Mourning What Could Have Been

Between 25 and 30 percent of pregnancies end in miscarriage, but is there anything you can do to prevent it from happening? And how do you know what caused yours, and if it will happen again? An expert answers all your burning questions.

- Colette Du Plessis

When you speak to women who had a miscarriage, you quickly realise that many of them would like to know why their pregnancies ended so suddenly, but that the answer often eludes them. If you ask doctors about it, they acknowledge that it’s a tough situation as there sometimes really is no answer. But it remains difficult for a woman to simply accept her miscarriage as “one of those things”.

“Every week, I see two to three patients who’ve had a miscarriage,” says the Cape Town-based gynaecologist and obstetrician Dr Martin Puzey. “And usually I can put them at ease by telling them it’s nature’s way to solve a problem.”

This is true for first-trimester miscarriages (during the first 12 weeks of pregnancy), as chromosomal abnormalities of the embryo are by far the greatest cause of early miscarriages. Sometimes a viral infection that’s accompanied by a high fever (like flu, German measles or malaria) can also lead to a miscarriage.

Dr Puzey says he also reassures women that the mere fact that you were able to fall pregnant means you’re healthy and able to do so again.

Giving women hope is one thing, but how about an answer to your question about why it happened? “That is very difficult,” Dr Puzey concedes. Medical professionals don’t always know why someone had a miscarriage.

The process of falling pregnant can be compared to a gearbox that firstly has to be split neatly into two, and then the one-half of the gearbox’s parts needs to be matched with every part in the other half of the gearbox, Dr Puzey explains. There’s a great chance that a mistake is going to slip in somewhere.

“It’s not something you did wrong but a fault that happened during the division and growth of the embryo.”