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Miscarriages should no longer be unmentionable

Monday April 12 2021
Misca pic
By Lucy Tomeka
By BEATRICE MATERU

One morning on August 17, 2018 Hope*(not her real name) found herself in extreme agony, laying in a hospital bed, 22 weeks pregnant waiting to deliver a baby boy whose heart was no longer beating.

Her doctor told her that her baby’s heartbeat was no longer there during an ultrasound exam earlier that morning . He couldn’t explain why because just a day before, Hope and her unborn baby were just fine no symptoms of miscarriage or any abnormality.

On the other hand, Beatrice was only 7 weeks pregnant when she had a miscarriage. Doctors told her she is no longer pregnant, gave her some antibiotics to clean her womb and told her to try again.

She experienced extreme stomach cramps and heavy breeding just a few hours before going to the hospital; her pain lasted only for a few minutes.

Both Hope and Beatrice recall their experience feeling clinical and cold. It took them months to fully process the information given to them, still questioning why, which was always followed by mourning.

Miscarriage can be an amazingly difficult thing to talk about; it is sometimes taken as shame to a woman who went through it.

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The issues surrounding miscarriages are more often than not, considered a taboo. In our society, Hope and Beatrice are but a small fraction of the number of women who lose their babies and are never given much thought afterward.

Miscarriages have touched women from all walks of life including the likes of Michelle Obama, Meghan Markle, Beyonce and many more stars. “Miscarriage is lonely, painful, and demoralizing” Michelle Obama wrote in her memoir.

After having the miscarriage, Michelle says she felt lost and alone. She blamed the lack of public health information and open conversations about fertility problems for her anguish. “I felt like I failed, because I didn’t know how common miscarriages were, because we don’t talk about them,” she explained. “We sit in our own pain, thinking that somehow, we are broken.”

“I think it is the worst thing that we do to each other as women; not share the truth about our bodies, and how they work, and how they don’t work.”

Due to the emotional nature that comes with miscarriages, many times women find themselves standing alone, with no one to talk to and no idea on how to process the flood of emotions and hormones running amok in them.

Not only does it represent a profound and heart-wrenching loss, but women are often met with an astonishing lack of empathy from caretakers, and even family, and friends.

The word ‘miscarriage’ is used to describe the early loss of a pregnancy mostly before 20 weeks of pregnancy, the first trimester.

Unfortunately, statistics show that between 10 and 15 percent of known pregnancies end in miscarriage.

For most couples, women normally wait to announce a pregnancy until the risk of having a miscarriage is lower. They say the further you are into the pregnancy, the less likely you are to miscarry.

Hope and Beatrice are not the only women to have an encounter with pregnancy loss, nor would they be the last.

These losses, and those that occur later on in a pregnancy, can leave women and families profoundly distressed, feeling vulnerable and uncertain about being able to fulfil their dreams of having a baby.

Although there is a need to open the dialogue about this issue and keep it going, it is also worth noting that men too tend to feel the sting that comes with the loss of an unborn child.

Ms Hilda Mshana, a practicing midwife and founder of Aunt Rafiki, explains just how dire miscarriages are to the expectant parents. “I deal with at least one miscarriage every day and I see first-hand how much of a traumatic experience this is” she says.

“I work closely with expectant mothers, probably more than doctors, because my job as a midwife is to provide care and attention all the way to delivery, unlike the misunderstanding that midwives only come in during the birth.”

Hilda created the Aunt Rafiki platform primarily to give aftercare to the women who she has worked with, both those that have been able to deliver successfully and those who have not.

She also give advice to women planning to have babies and is an active figure during the pregnancy of the women in her care.

As medical experts’ advice, first be sure that medical conditions, such as high blood pressure and diabetes, are under control before and during pregnancy.

Avoid smoking cigarettes throughout the pregnancy and try to reach and maintain a healthy weight before pregnancy.

There are known and unknown factors that can cause miscarriages, and at times doctors may not tell you what specifically may have caused of your miscarriage.

Miscarriages can occur in families of all races, ethnicities, and income levels, and to women of all ages.

However, there are things that a woman can do before and during pregnancy to avoid a miscarriage and to increase her chances of delivering a healthy baby.

However according to American Pregnancy Association (APA), miscarriages can be caused by a variety of known and unknown factors such as hormonal imbalance, medical conditions, infections, exposure to toxic environment and many more.


Common known factors that cause miscarriages

Genetics: Each of us is supposed to have a total of 46 chromosomes. That is 23 from one parent and 23 from the other.

When the sperm and egg meet, the cells come together. They then begin to divide to start forming the genetic material that makes up a person.

If something goes wrong when the cells are dividing, a chromosome may be missing or repeated.

About 50 percent of all first trimester miscarriages are because of chromosomal abnormalities.

This can occur more frequently in women who are considered advanced maternal age, or be at the age of 35 during her pregnancy.

Infections: Infections such as bacterial vaginosis, sexual transmitted infections (STIs) like Syphilis and gonorrhoea as well as pelvic inflammatory disease also play a big role in causing miscarriages if present.

Health experts also say that uterine and cervical infections can be dangerous to a developing baby and may lead to miscarriage.

Other infections that can also pass to the baby or placenta can affect a developing pregnancy and may lead to loss.

Infections like listeria, parvovirus B19, rubella, herpes simplex, and cytomegalovirus may increase risk to miscarriage

Anatomic problems: This refers to defects of the uterine cavity. If a woman’s uterus did not form correctly when she was developing, it may be unable to support a healthy pregnancy.

Clotting disorders: This is a condition that causes human body to form more blood clots than is normal. Examples include lupus anticoagulant and antiphospholipid syndrome.

In the case of pregnancy, blood clots can form in the placenta which will prevents nutrition and oxygen from getting to the unborn baby and prevents waste from being carried away.

Although there are times a doctor may not truly reveal what among the mentioned causes above is the reason for your miscarriage, normally extensive tests are conducted when a woman has met with two or three miscarriages.


Risk period

According to research findings, about 80 percent of miscarriages happen during the first trimester. First trimester of pregnancy is considered between zero to 13 weeks.

These early weeks mark the highest risk of a miscarriage. A woman can have a miscarriage in the first week or two without realizing she’s pregnant. It may sometimes seem and feel like a late period.


Signs and symptoms

The most common signs of a miscarriage are bleeding and cramping that are felt in the abdomen, pelvis, or lower back.

Some women experience spotting (light bleeding) during pregnancy.

A few drops or light flow of brown or dark red doesn’t necessarily mean trouble.

However, a doctor should be seen right away if there is bright red blood, particularly in large amounts.

Cramping can also happen in normal pregnancies, but severe or occurring more on one side of the pelvis is never a good sign.


Prevention

The majority of miscarriages are a result of genetic abnormalities and other health factors that are beyond human control and it is for those reasons that there is not a whole lot that can be done for prevention.

Doctors do recommend that the best thing one can do is to keep yourself as healthy as possible before trying to conceive and throughout the duration of your pregnancy.

Some of the suggested tips are easy to follow to staying healthy during pregnancy.

These include eating a well-balanced diet, exercising regularly, avoiding alcohol, recreational drugs, and cigarette smoking at all times.

For the caffeine lovers, doctors recommend reducing caffeine intake to 200 mg or less per day is equally as important for fetal growth and regular visits to the clinic, beginning as early as possible are highly recommended by all health care providers.

If you are worried about your risk of having a pregnancy affected by chromosomal issues, you can speak to your doctor about genetic testing before trying to conceive.

A blood sample will be taken from one or both partners, and then sent to a laboratory to be evaluated for major genetic disorders.

This testing and other evaluation are generally done after someone has recurrent losses.


Local care

Through the Aunt Rafiki platform, Hilda is able to keep up with her patients through online platforms to help assist pregnant women on how to take better care of themselves and their bodies to increase chances of a safer delivery.

“We help women acknowledge their loss, listens and gives them a safe place to grieve, educates them on what is normal after miscarriage (slight back/abd pain and pv discharge on first days)” explains Hilda.

She also connects them with other women who have had a miscarriage so they do not feel alone and know that others understand how they feel.

She also teaches them the importance of proceeding with pregnancy care (mineral supplements) and helps them plan their diets.

As the Nigerian actress, Adesua Etomi said in her recent testimony of how she lost her twins to miscarriage, “no woman needs to feel ashamed for having gone through miscarriage.”

Societies need to open up more on matters affecting women’s health just as much as we can comfortably address issues about different organs malfunctioning like the heart, kidneys, livers and more.