All posts in Pregnancy

Healthy Pregnancy with MS

What is it?
Multiple Sclerosis (MS) is an autoimmune disease that affects the central nervous system, mainly
the brain and the spinal cord. Like most autoimmune conditions, research remains inconclusive
on what causes it, other than: antibodies attack healthy tissue. In MS, your body attacks the
myelin sheath: the wiring protecting your nerve cells. This damage causes messages from your
brain to the rest of your body to slow down, or completely stop. Most common treatment for MS
is a Disease Modifying Therapy (DMT), tailored to the patient’s needs and the severity of the
condition.

DMTs and Pregnancy
Women who have been diagnosed with MS and are thinking of becoming pregnant have likely
been told that most DMTs are not safe to use during pregnancy. One of the most common
concerns with stopping DMTs is the risk of relapse after pregnancy. In fact, medical
professionals suggest you stop the therapy altogether once you embark on your pregnancy
journey.

Another research, however, has found that 12% of its women participants were taking a
DMT during the first trimester. This lowered to 3% of participants by the third trimester. This is
not to say that use of DMTs during pregnancy is safe, but it does point to the need for further
research.

What should I expect?
It’s common that during pregnancy most autoimmune diseases—including MS—quiet down:
you may not experience as many symptoms, or your symptoms may lessen. Researchers believe
this is due to the hormones your body produces during pregnancy.

There is no evidence MS causes any miscarriages, stillbirths, or congenital malfunctions. Some
research suggests that premature labor and the risk of infections have been found to be slightly
higher in women with MS. Your doctor may suggest closer monitoring of your pregnancy, more
prenatal visits, and further tests to ensure your health. It’s possible you may need to consider a
C-section, especially if your MS symptoms affect your pelvic muscles and nerves.

What about relapse?
Research has found that the risk of relapse is relatively low during pregnancy. However, it can be
treated with corticosteroids which are generally known to be safe during the first and second
trimester.

After giving birth, studies have found an increased chance of relapse in the first three months. A
significant factor is the stability of the disease prior to pregnancy, and it is used to reduce this
risk. Similar to use of corticosteroids, if you are thinking of breastfeeding, remember that DMTs
can also pass through breastmilk—their use is not recommended if you will be breastfeeding.

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IVF Step by Step

IVFMany women utilize In Vitro Fertilization to achieve a healthy pregnancy, and discussions of the IVF process become more and more common. It is the most common form of assisted reproduction technology and has been around for approximately 40 years. It may sound daunting, as it does have a few steps and comes at a price, but what really is In Vitro Fertilization and what should you be looking out for if this is an option you are considering?

What is it?

The original definition means “fertilization in a glass,” where mature eggs are collected from the ovaries and are fertilized by the sperm in an incubator outside the body. Then, the healthiest embryo is transferred into the woman’s uterus. Though your specialist will determine what exactly is the best process for you, there are some standard steps in the IVF process, and a full cycle of IVF commonly takes 3-4 weeks. Sometimes the common steps are split into different parts, in which case the process may take longer.

The Steps

  1. Ovulation Induction: what marks the beginning of an IVF cycle is the use of artificial hormones to stimulate the production of multiple eggs. Though ovaries produce one egg during ovulation, more eggs are needed during IVF as some may not fertilize or develop normally after fertilization.
  2. Trigger Injection: before your eggs are ready for retrieval, you need 2-3 weeks of ovarian stimulation. Vaginal ultrasound or blood tests are then done to determine if the eggs are ready. Then, to assist the egg’s final maturation stage and loosening from the follicle wall, you will be given an injection of human chorionic gonadotrophin (hCG).
  3. Egg Retrieval: 34-36 hours after the injection your specialist will retrieve the matured eggs from your body. You may be lightly sedated during this 20-30 minute procedure and given some pain medication. On the same day, a semen sample will also need to be provided at your doctor’s office.
  4. Fertilization: this is the exciting part where the semen sample is washed and concentrated, and then added to the eggs approximately 4 hours after egg retrieval. They spend the night in an incubator and are checked the next day for fertilization. Usually, with a normal sperm sample, 60-70% of eggs will fertilize.
  5. Embryo Transfer: 2-3 days after egg retrieval you will be called back into your doctor’s office for the embryo to be placed in your uterus. The procedure is usually painless, and if this part of the procedure is successful, 6-10 days later you will have an implanted embryo on the lining of your uterus. This is called the Luteal Phase, followed by the Pregnancy Test about 14 days after the Embryo Transfer.

Risks

The most common risk when a woman is undergoing IVF is that there will not be a successful fertilization, or it will not lead to a successful pregnancy. Multiple cycles of IVF are not uncommon, but they can be financially stressful—as they range anywhere from 12k to 17k, according to the New York Times—and sometimes disheartening. Other risks include multiple pregnancies, ectopic pregnancy, miscarriage, premature delivery, and birth defects—among others.

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Conceiving Tips

conceiving

Even though many high school teachers had teenagers convinced they could get pregnant simply by having sex (and there’s definitely merit to that), in adulthood things can get a little more complicated. If you and your partner are trying to get pregnant through natural insemination, there are a few factors you may want to take into consideration in order to increase your chances of conceiving.

First Things First would be to become familiar with your cycle so you can determine whether it is a regular one (every 28 days) or an irregular one (shorter or longer). That will also help you find out when you may be ovulating. You can use apps to help you track your cycle, as well as your symptoms on the days leading up to menstruation and after. You can also notice symptoms such as an increase in body temperature and more vaginal secretions on the days leading up to your ovulation.

Knowing when you ovulate means you can determine your most fertile days each month. On a regular cycle, this would be 2 weeks before you get your period. It can be a little more difficult to predict that on an irregular cycle, but it is usually 12-16 days before you menstruate. You can better determine this with the help of home ovulation prediction kits, which test urine for luteinizing hormone, a substance whose levels increase each month during ovulation.

The short fertility window spans 5 days before ovulation begins and the 1st day of it, and that’s when the chances of conceiving are even higher. Many couples wonder if it would be best to have sex every day during that window, and the short answer is: yes! The highest rates of pregnancy occur in coupled who have sex regularly, and near or on the time of ovulation.

Knowing the medical information about your body is definitely helpful, as is learning to recognize where your cycle is and being in tune with it. If you have an IUD, tied tubes, or feel that you need assistance in planning a pregnancy, you can always consult an expert and be in touch with your doctor. However, you may also want to take into consideration some of the following factors that contribute to conceiving:

  • Maintaining a healthy weight can help, as excess body fat has been found to produce more estrogen, which can interfere with ovulation. Underweight women can also suffer from irregular periods or could also stop ovulating.
  • Eating healthy foods that contribute to preparing a woman’s body for pregnancy by providing adequate calcium, protein and iron, and folic acid. Try to avoid foods that are high in mercury, as it has been found to enter women’s bloodstream and has been linked to negatively affecting a baby’s development.
  • Cutting down on alcohol and smoking are very important factors in not only maintaining your general health, but also ensuring your body is a healthy home for a fetus.

Keep in mind that stress can be a huge factor when trying to conceive. Lots of couples face heightened stress and anxiety once they embark on the journey of getting pregnant, which can lead not only to intimacy issues, but also affect a woman’s cycle and throw it all off-balance. Remember this may not be an easy process and being supportive of each other as well as seeking help when needed are key to remaining healthy.

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Pillows During Pregnancy

pillows

Back pain during pregnancy is one of the most common causes of pain and discomfort. In later pregnancy, the pain can lead to insomnia, fatigue, and women opting for early birth inductions. While many medical professionals and journals label back pain during pregnancy as a “minor” symptom, anyone who has experienced it will tell you that is an understatement.

If you’ve never heard of an Ozzlo Pillow, it’s a wedge-shaped pillow designed to prevent or alleviate both back-aches and back-ache induced insomnia. The wedge pillow is placed under the abdomen while laying on your side, providing great support and relief. An overwhelming 87% of women experience back pain in the last few weeks of gestation. Medical studies found that wedge-shaped pillows do indeed dramatically reduce pain and allow for a better night’s rest. Even using a regular pillow in the same placement can be almost as effective.

Aside from medical studies with the wedge pillow, here’s a list of tried and tested different support pillows that can make pregnancy an even better experience:

  1. U-Shaped body pillows rank first among most pregnant women, who praise their size and shape-adapting ability, reporting that they relieve most of the pain they feel and reduce discomfort. There are even some U-Shaped body pillows designed specifically for pregnancy with a special space for abdominal placement.
  2. Memory Foam Body Pillows also do wonders for forming to parts of your body, providing support and pressure relief.  This is a slightly more cost-effective option that provides the same level of pain alleviation as other—more specialized and expensive—orthopedic pillows.
  3. Yana Pillows are similar to U-Shape Pregnancy pillows and have a special filling that provides luxurious relief for both back and side-sleeping pregnant women. It shapes itself on the curves of the body, so when using it your body does not have to inconvenience itself. Rather, the pillow adjusts to provide the support you need and relieve you from the aches of pregnancy.
  4. The Belly-Bandit is a 3-piece and OB-GYN-designed pillow, best for helping pregnant women sleep on their side to achieve optimal blood flow and oxygen to their baby. As it is a more versatile pillow, its great advantage is that it can be used by women prior to pregnancy so that they get accustomed to sleeping on their sides.

The advantages of pregnancy/orthopedic pillows go beyond pain alleviation: relieving the pain is great, but these pillows also prevent the use of pain relievers, reduce heartburn, avoid orthopedic medical intervention in the long run, prevent postnatal back and sciatic nerve issues, and reduce stress levels. Feel free to consult your doctor if you’re unsure which support pillow would best fit your needs, as you may need different support during the different stages of pregnancy.

 

 

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Pregnancy Thyroid Conditions

Thyroid conditionsThyroid diseases affect hormone levels and may cause overall hormonal imbalances that ultimately can have an impact on a woman’s fertility. Additionally, women have been found to develop either hyperthyroid or hypothyroid during pregnancy. However, it is untreated thyroid diseases that may have more of a negative impact on a pregnancy and not medicine-regulated thyroid conditions.

What is the difference?

Hyperthyroidism: refers to an overactive thyroid, when your thyroid gland produces too much of the hormone thyroxine. It usually heightens your metabolism, causing an irregular fast heartbeat and often accompanied by unplanned weight loss.

Hypothyroidism: as the name suggests, this is when your thyroid gland is less than regularly active, thus producing less of the hormone thyroxine than your body needs. It may initially not cause any symptoms, but if left untreated hypothyroidism may lead to obesity, infertility, and heart disease.

Thyroid Risks & Pregnancy

You may be at a higher risk for a thyroid condition during pregnancy if:

  • You are currently being treated for a thyroid condition.
  • Have already had a thyroid condition or have had a child with a thyroid condition.
  • Have a family history of thyroid autoimmune conditions, such as Graves’ disease or Hashimoto’s disease.
  • Have an autoimmune condition or Type 1 diabetes.

Hyperthyroid and Pregnancy

Untreated or inappropriately treated hyperthyroidism can lead to the following issues during pregnancy, especially affecting the baby:

  1. Premature birth, before the 37th week of pregnancy.
  2. Low birthweight, with the baby being born under 5 pounds.
  3. Goiter, the abnormal enlargement of the thyroid gland as well as general thyroid problems.
  4. Miscarriage or stillbirth.

Hypothyroid and Pregnancy

Some of the problems untreated hypothyroid can cause for the baby are the same as in the case of untreated hyperthyroid—such as thyroid problems, miscarriage or stillbirth—but there are a few that are different:

  1. Problems with nervous system developmenta and brain growth, especially when untreated hypothyroid happens during the first trimester.
  2. Infantile myxedema, which is linked to severe hypothyroid can lead to dwarfism (when an adult person is less than 4ft tall) as well as lower-than-average intelligence and a lack of skills necessary for daily life. 

Thyroid Medicine

Whether you are experiencing hyperthyroid or hypothyroid, thyroid medicine is meant to balance thyroid hormones in your body and keep them at the right level. If you are taking thyroid medicine and planning to become pregnant, consult with your doctor for possible adjustments. If you are taking medicine and become pregnant, do not stop taking your medication—as untreated thyroid problems lead to more severe issues than taking the medicine—but do get in contact with your doctor as soon as possible to ensure your and your baby’s health.

Remember that since thyroid diseases are a hormonal imbalance, lack of medicine and proper treatment is what leads to severe, or even fatal, issues during pregnancy; thyroid medication is not likely to harm an expectant mother or her baby.

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Seasonal Allergies

seasonal allergies

 

Seasonal allergies can be exacerbated during pregnancy. It’s not always the seasonal allergens that cause your body to react, as pregnancy hormones can also be the cause of unexpected, atypical, or more severe histamine production. Pregnancy is already stressful and physically challenging at times: worrying about what you can and cannot eat, consume or drink, and which activities should be avoided. But as far as allergies are concerned, there are plenty of antihistamine remedies available during a healthy pregnancy.

Seasonal Allergies & Your Baby

Even if you never experienced any seasonal allergy symptoms prior to your pregnancy, but are allergically reacting to something, rest assured your baby will not be the slightest bit uncomfortable—despite what you may be experiencing. More importantly, your reactions don’t indicate that your child will be born with allergies.

Different Seasonal Allergies & Pregnancy

There are two types of seasonal allergies during pregnancy: typical spring allergens that begin as early as February, and summer allergies that last until late fall. Pollen is the culprit for seasonal symptomatic reactions. Ragweed, grass, mold, tree pollen, and other regional pollen-producers can thankfully be avoided and there are healthy ways to soothe your symptoms.

Other pregnancy-related reactions are not caused by your environment: a condition called “Rhinitis of Pregnancy,” usually experienced during the third trimester, is caused by hormone level changes that mimic reactions to seasonal pollens. If you experienced season allergies prior to pregnancy, they may potentially worsen while pregnant. Fortunately, there are many safe ways to treat the reactions.

Treating Seasonal Allergies in Pregnancy

First, stay informed by checking your local pollen forecasts on weather and news apps. You may know some pollens to avoid, but your body can react to new irritants. Wear protective masks while doing outdoor activities like gardening or mowing, and make sure to shower and change clothes once inside. Stay indoors when pollen counts are highest, usually between 5am and 10am.

If you’re experiencing symptoms, saline nasal spray is a safe, effective treatment. It’s important to not use them more than three days in a row, as overuse can worsen nasal congestion. Wearing nasal strips at night opens breathing pathways and leads to a better night’s rest.

Avoidance is always the best form of treatment, but there are over the counter safe medications:

  • Benadryl (diphenhydramine) is most recommended
  • Zyrtec (cetirizine)
  • Claritin (Loratadine)
  • ChlorTrimeton (Chlorpheniramine)

Allergy shots, if begun prior to pregnancy, are usually safe to continue. It’s best not to start any allergy treatment during your pregnancy if you aren’t sure how your body will react. As always, should you experience abnormal symptoms of allergies—or severe reactions to allergy medications—while pregnant, reach out to your doctor.

 

 

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Pregnancy Immune Support

Immune SupportAny expectant mother’s goal is to deliver a safe and healthy baby, and the work to achieve that begins as soon as a woman realizes she is pregnant. From prenatal vitamins to diet changes, and more that are discussed here, women employ a variety of methods to boost their immune system during pregnancy. Did you know that your body actually lowers its immune defenses upon pregnancy to allow the fetus to grown? As a result, of course, your immune system becomes weaker and needs some extra support. This is especially important now, when COVID-19 poses an extra threat to individuals with a weakened immune system.

Immune Support Techniques

  • Prenatal Vitamins: During pregnancy, not only do you have a weakened immune system, but you also need to be careful with your diet. This can often make it difficult to have a healthy intake of necessary nutrients, so taking prenatal vitamins recommended by your doctor is a good way to ensure you are boosting your immune system and your overall health. In fact, it’s ideal to get on prenatal vitamins when you start trying to conceive.
  • Hydration: Staying hydrated is a good way to avoid illness and to help alleviate symptoms of it if you get sick. Our bodies need water, so extra intake of water ensures that your immune system runs effectively. Though there can be other sources, avoid drinks high in sugar or caffeinated beverages.
  • Diet: A diet high in fruits, vegetables, and proteins has the ability to naturally boost your immune system and help you get better if you get sick. Avoid foods with high sugar percentages and other carbohydrates. This way, you are ensuring you are consuming the necessary vitamins and minerals.
  • Rest: Though self-explanatory, a good night’s sleep goes a long way in boosting your immune system and in making sure your body is getting enough energy to stay healthy and to sustain a growing baby.
  • Humidifier: Not only can humidifiers help alleviate cold symptoms, they also keep the air pleasantly moist and generally cleaner.

Pregnancy and COVID-19

Because pregnancy can cause a lower immune system, it follows that the risk of contracting COVID-19 is higher. At this moment, the World Health Organization does not specify different protection measures against COVID-19 for pregnant women, but it does caution to the higher risk the virus poses to pregnant women.

As is recommended:

  • Wash your hands frequently with soap and water or with an alcohol-based hand rub.
  • Keep recommended space between yourself and others and wear a fabric mask.
  • Avoid crowded spaces.
  • Avoid touching your eyes, nose, and mouth.
  • Practice respiratory hygiene by covering your mouth and nose with your elbow should you need to sneeze.

 

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C-Section v. Natural Birth

C-SectionThere comes a time at every pregnancy when the delivery of the baby becomes the issue at hand; many mothers have a choice on whether to go through a natural birth—also referred to as vaginal birth—or request a Caesarian section, most commonly known as C-section. Sometimes a C-section is necessary, especially in cases of medical concerns for the health of the baby or the mother, but when faced with the option it is a wise idea to be informed of the differences between the two methods of delivery, as well as their respective risks and complications.

Overview

C-sections are a surgical procedure to deliver the newborn, and it takes place either when requested by the mother in lieu of natural birth, or when medical conditions make it necessary. Sometimes a C-section is pre-planned, while other times it may become necessary during labor. They are not as common as natural births, but the following conditions may make a C-section necessary for the safety of both the mother and the baby:

  • General health medical concerns for the newborn
  • Delivery of more than one baby
  • Maternal infections or conditions, such as diabetes
  • Problems with the placenta
  • Delivery of a larger baby
  • A labor that is not progressing in a timely manner, making it unsafe to continue naturally

A natural birth is a vaginal delivery, and it may take place with or without medical assistance for the pain. Natural births usually require a shorter hospital stay and have a faster recovery period. If the mother chooses to have a medical intervention to assist with a natural birth, this may be one of the following:

  • Using Pitocin to induce labor
  • An incision to help with the delivery of the baby without tearing the skin
  • Artificially breaking the water, which would mean a rupture of the amniotic membrane
  • A vacuum extraction

Procedure and Healing

Caesarean Delivery

In the case of a Caesarean section, the surgical procedure in general takes about 45 minutes. An incision is made through your abdomen and uterus to remove the baby, usually in the lower part of your uterus. As it is an operation, mothers may be given general anesthesia or an epidural block, where you will be awake during the procedure but not feel the lower part of your body.

The doctor cuts the umbilical cord, removes the placenta and closes the incision while the nurses may need to check the baby and clear their airway before they return it to the mother. Unlike natural birth, it may be a few minutes before the mother is united with her baby after a C-section.

As it is a surgery, recovering from a C-section will be similar to that of any kind of operation. There is a two to four day required stay at the hospital, and pain is to be expected when moving around or getting in and out of bed. The scar from the procedure may be itchy or painful in the first few weeks, like with any surgical scar, and cramps or discharge for about four to six weeks are natural.

Vaginal Delivery

A vaginal delivery happens in the hospital or a birthing center, and sometimes at home. In some cases, mothers opt for an epidural to numb the pain. There are three stages to this procedure: early, active, and transitional. Periodically, your cervix will be measured to determine whether you are fully dilated.

A full dilation is when the cervix is at 10 cm, when it is time to push. As the baby moves down the birth canal, the medical team assists with the delivery and uniting the newborn with the mother immediately. While the baby may be out, more contractions to extract the placenta are expected. Unlike a C-section, natural delivery has no specific timeframe and may take hours.

Takeaway

When the time comes to consider the safest option for you and your baby, always consult with your medical professional or your doctor. The safest choice depends on your medical history.

 

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Smoking While Pregnant

smoking while pregnant

The first thing that anyone will tell you is that smoking while pregnant is not good for the health of you or your baby. More specifically, it can cause an early delivery or a baby to be born too small. It can also cause certain birth defects, or even stillbirth. You should also remember that second-hand smoking or being exposed to tobacco smoke while pregnant can also cause serious issues. Though quitting before your pregnancy is ideal, early on during your term is the next best. Whatever the case may be, it is never too late during your pregnancy to quit smoking.

Studies show that about 10% of women smoke while pregnant, though this does not justify it. The percentage is higher among women who have been diagnosed with psychiatric problems. Since smoking is an addiction, it is likely that many women cease for the duration of their pregnancy but revert to it after their baby is born. With post-partum depression lurking, mothers who were smokers are more likely to go back to smoking even if they are still breastfeeding.

Birth Defects

Babies born to mothers who smoked during their pregnancy are more likely to have an orofacial cleft, which is a defect of the mouth and lip. A cleft lip can happen between the 4th and 7th week of pregnancy, if the tissue that forms the facial structures of the baby does not join completely at the lip, and possibly palate, before birth.

Babies who are exposed to other people’s tobacco are more likely to develop ear and lung infections, such as bronchitis and pneumonia. Second-hand smoking in this manner can also trigger asthma attacks, and it increases the risk of Sudden Infant Death Syndrome.

Nicotine Products

In their effort to quit smoking, many people will turn to e-cigarettes or other nicotine products. However, none of these options are safe to use during pregnancy as nicotine can damage a developing baby’s brain and lungs. On top of the danger nicotine poses, some of the flavorings used in e-cigarettes are also harmful to a developing baby.

Smoking and Breastfeeding

Though many women will pause smoking for the duration of their pregnancy, it is likely that they relapse after their baby is born. Nicotine and other chemicals are transferred into the breast milk at high levels, and you may be surprised to know that the amount of nicotine that accumulates in the breast milk and transfers to the baby is double that of the amount transferred through the placenta.

Women who smoke are more likely to have a lower milk supply, and to wean their babies faster than women who do not smoke during breastfeeding.

If you are considering a pregnancy, and are struggling with quitting smoking seek advice from your healthcare provider or doctor, and develop a quitting plan as early as possible to protect your health and the health of your baby.

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The Truth About Miscarriages

miscarriagesThe loss of a pregnancy before the 20th week is what we usually refer to as a miscarriage. Even though we know about 10% to 20% of pregnancies result in miscarriages, the actual number is much higher. This is because most miscarriages happen so early on in the pregnancy that a woman may not have realized she is pregnant. It is a common misconception to think of a miscarriage as a failed pregnancy, but this is not the case. A miscarriage suggests that the fetus is not developing normally, and therefore the body cannot carry the pregnancy to term safely.

Symptoms

These symptoms refer to miscarriages that occur before the 12th week of pregnancy:

  • Vaginal spotting or even bleeding
  • Fluid or tissue passing from your vagina
  • Cramping in your abdomen or lower back

It is actually quite common for women to experience spotting or bleeding in the first trimester, and it does not necessarily lead to a miscarriage. However, if you do pass fetal tissue, place it in a clean container and take it to your health care provider, or to the hospital, for analysis.

Causes

The main cause of a miscarriage is the abnormal development of the fetus, and half of known miscarriages are associated with either missing or extra chromosomes. These chromosome problems are not inherited from the parents, but rather occur as the embryo divides and grows.

Chromosomal abnormalities may lead to:

  • Blighted ovum: when the embryo does not develop at all
  • Intrauterine fetal demise: when the embryo forms bust stops developing before any symptoms of pregnancy are noticeable
  • Molar pregnancy and partial molar pregnancy: these pregnancies have to do with abnormal growth of the placenta, and there is either no fetal development, or abnormal fetal development. In both cases, the uterus miscarries the fetus.

In fewer cases, the health condition of the mother may lead to a miscarriage. Health conditions such as uncontrolled diabetes, infections, hormonal problems, thyroid disease, and uterus or cervix problems can result in the mother’s body terminating a pregnancy.

Diagnoses

There is a multitude of tests you can get done to confirm whether you have experiences a miscarriage or not:

  • Pelvic exam
  • Ultrasound
  • Blood, tissue and chromosomal tests

Future Pregnancies

Many women are worried about carrying on future successful pregnancies after a miscarriage, or even becoming pregnant. It is actually possible to conceive even in the first menstrual cycle immediately following a miscarriage, so the main factor to consider in this case is whether you are physically and emotionally ready. You should remember that a miscarriage is rarely a repeat phenomenon: most women experience it once and go on to have successful pregnancies after. Less than 5% of women have two consecutive miscarriages, and even 60% to 80% of women with undiagnosed causes of miscarriage have healthy pregnancies. If you do decide to try and conceive after a miscarriage, be sure to consult your health care provider for guidance.

 

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