Chapter 2
Miscarriage
WHETHER OR NOT GETTING PREGNANT COMES EASILY TO YOU, not every pregnancy “sticks.” Pregnancy loss can be an agonizing experience. For women undergoing fertility treatments, the devastation that comes with miscarriage is compounded—all the visits to the doctor, untold dollars spent, and life put on hold—simply adding insult to an already significant loss.
What the West Says 
Miscarriage, clinically referred to as spontaneous abortion, and defined as the spontaneous loss of pregnancy before the 20th week, is much more common than most people realize. According to the American Pregnancy Association, 10 to 25 percent of known pregnancies end in miscarriage, but many more than that occur because they happen before a woman even realizes she is pregnant. In fact, up to 75 percent of all pregnancy losses are what are called “chemical pregnancies,” where the miscarriage occurs shortly after implantation and the period arrives just a few days late.
Often we don’t find out exactly what caused a miscarriage, though statistically we do know that most pregnancies end because the fetus isn’t growing properly, usually caused by chromosomal abnormalities.
Women sometimes take miscarriage very personally, often blaming themselves and creating a belief system that their bodies have failed them. The truth is, this is rarely the case. While the experience of loss can bring sadness, miscarriage is a common reality for women of childbearing age.
What Won’t Cause Miscarriage
When pregnancies end, women will often try and think back over everything they have done since the day they conceived, in an effort to pinpoint a reason for their loss. Not only is this practice quite unproductive, it’s also myth driven. Let’s take a look at what doesn’t cause miscarriage, so you can give yourself a break:
EXERCISE—Getting your heart rate up won’t make you lose your baby. That said, pregnancy is not a time to train for a marathon or start a new rigorous fitness routine, unless you were doing those things before you conceived.
SEX—Sometimes sexual intercourse can lead to a bit of cramping, but it typically passes pretty quickly and will not dislodge a healthy pregnancy. That said, if your doctor recommends that you abstain for a period of time, please heed his or her advice.
WORK—While you may be looking for a reason to stay home and watch streaming TV shows, doing your regular job won’t cause you to lose your baby. You should, of course, avoid exposure to toxic chemicals and radiation.
STRESS—While too much stress in and of itself is not healthy or ideal in pregnancy, it’s not likely to be the cause of miscarriage on its own. If stress alone induced miscarriages, we’d have a lot fewer people on the planet.
Common Causes of Miscarriage
There are some general risk factors that increase a woman’s potential for miscarriage including age, history of miscarriages (more than two), being overweight or underweight, smoking, alcohol and drug use, and invasive prenatal tests to check for chromosomal issues—including CVS and amniocentesis. Issues with the sperm and egg quality and health issues with the prospective mother can also lead to miscarriage.
CHROMOSOMAL ABNORMALITIES
Chromosomal abnormalities are the most common cause of miscarriage. At the time of conception, the egg and sperm have to meet, divide, and grow. This process is immensely complex, and errors frequently happen along the way resulting in conditions such as Down syndrome. Inherited genetic abnormalities—such as cystic fibrosis—are when one or both parents are the carriers of a disease.
Some of the most common examples of miscarriage due to chromosomal abnormalities include the following:
BLIGHTED OVUM—This happens when fertilization and implantation take place, but the embryo doesn’t grow. On ultrasound, it looks like an empty sac.
INTRAUTERINE FETAL DEMISE—This occurs when a pregnancy has been established, but the fetus stops growing before any signs of miscarriage. In this case, and depending on how far along she is, a woman may choose to undergo a D&C or allow her body to spontaneously miscarry.
HEALTH ISSUES IN THE MOM-TO-BE
Expectant moms with certain health issues may be at greater risk for miscarriage. If you have been diagnosed with any one of the following, it is important to be under the care of a qualified medical doctor and possibly a fertility specialist before you become pregnant, so you can be carefully monitored to avoid problems:
UNCONTROLLED DIABETES: It is crucial to make sure you are eating properly and that your medications are properly dosed to avoid complications in your pregnancy.
INFECTIONS: Certain infections can cause an increase in miscarriage risk including bacterial vaginosis, chlamydia, rubella, toxoplasmosis, and certain foodborne illnesses, such as listeria.
LUTEAL PHASE DEFECT: After ovulation, the outer shell of the follicle, called the corpus luteum, stays in the ovary and produces the hormone progesterone. Progesterone is vital to pregnancy, and a defective corpus luteum that doesn’t make enough, or peters out too soon, can cause an otherwise healthy pregnancy to end.
UTERINE AND CERVICAL ISSUES: Structural issues in the uterus, such as septum, bicornuate shape, or fibroids pushing into the cavity, can all impact the ability to hold a pregnancy. A weak cervix, often the result of surgical procedures, can also make it difficult to maintain a pregnancy to term.
AUTOIMMUNE DISEASE: Conditions such as lupus, rheumatoid arthritis, and other diseases where the immune system becomes overactive and attacks itself are associated with an increased rate of miscarriage.
THYROID DISEASE: Thyroid issues can cause a myriad of fertility-related problems including miscarriage. See page 174 for more about thyroid conditions and fertility.
Western Treatment for Recurrent Miscarriages
Western medicine has a small bag of tricks when it comes to preventing miscarriage. The primary treatments include the following:
Progesterone supplementation for those who are low
Aspirin to thin the blood and help with implantation/blood clotting problems
Heparin for known clotting disorders
Steroids to suppress the immune system for people with overactive immune responses that might be attacking the developing embryo/fetus
What the East Says
Chinese medicine can be an extremely useful tool in preventing miscarriage, unless the fetus is not chromosomally normal. In the case of chromosomal abnormalities, nature will usually stop the pregnancy on its own, and Chinese medicine can support the mother’s physical and emotional recovery. If medical intervention is required (such as a D&C), Chinese medicine can assist with healing and preparing the body for getting pregnant again.
With regard to recurrent miscarriage, Chinese herbs have proven to be quite effective when it comes to treatment, especially when the loss is caused by an overactive immune system or autoimmune disease.
Chinese medicine looks at an individual’s diagnosis to determine how to bring the body into balance in order to protect the pregnancy or prevent future pregnancy loss. Aside from the waning of Jing that comes with age, miscarriage may be caused by Kidney deficiency, Qi deficiency, heat in the Blood, or Blood stagnation. Refer to the section on Chinese medicine and fertility on page 45 to learn more about each of these diagnoses.
JANE’S STORY