How Can I Prevent Miscarriage?

By Myrah M.

“Human reproduction is extraordinarily wasteful.” This quote from a major medical journal article sums up what science knows about miscarriage and what many prospective parents may not recognize. In a perfect world, conceiving a baby would be a flawless occurrence every time and all pregnancies would proceed smoothly. Unfortunately, nature has other plans for us.

In an ideal “textbook” pregnancy, conception happens in the fallopian tube when the sperm and egg meet to create a zygote (a single-celled embryo) with exactly 46 intact chromosomes. This single-celled zygote quickly divides and develops further to become a human embryo.

This extremely tiny embryo travels into the uterus and settles in among the nourishing tissues that line the inside of the uterus. This becomes the place where the embryo further develops, and a tiny placenta connecting a growing human to her mother’s uterus for the remainder of the pregnancy is formed. The embryo further grows and develops over approximately the next 280 days to become a fully functioning baby who is prepared to be born.

In the real world of human reproduction, a third of all conceived pregnancies are lost even before they get implanted. You would never know you were pregnant and wouldn’t have a positive pregnancy test.

Implantation of the embryo isn’t a guarantee of success because another 30% of pregnancies are lost after implantation but before you miss your period. Very sensitive urine or blood pregnancy tests might show positivity, but the oncoming period sadly indicates that the embryo was lost. This is called biochemical pregnancy because the positive test is the only real sign it existed at all.

You’ve Missed Your Period. Now What?

Once you miss your period and test positive for pregnancy, the baby has tackled a big hurdle. Yet many women, especially those who have had a miscarriage in the past, begin worrying about a possible miscarriage. This is natural. Every woman worries about miscarriage, even those who are naturally optimistic. Miscarriage is defined as the spontaneous loss of a fetus or embryo before the 20th week of pregnancy. Miscarriage is also called early pregnancy and is accompanied by the death of the baby within the womb.

An embryo that survives early implantation stands a good chance of being born healthy. Sadly, however, 15% of clinical pregnancies (with a positive test AND missed period) are still lost to miscarriage. If you are an older expectant mom (over 40 years), this rate is much higher. About half of all clinical pregnancies among women above this age are lost to miscarriage.

Everyone wonders what they can do to prevent a miscarriage. Should I rest more? What should I eat? Should I reduce my stress levels? Or is there nothing I can do? Will a miscarriage happen no matter what I do?

There are many reasons behind a miscarriage, and sometimes, expectant moms and their partners may be able to do something to prevent this heartbreaking pregnancy outcome.

What are the main reasons for miscarriage?

It might help to divide the main causes of miscarriage into things we have control over and those we might be able to manage through changing our lifestyle or through medical intervention.

1. Reasons for Miscarriage that We Can’t Control

   • You may have heard that miscarriages are all about genetic defects we have no control over. This is partly true, especially in very early miscarriages. About 85% of miscarried embryos have some serious malformation, almost always caused by a genetic problem.
   • Most genetic causes of miscarriage are not inherited. They are often related to things like accidentally broken pieces of DNA or an extra or missing chromosome. Down syndrome is just one example of a baby born with an extra chromosome. A third of embryos with this defect do not survive.
   • Unfortunately, human fertilization is a delicate process with far from perfect outcomes. Older parental age (of both mother and father) can complicate things because older eggs have had a longer time to collect DNA damage in the woman’s ovaries. In men, lifestyle factors similarly make their sperm more prone to having damaged or fragmented DNA.
   • In some situations, the woman’s uterus can be malformed. A normal uterus is shaped like a pear. If yours didn’t develop properly, this can make it hard to carry a pregnancy to term.

2. Reasons for Miscarriage that We Can Prevent

   • There are some potential miscarriages you may be able to prevent, even if you can’t control the existence of the problem itself. Women with certain autoimmune diseases tend to have more miscarriages, especially those with lupus, autoimmune thyroid disease, and anti-phospholipid syndrome (APS). Fortunately, there may be medications you can take during early pregnancy to reduce inflammation from these diseases and prevent your body from accidentally rejecting the embryo.
   • Diabetes, obesity, and PCOS (polycystic ovarian syndrome) are all common miscarriage risk factors you can lessen, often by losing weight before pregnancy or by controlling your blood sugars. Each of these problems results in higher levels of inflammation in the body. Losing weight lowers the body’s inflammatory response, possibly preventing a miscarriage.
   • Certain blood-clotting diseases like hereditary thrombophilia or thrombophilia acquired later in life (because of cancer or certain medications) can cause miscarriages by increasing the chances of blood clots in the delicate placenta blood vessels. Thrombophilia is a situation where your blood forms clots easily. If you know you have a blood-clotting problem, see your doctor for treatment to prevent clotting during pregnancy.

3. Reasons for Miscarriage that We Can Completely Control

   • The lifestyle factor most connected to miscarriages is the consumption of alcohol. Experts agree that no amount of alcohol is safe at any time during pregnancy. If you are trying to become pregnant or have a positive pregnancy test, stop drinking immediately.
   • Less commonly, lifestyle factors that may be related to miscarriage include smoking, caffeine, and stress. Everyday stress is not likely to contribute to miscarriage, but things like domestic violence or other causes of extreme traumatic stress are linked to a higher miscarriage rate.

How Can You Prevent Miscarriage?

Every woman’s life and her circumstances are different. Older women can’t turn back the clock, and those with known autoimmune diseases can’t undo their conditions. Yet we can take the cards we’ve been dealt and play them as well as we can.

If you have any disorder known to increase miscarriage risk (diabetes, thyroid disease, PCOS, etc.), you should try to be in tiptop shape before you get pregnant. If this isn’t possible, see your doctor as soon as possible to make sure you are as healthy as you can be moving forward.

Take charge of your lifestyle as soon as you can by stopping smoking and alcohol consumption. Reduce your caffeine intake and try eating foods that naturally reduce inflammation, such as fresh fruits and vegetables. Many fried foods increase inflammation, so reduce your intake of these. If there are avoidable stressors in your life, avoid them if you can. Make your pregnancy your new priority.

Some women feel better if they purchase a fetal doppler heart rate monitor to listen to their baby’s heart rate at home. Don’t panic if you don’t hear it before 10-12 weeks into the pregnancy. Even the best obstetricians have trouble hearing it consistently in the first trimester. Still, hearing your baby’s heartbeat on a monitor at home can be reassuring and stress-reducing.

Lastly, relax. Your baby needs you to remain calm and healthy throughout your pregnancy. The time for you to practice becoming the best mom possible is in this moment.