Miscarriage. The scale of the problem
According to new estimates from The Lancet, there are about 23 million miscarriages worldwide every year. This corresponds to approximately 15% of all pregnancies. The authors of the article note that their real number will be higher, because they often pass unidentified or without seeking medical help.
Scientists estimate that, on average, one in 10 women has experienced miscarriage at least once in their lives. About 2% of women suffered two miscarriages, three – about 1%.
“Repetitive spontaneous abortion is a debilitating experience for most women, but its mental consequences are rarely the focus of the medical system. Women can feel trauma and grief that are not explicitly expressed, so they can pass unrecognized, ”said Professor Arri Coomarasamy, professor at the University of Birmingham and co-author of one study.
Kumarasami reported that according to their data, PTSD, depression or anxiety occurs in about 20% of women after a miscarriage. Therefore, he and his colleagues believe that in such cases, women should be offered screening for these mental disorders.
In Britain alone, researchers have calculated that the short-term effects of spontaneous abortion cost the government at least £ 471 million a year.
The analysis carried out by scientists confirms that the risk of miscarriage increases with chromosomal abnormalities of the fetus, parental age over 40, low body mass index, smoking, alcohol consumption, history of miscarriages, working night shifts, exposure to environmental pollution, prolonged stress.
Problem “Release on the brakes”
In an editorial in The Lancet, the authors point out that the problem of miscarriage is often poorly understood not only by women and their partners, but also by medical professionals. Women often believe that there is simply no effective treatment and therefore do not seek help. On the other hand, doctors may also consider miscarriages as “inevitable”. Recommendations for the treatment of miscarriage often require a detailed examination for a woman only after many miscarriages. This leads to the fact that experts regularly suggest that women “just try again”.
If women turn to specialists, then they have to go to many clinics of different profiles, scientists write. The recommendations they receive from different specialists are often contradictory. This is stressful for the patients.
“The lack of medical progress should be shocking. Instead, there is widespread acceptance of the problem, ”the authors write.
What help is required
Authors of new articles in The Lancet believe that nowadays women often receive insufficient medical care after miscarriage. In their opinion, investments in this type of assistance are required all over the world. They note that this problem is especially urgent for low- and middle-income countries.
Scientists have described how much help, based on modern knowledge, is required for miscarriage. After the first miscarriage, the authors recommend that doctors provide the woman with information about this problem, the physical and psychological aspects that are associated with it, and talk about what needs to be done to support a future pregnancy.
The second miscarriage is a reason for examination in a specialized clinic, identifying risk factors under the influence of which a spontaneous abortion could occur. In this case, additional support may be required during pregnancy.
After the third miscarriage, additional examinations are required. These may include genetic testing, ultrasound scans, screening for both partners, and screening for mental health problems. Obstetric risk screening should be done prior to subsequent pregnancies.