The loss of a pregnancy can occur early or late. Early in the pregnancy, during the first two trimesters (13 week intervals), miscarriages can occur in up to 25% of pregnancies. Most commonly, these are due to chromosomal or genetic problems with the pregnancy. If the pregnancy lasts into the second trimester, there is a greater likelihood that an anatomic or structural abnormality with the uterus (womb) or cervix (opening to the uterus) may be the problem. During the third trimester of pregnancy, death of a fetus may occur while still inside the womb (intrauterine fetal demise). There are many possible causes for this, such as infection or medical problems. Often, the exact reason is never discovered
Whenever a pregnancy loss occurs, it should be recognized that the results can be devastating. The grief process may take several weeks to months, and is different in each patient.
For some patients, even after their body has returned to the nonpregnant state, the emotional healing process is not yet complete. Often, women feel a strong sense of loss because they have already emotionally bonded with the fetus. Women may blame themselves for the loss, resulting in physical problems such as fatigue, trouble sleeping, difficulty in concentrating, or loss of appetite. Even depression may occur.
In some cases, the partner may be of great support to the woman. In other cases, however, the partner may also have problems coping with the loss of the pregnancy. Sometimes, the communication between the two partners is not open enough to allow each to express their own feelings to the other. This, unfortunately, leads to problems between the two.
When problems such as this arise, the woman's physician should be made aware of the situation. The doctor or a counselor may be brought in to help one or both partners better express their feelings and responses to promote the resolution of the grief process.
The grief process includes an acceptance of the situation, and should not include trying to place blame for the occurrence. Physical and emotional recovery may occur at different rates in different individuals. Similarly, different couples may be able to cope with the pregnancy loss with greater or lesser success. Often, this is a reflection of other pressures that the couple may feel.
Letting the doctor know about all previous pregnancies and their specific outcomes will minimize misunderstandings. Communicating your feelings throughout the entire pregnancy and how you felt during and after the loss will help your physician make better decisions for your care.
Thomas G. Stovall, M.D.
Dr. Stovall is a Clinical Professor of Obstetrics and Gynecology at the University of Tennessee Health Science Center in Memphis, Tennessee and Partner of Women's Health Specialists, Inc.
Date Published: 2004-03-10
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Vanessa M. Givens, MD
Sherri Li, MD
Frank W. Ling, MD
Thomas G. Stovall, MD
Margaret Z. Summitt, MD
Robert L. Summitt, Jr., MD
Val Y. Vogt, MD
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