Miscarriage: Risks, Symptoms, Treatment, and Care

Our big compensation, however, is our brain, which allows us the see the importance of protecting and raising a child. It also lets us sense and foresee danger, so a baby in your womb is well protected indeed, since you yourself are smart enough to keep from personal harm. What all of this means is that it's tough to accidentally hurt your baby.

Surely babies aren't invulnerable. If you were to try, it can be done. Alcohol, smoking, other drugs, and trauma can hurt your unborn child. Normal everyday activity, however, is not only harmless, but often helps the health of your baby. Patients often ask me if stress is hurting the baby. Only on soap operas. And the thing to remember is that everyone has stress. Life is stress. It's a normal part of our lives. It's why we have adrenalin.

Exercise especially is maligned unfairly, due in part to that soap opera mentality that pregnant women should merely glide along life on an air cushion without so much as a speed bump. All of the studies have shown conclusively that not only is exercise good for you and your baby, but it also decreases the likelihood of a C-section. The only warning is against overheating and dehydration. Aside from that, it seems all exercise is acceptable. Except kick-boxing. You should probably stay away from that.

Many patients and their husbands ask me when they should stop intercourse. The only time you shouldn't have intercourse during pregnancy is in the delivery room. Please. I think that says it all. Of course, this is advice in normal pregnancy. High risk pregnancy complicated by bleeding, premature labor, or infection have a completely different set of criteria, but generally all normal pregnancies are sex-worthy till the very end. Even orgasm, which is known to cause contractions of the uterus, seems harmless in normal pregnancies. A good rule of thumb is that you should avoid intercourse if it becomes uncomfortable; otherwise, sex is not a problem.

So far I'll bet I'm saying all of the things you want to hear, but they bear repeating. Sex is important in a marriage. Exercise is important to the mother. A baby is important in a daytime TV drama only if it moves the story line. Real people don't have story lines—they have lives. Just because you're pregnant doesn't mean you should stop living life as you know it. The simple joys of life are not only safe for baby, but good for maternal and marital well-being on many different levels.

Types of Miscarriage

The word abortion refers to any interruption of a pregnancy. In today's media, abortion is assumed to mean elective termination, but medically the word also refers to all of the types of spontaneous miscarriage. It is sometimes abbreviated AB. Under the heading of abortion, there are several designations that are clinically important:

Threatened abortion/Threatened miscarriage: any bleeding in the first trimester until other innocent causes are ruled out. Serial hCG levels can determine well-being or danger. Ultrasound is also important in following such a condition.

Missed abortion: a pregnancy that is no longer viable but hasn't passed or caused any bleeding yet.

Incomplete abortion/Incomplete miscarriage: a spontaneous miscarriage that hasn't completely passed. This situation may lead to heavy bleeding and serious infection if some tissue were to remain in the uterus. A dilation and curettage (D&C) is warranted.

Inevitable abortion/Inevitable miscarriage: when the cervix begins to dilate, which is a sure sign of impending expulsion of products of conception within the uterus, but before actual expulsion has begun.

Complete abortion/Complete miscarriage: miscarriage in which the entire gestational sac, placental tissue, and fetus are expelled. No further treatment is necessary.

Septic abortion/Septic miscarriage: any type of miscarriage associated with an infection of remaining pregnancy tissue or of the uterus itself.

Ectopic pregnancy: This is a pregnancy that implanted anywhere but the right place, the uterus. Most are in the fallopian tubes, but they can be seen in the pelvis, ovary, and even the higher abdomen. Since almost all of them are in the tube, however, this makes diagnosis much easier. The tube has limited capacity for a growing process, and soon it will stretch enough to cause pain. The very rare ectopic, in the pelvis for example, may get further along before symptoms hint at trouble, making blood loss worse with surgical treatment. Nonsurgical treatments are also available.