When Pregnancy Goes Wrong

When Pregnancy Goes Wrong

Unfortunately, not all pregnancies end well. For a few, pregnancy ends with a miscarriage or with the death of the baby. This chapter describes some of the things that can go wrong. If your pregnancy ends in this way, then you will need both information and support. Talk to the people close to you about how you feel and to your doctor, midwife or health visitor about what has happened and why. Sometimes it is easier to talk to someone outside your immediate circle

Ectopic Pregnancy

After fertilisation the egg should move down into the womb to develop. Sometimes it gets stuck in the fallopian tube and begins to grow there. This is called an 'ectopic' or 'tubal' pregnancy. The fertilised egg can't develop properly and has to be removed in an operation.

A common cause of an ectopic pregnancy is some sort of blockage in the fallopian tube, possibly as a result of an infection. Warning signs start soon after a missed period. They are a severe pain on one side, low down in the abdomen, vaginal bleeding or brown discharge, and sometimes feeling faint, and women should see their doctor immediately.

Talk to your doctor to find out why it happened and whether your chances of conceiving a baby have been affected.

Miscarriage

If a pregnancy ends in the first six months it is known as a miscarriage. Miscarriages are quite common in the first three months of pregnancy. Probably at least one in six clinically recognised pregnancies ends this way. At this stage a miscarriage usually happens because there is something wrong with the baby. A later miscarriage may be due to the placenta not developing or working properly, or the cervix being weak and opening too early in the pregnancy.

An early miscarriage can be rather like a period, with bleeding and a similar sort of aching pain, maybe occurring on and off, happening at the time when a period would have been due. With a later miscarriage, bleeding is likely to be accompanied by pains that feel more like the pains that come with labour.

If you bleed or begin to have pains, you should contact the person who is giving you antenatal care, either at the hospital or your GP's surgery. You may be told to lie down quietly or to come into hospital immediately. Sometimes the bleeding stops by itself and your pregnancy will carry on quite normally. But if a miscarriage is going to happen, there is very little that anyone can do to stop it.

After a miscarriage, you may have a 'D and C' (that is, dilatation and curettage) to empty the womb. This is done under anaesthetic. The cervix is gently widened and the lining of the womb scraped or sucked away. The cervix narrows again afterwards.

Afterwards

One miscarriage will not affect your chances of having a baby in the future. Even after three miscarriages you still stand a good chance of carrying a baby to term. If you have three or more miscarriages, you should be referred for further investigations. In some cases, all investigations will be normal and no precise cause found.

A miscarriage can be very difficult to come to terms with. You may feel disappointed, angry, or even guilty, wondering what you did wrong. Some people fear that the miscarriage may have been caused by making love, though this is extremely unlikely. In fact, whatever the cause, it is very rarely anyone's fault.

You will almost certainly feel a sense of loss. You need time to grieve over the lost baby just as you would over the death of anyone close to you, especially if the miscarriage has happened later in pregnancy. Many people find it helps to have something to remember their baby by. In early pregnancy you might be able to have a picture of a scan. After about four months you could ask for a photograph of the baby. If your miscarriage is very late you may be able to see and hold your baby, if you wish, as well as having a photograph. Talking also helps. Talk about your feelings with your partner and those close to you. The Miscarriage Association can give you information and put you in touch with other women who have experienced a miscarriage.

To learn more about the pregnancy and its associated issues visit: http://www.nlm.nih.gov/medlineplus/pregnancy.html (USA national library of medicine and national institutes of health website)

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