Miscarriages: For a Better Care

Miscarriage is a common event which occurs in approximately 15% of all pregnancies and affects one in ten women. An estimated 23 million miscarriages occur every year worldwide, which is equivalent to 44 miscarriages every minute.

In spite of this, the consequences and impact of miscarriages on individuals’ lives are still underestimated and even minimized. This is the conclusion of a series of 3 studies, published by The Lancet, which question many misconceptions and call for better overall care. Professor Siobhan Quenby, co-author of the study laments: “Many  women complain about the lack of empathy with which they are cared for after a miscarriage: some receive no explanation, and the only advice they are given is to try again.”

The research was carried out over the past 20 years. The first of the three reports deals with the epidemiology and psychological, physical and economic impacts of miscarriage. The second one focuses on demonstrating the value and effectiveness of healthcare, and the last one evaluates specific cases of recurrent miscarriages.

The authors point out that the woman and her partner often goes through this experience feeling isolated, that they are left alone to fend for themselves and that they sometimes feel guilty. There are still many misconceptions that persist: that miscarriages are inevitable, that you need to suffer several miscarriages before investigations can be made….

Several risk factors were identified, including having a history of miscarriage, the woman’s age (under 20 and over 35), and, to a lesser extent, the man’s age (after age 40), very low or very high body mass index, alcohol, smoking, air pollution, pesticides, omnipresent stress and working night shift…

For subsequent pregnancies, the study showed that most women who had a miscarriage were then able to carry their babies to term without any complications. However, it also demonstrated a higher risk of preterm birth, fetal growth retardation and other obstetric complications in those subsequent pregnancies. For the woman’s health, a prior miscarriage was also associated with a higher long-term risk, for example, cardiovascular disease but also psychological complications: risk of anxiety, depression, and/or post-traumatic stress disorder. The report also discusses how obstetricians treat miscarriages and prevention strategies.

Based on this study, the authors urge improving overall management for miscarriages but also for subsequent pregnancies. Finally, the authors recommend exchanging data between countries, to facilitate comparison, combine research efforts, improve patient care and reflect on how the data could be used in government policies.

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