Finding hope again after a miscarriage

2026-03-08 - 00:54

In Malaysia, about 15.9% of women of reproductive age have experienced a miscarriage. (Envato Elements pic) PETALING JAYA: Miscarriage is far more common than many realise, yet it is often spoken about in whispers. In Malaysia, about 15.9% of women of reproductive age have experienced one. Globally, an estimated one in four to five pregnancies ends in miscarriage, although the true number may be higher as very early losses often go unreported. Despite being common, experiencing miscarriage is never easy. For some women, recovery – both physical and emotional – happens relatively quickly. For others, grief and guilt can linger. Understanding what miscarriage is, why it happens, and what comes next can help women and their loved ones navigate this painful chapter with greater clarity and compassion. What is miscarriage? Miscarriage refers to the spontaneous loss of a pregnancy before the foetus reaches viability, usually before 20 to 28 weeks. Around 75-80% occur in the first three months of pregnancy. One of the most significant risk factors is maternal age. The risk of chromosomal abnormalities rises from about 6.4% in women under 35 to 23.1% in women over 40. About one in 100 women experiences recurrent miscarriage, often without a clear cause. The reassuring news is that with specialised care, the chances of a successful pregnancy can be as high as 75%. Certain medical conditions can also increase risk, including diabetes, thyroid disorders, polycystic ovary syndrome (PCOS), and blood-clotting issues. Lifestyle factors such as smoking, recreational drug use, alcohol abuse and obesity play a role as well. It is equally important to clear up common myths: exercise, sexual activity, and most day-to-day activities during a healthy pregnancy do not cause miscarriage. Recognising the signs The most common symptoms are vaginal bleeding and cramping. Bleeding can range from light spotting to heavy flow, sometimes with clots. It may last one to two weeks, with the heaviest bleeding often occurring in the first couple of days. Early assessment by a doctor ensures that proper care is given and complications are minimised. (Envato Elements pic) Notably, any bleeding during pregnancy – even mild spotting – should be checked by a doctor. Severe abdominal pain, fever, or foul-smelling discharge require urgent medical attention. Diagnosis is usually confirmed through a medical history, physical examination and ultrasound. Early assessment ensures that the right care is given and complications are minimised. Types and treatments There are several types of miscarriage: Complete miscarriage: The pregnancy tissue has been fully expelled and the uterus is empty. Incomplete miscarriage: Some tissue remains in the uterus. Missed miscarriage: The foetus has stopped developing, but there are no obvious symptoms. Septic miscarriage: Retained tissue leads to infection, causing fever and foul discharge. Treatment depends on the type of miscarriage and the woman’s condition. In a complete miscarriage, no further treatment is usually needed. If pregnancy tissue is passed at home, it should be collected in a clean container and brought to the hospital for evaluation. Other treatment options include: Expectant management: The body is allowed to expel tissue naturally. Medical management: The patient is given medication to help the uterus empty. Surgical treatment: A procedure to remove retained tissue, particularly in cases of heavy bleeding or infection. Antibiotics are given if infection is present. Your doctor will discuss the safest and most suitable approach. From shock and sadness to anxiety and guilt – all these emotions are valid after a miscarriage and deserve attention. (Unsplash pic) Healing the body and heart Physically, miscarriage can involve heavy bleeding, pain and, in some cases, infection or the need for repeat procedures. Ovulation could resume within two weeks, and menstruation typically returns within four to six weeks. Doctors generally advise waiting until at least one normal menstrual cycle before trying to conceive again. Emotionally, however, the impact can be even more profound. Women may feel shock, sadness, anger, anxiety or guilt. Some experience depression, post-traumatic stress disorder or even suicidal thoughts. All these feelings are valid and deserve attention. Follow-up care within two weeks is important, not only to ensure physical recovery but also to assess emotional well-being. Counselling or support groups can be helpful. Meanwhile, partners and family members also need space to process their own grief. In addition, employers can play a role by offering compassionate leave and flexibility for medical appointments and recovery. While miscarriage leaves an imprint, it does not define a woman’s future. With accurate information, timely medical care and strong emotional support, healing is possible. Happily, many women go on to have healthy pregnancies. Above all, no one should have to walk this road alone. This article was written by Dr Anitha Ponnupillai, an associate professor in obstetrics and gynaecology.