbilical cord to determine whether the problem is one due to genetics (making it more probable in a subsequent pregnancy) or just a problem with the developing baby. If you have suffered a late miscarriage, it is important to ask physicians to perform a karyotype and have it assessed by a genetic doctor.
Late miscarriage can also occur due to infection in the mother or baby that gets into the amniotic fluid. Often, these are hard to diagnose early on when medications could be given and cause the fetus to go intro distress. There are several types of known bacterial infections that attack amniotic fluid. These infections are rare and can often be assessed with proper prenatal care and pregnancy well checks. It is very rare that they would occur twice in one person.
A weak cervix or uterine abnormalities can also be a problem causing late miscarriage. If the uterus is misshapen or is unable to conform to the growing baby, a baby will be unable to grow properly. Similarly, if a cervix is weakened from surgery or injury and a succlage has not been performed, the mother will go into labor too quickly. Most of the time doctors can tell through ultrasound and check-ups if there are problems and bed rest for either may be required from around the 18-week mark. Some women carry antibodies known as antiphospholipids that are from past illnesses which also cause late miscarriage. If this is suspected, aspirin therapy before conception is normally recommended.
Most disheartening is that often women in the second trimester who suffer loss do not know that they miscarried right away. The baby is still very small and movements are not as pronounced as they are after the 2nd trimester. However, you should start to become accustomed to the way your belly feels and the way your baby moves. If you do not feel any movement, it is best to err on the side of caution and have it checked out immediately. Lie down on your left side, eat or drink something very sweet, and see if you can get your baby to move. Also, if you feel – just through intuition that something isn’t right – require your doctor to do an ultrasound. Too often, mother’s instinct is overlooked.
All miscarriages are heartbreaking. When they happen it doesn’t matter why, how, when, or what – it just hurts. In the moment, you will not understand why you had to suffer such a loss nor will you be able to make sense of the situation. However, late miscarriages are very rare. Less than 1 out of 78 women suffer 2nd trimester miscarriages, and in those, most women have a known medical illness that makes them susceptible.
While you could spend the entirety of your pregnancy worrying and wondering if everything is okay, you will do nothing but drive yourself crazy. Instead, try to relax, take care of yourself, and do your best to ease your fears so that you can enjoy these very special months.