There is hope for those who have suffered a devastating loss
Do you know there is no word in the English language describing the status of a parent who has endured the unbearable loss of a child? We doubt this word exists in any other language either. The pain and sorrow experienced by these parents are indeed indescribable, as well as universal.
October is Pregnancy and Infant Loss Remembrance Month. Parents around the globe use this occasion to honor the babies lost during miscarriage and stillbirth. On October 15, many lit a candle and released a balloon into the skies in memory of their lost dreams and babies.
The spectrum of pregnancy and infant loss
It is estimated that 10 to 20 percent of known pregnancies end in miscarriage, with more than 80 percent of these losses occurring before 12 weeks. One percent of pregnancies will result in stillbirths.
A miscarriage usually refers to a fetal loss in the first 20 weeks of pregnancy, and a stillbirth means a loss 20 or more weeks after a pregnancy begins. Stillbirth further can be classified by when it occurs: early, late, term, or during childbirth.
To prospective parents who have yearned for children of their own and who have been in infertility treatment, pregnancy loss at any stage is overwhelming. This includes when treatment cycles fail or anytime after a confirmed pregnancy, including in its earliest days as a chemical pregnancy.
Why did I lose my baby?
Most women and their partners want to know why they lost their baby and their pregnancy failed. Not everyone will learn an answer. Fortunately, most women will only experience one miscarriage and do not need further testing or care. However, about 20% will have another one the next time they become pregnant. For these women, we recommend testing for those who have had more than one miscarriage in the first trimester of pregnancy or one in the second semester.
A recurrent pregnancy loss (RPL) assessment will look at uterine abnormalities, genetic/chromosomal causes, hormone disorders and immunological issues.
- Uterine/anatomic abnormalities: A hysterosalpingogram or hysteroscopy is used to diagnose this type of dysfunction, which can include fibroids, an abnormally shaped uterus and a septum, a band of tissue inside the uterus. In some cases, uterine abnormalities can be surgically treated. Where successful treatment is not possible, surrogacy may be an option.
- Hormonal and immunological disorders: Irregular endocrine conditions, such as thyroid problems, Type I diabetes and elevated prolactin levels have been associated with recurrent miscarriage. Blood clotting and immune conditions also can impact a woman’s ability to carry a pregnancy. Blood tests can confirm any of these problems.
- Genetic/chromosomal causes: Miscarriage often is associated with genetic or chromosomal abnormalities of the fetus. If we suspect a genetic association, we encourage couples to have a genetic evaluation.
Most chromosomal abnormalities are seen in the fetus and are random occurrences due to a missing or extra chromosome. As a woman ages, however, the likelihood of this happening increases with the risk rising to more than 50% in women over 40 years of age.
Treatment for miscarriage and recurrent pregnancy loss will depend on its cause. Many anatomical and structural problems can be resolved by surgery. For autoimmune or clotting issues, physicians might prescribe medications, such as low-dose aspirin or heparin. Underlying medical conditions that are the reason for loss should be treated before attempting the next pregnancy. If karyotype testing reveals one of the parents has a chromosomal translocation, then IVF with preimplantation genetic testing (PGT) is recommended.
Preimplantation genetic diagnosis (PGD) can be used to rule out many chromosomal abnormalities in the fetus. In PGD, embryos are created using in vitro fertilization and a small sample of DNA is taken from a cell in the embryo and tested. If the genetic disorder is present, the embryo will not be transferred to the mother's uterus.
Rainbow babies bring hope
A rainbow baby is a child born after a miscarriage, stillbirth, neonatal death or infant loss. A rainbow baby is the pot of gold at the end of the rainbow that awaits many families who have experienced these losses.
The births of their rainbow babies have encouraged many parents to share their journeys with others who have experienced similar tragedies. In fact, it has started a social media movement of gorgeous photos of pregnant women proudly showing off their bumps while dressed in every color of the rainbow.
Though these parents will never forget the little ones they have lost, the births of these new babies give them and others hope and encouragement.
Pregnancy and infant loss resources