A miscarriage, also called a spontaneous abortion, refers to a pregnancy loss before the 20th week of gestation or the expulsion an embryo or fetus weighing 500 g or less. Miscarriage at this stage occurs in about 31% of pregnancies.
It is not harder to have a baby after a miscarriage, in fact, fertility may actually improve slightly following a miscarriage.
- Some research found that women may be a little more fertile for a few months following a miscarriage. Researchers found that pregnancies conceived within 6 months of a miscarriage were more likely to be successful than those who waited before trying again.
- It is generally advised to wait before attempting to conceive again after a miscarriage until one is physically and emotionally ready. Waiting helps ensure the body is ready to support a pregnancy and reduce the chance of a repeat miscarriage.
- It is usually considered medically safe to conceive after two or three normal menstrual periods if tests or treatments for the cause of the miscarriage are not performed. However, some doctors may recommend couples wait six months to a year before attempting another pregnancy to come to terms with the loss.
Three or more miscarriages may be a sign there is an underlying condition that is affecting fertility, such as:
- Blood clotting problems (antiphospholipid syndrome, also known as Hughes syndrome)
- Chromosomal abnormalities
- Cervical weakness
What Are Symptoms of Miscarriage?
Miscarriage does not always cause symptoms and it is discovered on a routine ultrasound in early pregnancy.
When symptoms of miscarriage occur, they may include:
- Vaginal bleeding
- May be light or heavy
- May depend on how far along the pregnancy is
- Abdominal cramping
- Sudden loss or reduction of pregnancy symptoms
- Passage of pregnancy tissue
- Mild to severe back pain
- Weight loss
- Painful contractions occurring every 5-20 minutes
- If you are pregnant and have signs of a miscarriage, see your doctor right away.
What Causes Miscarriage?
Causes of miscarriage include:
- Chromosomal abnormalities
- Present in up to 70% of pregnancy losses before 20 weeks
- Maternal anatomical abnormalities
- Uterine fibroids (leiomyomas)
- Endometrial polyps
- Uterine adhesions
- Uterine septum
- Trauma
- Penetrating injuries
- Intimate partner violence
- Gunshot wounds
Risk factors for miscarriage include:
- Increasing maternal age, over 35 years
- Medical conditions
- Medication and/or substance use
- Alcohol
- Smoking
- Caffeine
- Some nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen (Advil, Motrin) and diclofenac
- Environmental exposures
- Race and ethnicity
- Women of color have an increased risk compared to white women
What Is the Treatment for Miscarriage?
If an ultrasound confirms a miscarriage and determines the embryo is no longer viable or has not fully formed, there are several treatment options:
- Expectant management
- Let the miscarriage progress naturally and allow the embryo to pass on its own
- This may take up to 4 weeks and can be difficult emotionally
- If the embryo does not pass on its own within 4 weeks, medical or surgical intervention is recommended because of the risk of infections, potential for loss of the uterus, or threat to the mother’s life
- Medical treatment
- Medications given to help the body expel the pregnancy tissue
- For most women, these medications work within 24 hours
- Mifepristone (Mifeprex) followed by misoprostol (Cytotec)
- Misoprostol (Cytotec) alone
- Surgical treatment
- Suction dilation and curettage (D&C)
- If miscarriage occurs with heavy bleeding or signs of infection, surgical treatment is recommended
From 
Women's Health Resources
References
Image Source: iStock Images
https://www.uptodate.com/contents/overview-of-pregnancy-termination?search=abortion&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
https://www.uptodate.com/contents/pregnancy-loss-miscarriage-risk-factors-etiology-clinical-manifestations-and-diagnostic-evaluation?search=miscarriage&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2
https://www.uptodate.com/contents/spontaneous-abortion-management?search=miscarriage&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/signs-of-miscarriage-916
https://americanpregnancy.org/getting-pregnant/pregnancy-loss/pregnancy-after-miscarriage/
https://www.babycentre.co.uk/x546737/ive-had-a-miscarriage-will-this-affect-my-fertility
https://www.tommys.org/about-us/charity-news/tommys-professor-shennan-new-study
https://www.uptodate.com/contents/overview-of-pregnancy-termination?search=abortion&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
https://www.uptodate.com/contents/pregnancy-loss-miscarriage-risk-factors-etiology-clinical-manifestations-and-diagnostic-evaluation?search=miscarriage&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2
https://www.uptodate.com/contents/spontaneous-abortion-management?search=miscarriage&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/signs-of-miscarriage-916
https://americanpregnancy.org/getting-pregnant/pregnancy-loss/pregnancy-after-miscarriage/
https://www.babycentre.co.uk/x546737/ive-had-a-miscarriage-will-this-affect-my-fertility
https://www.tommys.org/about-us/charity-news/tommys-professor-shennan-new-study