MISCARRIAGE

Miscarriage is a synonym for "spontaneous abortion" or "spontaneous pregnancy loss." A miscarriage occurs because of an abnormal fetus (usually within the first twelve weeks) or disruption of the uterus as a safe environment (more prevalent after thirteen weeks). Miscarriages are common, occurring in up to 19 percent of pregnancies.

Miscarriage usually leads to vaginal bleeding, abdominal cramping, and occasionally severe pelvic pain as the disrupted fetus and placenta pass through the cervix. The major concerns are the health of the mother; there are no medical interventions that will mitigate against fetal death.

Miscarriages are unanticipated and occur early during a time of frequent maternal ambivalence regarding the pregnancy. Grief is often prolonged, with self-reproach as to the cause of the miscarriage. Siblings usually experience turmoil due to various combinations of previous jealousy of the pregnancy, lack of parental emotional availability, and processing the reality of death.

See also: BIRTH; PREGNANCY; PRENATAL DEVELOPMENT

Bibliography

Reindollar, Richard H. "Contemporary Issues for Spontaneous Abortion: Does Recurrent Abortion Exist?" Obstetrical and Gynecological Clinics of North America 27 (2000):541-554.

Scroggins, Kathleen M., William D. Smucker, and Adarsh E. Krishen. "Spontaneous Pregnancy Loss: Evaluation, Management, and Follow-up Counseling." Primary Care 27 (2000):153-167.

Simpson, Joe L. "Fetal Wastage." In Steven G. Gabbe, Jennifer R. Niebyl, and Joe L. Simpson eds., Obstetrics: Normal and Problem Pregnancies, 3rd edition. New York: Churchill Livingstone, 1996.

Michael Storr