Miscarriage

By Dr. Loretta Lanphier, ND, CN, HHP, CH

Losing a baby to miscarriage must be an extremely difficult emotional burden for any parent to bear. I imagine many who have suffered through this must wonder if there is anything that can prevent this tragedy, and what could possibly be the cause of it. Let’s see if we can learn more about these critical questions.

What is a  Miscarriage?

A miscarriage is defined as the loss of an embryo or fetus before the 20th week of pregnancy. The official medical term for a miscarriage is “spontaneous abortion” (SAB). There are varying estimates regarding how common miscarriages are, but it is thought that 15-25% of all pregnancies may end in a miscarriage. It is hard to give precise statistics, because many miscarriages happen so early in pregnancy, that a woman may be unaware that she has had one, and may not even know that she was pregnant. The majority of miscarriages occur prior to the 14th week of pregnancy.

Many couples are able to recover from the physical and emotional trauma of a miscarriage and go on to have a healthy baby. Statistically, 90% of women who have had one known miscarriage will go on to have a successful pregnancy. After two miscarriages, the percentage drops to 60%. If a woman experiences three miscarriages in a row, the statisticians claim only a 50% chance of a forthcoming healthy pregnancy. But there are so many varied causes and factors involved in miscarriages, that I find it hard to believe that these numbers are written in stone. As we will see, we can have a significant impact on many health issues in our lives simply as a result of our lifestyle choices, and miscarriages, in most cases, are no exception.

What are the Symptoms of Miscarriage?

Common signs include:

  • Vaginal spotting or bleeding (this is somewhat common for many women in early pregnancy, and may not indicate a pending miscarriage)
  • Cramping or pain in the lower back or abdominal area
  • Passage of fluid or tissue from the vagina

Bleeding without a dilated cervix indicates a threatened miscarriage. Many women experience this and go on to have normal and full term pregnancies with no other complications.  However, if the cervix is dilated, the miscarriage cannot be stopped and it is called an inevitable miscarriage.

What Are the Causes of Miscarriages?

The thinking in the mainstream medical world often seems to be that most miscarriages are from unknown causes, and that the high numbers of them that occur are statistically “normal.”  They may be average, but I do not believe they are normal. Heart disease and obesity are very common in our society, but this does not make them “normal.” They can be managed and prevented by looking at ways we can change our choices. I believe the same can be said for many cases of miscarriage. This means taking an honest look at a variety of potential hazards of our modern unnatural lifestyles that can contribute to miscarriage. This is just as true for males as for females. It is estimated that up to 40% of all infertility issues with couples can be traced to the male. Some of the most common suspected risk factors for miscarriages are:

  • Up to 50% of all miscarriages, especially those that take place within the first eight weeks of pregnancy, are the result of chromosomal abnormalities. Researchers believe most of these are the result of a particular egg or sperm that developed incorrectly, and are not likely to be repeated. This is different from inherited genetic faults that could conceivably happen over and over. The embryo is not developing correctly, and the body, with it’s own inherent wisdom, terminates the pregnancy.  Other times these abnormalities surface as the new life grows and cells divide, sometimes involving errors with genes or chromosomes. What causes these problems? It is not normal, and there are definite factors that can contribute:
  • Smoking:  Women who smoke greatly increase their risk for a miscarriage, by up to 50%. If the father is a smoker, this can also contribute to miscarriages. It has been shown that certain chemicals in tobacco smoke can damage the DNA in sperm. Damaged sperm can cause the body to abort the embryo just as an abnormal egg can. Another interesting fact was discovered during a multi-generational study of the effects of smoking and pregnancy. Even if a woman does not smoke during pregnancy, her chances of having a miscarriage are increased if her mother smoked while carrying her. Brings a new meaning to the term “second hand smoke,” doesn’t it?
  • Alcohol:  Alcohol is a toxic substance that has been proven to cause mutations. In a study done on pregnant mice that were given alcohol, up to 20% of the embryos were found to have significant chromosomal damage as compared to those that were not exposed to alcohol. Even moderate drinking can act as a reproductive toxin.  Studies on women have determined that as little as one drink of alcohol per day during pregnancy can increase the risk of miscarriage by two and a half times over non-drinkers. If you drink and smoke during pregnancy, the risk increases to four times. As in the case of tobacco, fathers who drink can also increase risk of miscarriage. It is a known fact that use of alcohol can both alter a man’s sperm count and the percentage of abnormal sperm. Advertisers neglect to mention that in beer commercials.
  • Caffeine:  This stimulant found in high amounts in many American’s diets has been clearly linked to chromosomal abnormalities, miscarriages, and other infertility problems. In other words, it can cause damage both before and during a pregnancy. A 1996 study at Yale University involving almost 3000 pregnant women found that three or more cups of coffee or tea per day definitively increases a woman’s chance for miscarriage. Decaffeinated coffee may even be a worse villain. Women may drink more of it, thinking it is safe because it has no caffeine. In reality, decaffeinated coffee still contains a certain amount of caffeine as well as other stimulants, such as theobromine and theophylline, which are not removed in the decaffeination process. In addition, many decaffeinated coffees contain chemicals used in processing that make it even more toxic to mothers. Don’t forget about other sources of caffeine that should be avoided as well, such as soft drinks, chocolate, and some medications.
  • Pain medications:  Some doctors recommend the use of aspirin or other blood thinners to prevent clotting that is suspected in some miscarriages, but there is evidence that aspirin and NSAIDS (non-steroidal anti-inflammatory drugs), another common family of pain relievers, can increase the risk of miscarriage by up to a whopping 80%!  Use of most of these drugs before or at the time of conception is associated with increased miscarriages just as much as use during pregnancy. The study only looked at women who had taken aspirin or NSAIDS for more than seven consecutive days either at or shortly before conception, or while pregnant.
  • Recreational drug use:  Use of any illicit drug has been linked to increased incidence of miscarriage as well.
  • Environmental toxins:  Exposure to heavy metals and other pollutants are clinically associated with miscarriages. Some substances specifically identified with increased risk are lead, arsenic, benzene, ethylene oxide, and formaldehyde. These can be picked up in many household products (cleaning solutions, construction materials such as treated wood or new carpeting), on the job, or simply from heavily polluted air (automobile and factory emissions). As bad as the air can be, studies show that indoor air pollution can be much worse. All of these toxins, and others, can contribute to miscarriages.
  • DES:  Diethylstilbestrol is a form of synthetic estrogen that was often given to pregnant women from about 1938-1971 because it was thought to prevent miscarriage. Some women whose mother’s took DES while they were pregnant with them may have numerous health problems, usually related to birth defects, and some of these can increase their chances of miscarrying. Male children also often have birth defects if their mothers took DES.
  • Low Progesterone levels:  Insufficient amounts of the hormone progesterone have been linked to miscarriage. Progesterone is needed to enable successful implantation of the ovum and to help prevent the developing embryo from being rejected. Sometimes too much estrogen (such as from DES, or commercial meat, poultry, or dairy) can contribute to miscarriage, and progesterone can help to offset that factor. For women who have experienced multiple miscarriages, supplementation with natural progesterone as soon as possible after conception has been shown to be very effective. Stay away from synthetic progesterone or any synthetic hormone. It simply does not work as well as natural progesterone, and can have numerous side effects including heart palpitations, elevated cholesterol levels, weight gain, headaches, depression, and other emotional disorders. Do your homework when choosing a natural progesterone as the word “natural” can be very misleading. Some companies may try to disguise harmful or synthetic ingredients in their products with “natural” sounding names. Be sure you know what you are putting into your body.
  • Fertility drugs:  Medications given to increase fertility can have some very serious side effects, one of them increasing the risk of miscarriage by 20-30%. Clomid (clomiphene citrate) is one of the most commonly prescribed.
  • Infections:  Certain infections, especially those of the genitourinary type, have been cited as risks for miscarriage. Coming down with one during pregnancy or having one at the time of conception have both been identified as risk factors. One study focused particularly on bacterial vaginosis, and discovered that this infection may increase miscarriage risk by as much as five times. It has also been found to play a role in many premature births. Bacterial vaginosis can often be eliminated by the use of a good probiotic to keep up the levels of  “friendly bacteria” in the vaginal area. Infections associated with sexually transmitted diseases (STDs) have also been indicted, such as chlamydia, cytomegalovirus (CMV), and genital herpes. Herpes can increase risk by up to 24%, and CMV has been linked to a reduced sperm count in men.
  • Diet:  What we eat (or don’t eat) can have a huge effect on disease processes in our bodies, and miscarriages are no exception. A diet high in antioxidants that fight the free radicals associated with toxins in our bodies is recommended. Load up on fruits and vegetables and other whole foods, and stay away from fatty, processed foods that have little nutrition and do more harm than good. Toxic substances can cause chromosomal damage that is directly linked to miscarriages. Selenium, either through supplementation or food sources (brazil nuts, tuna, cod, eggs), is a key mineral for protecting the body from toxins. In fact, studies have found that women who miscarry have lower blood levels of selenium than those who go full term. The B vitamin folic acid has also been clearly linked with decreasing miscarriages and birth defects. One study found that supplementation with folic acid and vitamin B6 dramatically improved successful pregnancies for women who had previously miscarried.
  • Invasive prenatal tests:  Be very careful of certain tests that may be ordered for you, as they are associated with increased risk for miscarriage. They may be necessary under certain circumstances, but it’s a good idea to get a second opinion and do some research into the skill and experience level of the person performing the test. Two tests to be especially concerned about are chorionic villus (fetal tissue sampling) and amniocentesis (amniotic fluid sampling).
  • Chronic conditions:Some chronic illnesses, especially diabetes or thyroid disease, are linked to a greater incidence of miscarriage. If you have either of these conditions, carefully manage them both before conception and after.
  • Other risk factors:  Age (women over 35 and men over 40), structural abnormalities in the uterus or cervix, previous miscarriages.  All of these play a role in increased risk for miscarriage.

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