The Causes of Miscarriage During First Trimester

There are several reasons for miscarriage during the first trimester of a pregnancy; unfortunately, they cannot always identified. A miscarriage during the first three months of a pregnancy is usually down to a problem with the foetus.

Although miscarriages are relatively rare, three out of four in Britain occur during the first trimester. Private pregnancy scans can sometimes identify problems before they lead to miscarriage, but some of the causes may be related to lifestyle.

Although there are several known causes of miscarriage, the most common fall into the following categories:

Lifestyle choices

A-bad-days-mothering2.thumbnailWhile many miscarriages are beyond the control of anyone, there are certain lifestyle choices that can make them more likely. Women who eat well and exercise during the early stages of pregnancy may already be at a lower risk of miscarriage than women who don’t. However, there is evidence to suggest that women who are obese are at a heightened risk of losing their baby during those all-important first three months of pregnancy.

It is now common knowledge that smoking and excessive consumption of alcohol during the first trimester can drastically increase the chances of a miscarriage. Women are advised not to drink at all during pregnancy, but if they do, no more than two units of alcohol per week should be consumed. To put this into some context, this equates to just one average-size glass of wine.

In a society where recreational drug use is on the increase, it is important to remember that certain substances also have the potential to increase miscarriage risk. There is also a risk involved with the excessive consumption of caffeine during the first trimester of a pregnancy. Government guidelines recommend that no more than 200mg of caffeine should be consumed in one day, which is the equivalent to just two cups of instant coffee.

Age

Statistics show that the older the mum-to-be, the higher the risk of a miscarriage during the first trimester. Sadly, more than half of pregnant women over the age of 45 will suffer a miscarriage. Women aged between 35 and 39 have around a 20 percent chance of miscarriage, while women under 30 have a 10 percent chance of miscarrying.

Chromosome issues

A range of biological factors are determined by chromosomes – which are blocks of DNA. These chromosomes control everything from hair colour to how the cells of the body develop. Unfortunately, things can go wrong inside a foetus from the moment of conception, which often results in too many or too few chromosomes developing. If this happens, the foetus will be unable to develop in the normal way, and a miscarriage will occur. Despite a huge amount of research, the reasons for these chromosomal imbalances are still not clear. It is believed that up to two thirds of miscarriages during the early stages of pregnancy end this way.

Problems with the placenta

The placenta is an organ that directly links a mother’s blood supply with that of her baby. If there are structural or developmental abnormalities in the placenta, a baby’s access to oxygen might become cut off. One of the most common issues involving the placenta is a condition known as placental abruption. This is a very serious condition that can be picked up with a pregnancy scan at The Portland Hospital. It occurs when the placenta starts to detach from the lining of the womb. As well as miscarriage, this condition can cause growth and development problems in an unborn child.

Private maternity hospitals tailor prenatal care programmes based on a mother’s medical history and preferences. Carrying out the right scans at key points during a pregnancy can help clinicians to quickly identify issues that have the potential to cause a miscarriage.

 

“Have You Tried Ginger?” And Other Things Not To Say To A Hyperemesis Gravidarum Sufferer

Buckingham Palace this week announced that the Duchess of Cambridge is pregnant with her second baby, and that she is again suffering from Hyperemesis Gravidarum, or extreme morning sickness. If it was just the first part of that sentence, I’d say, “oh, that’s nice” and move on with my life, but with the announcement of Hyperemesis Gravidarum, my interest and empathy thoroughly perk up!Hyperemesis Gravidarum

In her first pregnancy, I found the plethora of comments about how she just had to suck it up, how she was ‘delicate’ and other disparaging remarks quite upsetting, as someone who had suffered from the same condition but now I just look at them as signs of ignorance. Honestly people, if you haven’t suffered from Hyperemesis Gravidarum, don’t comment on it. As simple as that. Especially not if you want to say one of these things, because there are some things that you should never say to someone who suffers from HG.

Read more… 

My Body, My Choice With A Backup – A Look At IUD’s

After I had my first son, I knew that I would want to get pregnant in the future but not right this minute and I wanted some assurance that it would not happen. I had been on hormonal birth control prior to having children and I was not happy with what it had done to my body over the 10 plus years I used it and I also did not like the possibility that it might mess with my precious milk supply.

I was much too lazy and forgetful for the charting and NFP that we had learned about through our Pre-Canaan classes before I was a mom. As a new mom I barely remembered to take my prenatal vitamins and I was exclusively breastfeeding, which in itself is a form of birth control called ecological breastfeeding or LAM but I wanted to be sure.


Just look at all the little doo-dads we have used over the years for IUDs

I couldn’t rely on knowing when my cycle would return in order and I wasn’t ready to trust my body to know when a cycle was coming. I don’t like and have never liked condoms and besides I am allergic and need to use only one specific brand. Who has time as a new parent to remember to put one on when you find that one moment of together time? That wasn’t going to work. So what is a newly natural minded mama to do?

I decided on an IUD or intrauterine device. I opted for the non-hormonal copper unit because I hated the hormone birth control and there was still the risk of interfering with milk supply. I was still taking a chance that I might have a reaction to copper since my skin reacts to cheap jewelry and I never really had copper around me before – luckily I didn’t.

I barely felt the insertion and I was only aware of the device being inside me for a few hours after. We weren’t completely positive when we would like to have another child (I was thinking in another year, he was thinking talk to me after we’ve been parents for a bit) so I liked that it could be left in for up to 10 years or it could be removed before that.

It contained no hormones so it was not interfering with my body in that way. It would however physically block sperm from meeting the egg or the egg from implanting.

Paragard packaged prior to use

I chose to use the IUD for around a year. By then I had seen some side affects from it and I really never saw the return of my period because I was using the IUD and breastfeeding. Maybe there is something to LAM after all? But we decided to add another member to our family.

I was expecting to feel some discomfort from the removal but I did not feel anything. That could be attributed to having a vaginal birth prior because some women do complain of discomfort during insertion and removal.

Overall though I was happy. I was not constantly worried that I was going to get pregnant before I wanted to but I also did not feel the way I did on hormonal birth control with the ups and downs of mood swings. After the birth of my second child this will definitely be a consideration for me again because just like every pregnancy is different, every post-natal menstrual cycle is different and I’m not taking bets that breastfeeding will work the same way again.

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Information About The Author:

AUTHOR BIO: Shannon R writes at The Artful Mama and is Co-editor of Natural Parents Network’s Reviews and Giveaways. She writes about her choices in natural parenting as a working parent to a toddler and soon to be new baby.

 

Maternity Photo Shoot With Urbanvox

*This is NOT a sponsored post

If you’re a regular reader, you’ll have seen a few of these pictures already, and if you’re a follower on Facebook they’ve surfaced there a few times already, but now, as my little Aviya uncurls and loses her new born look, I’m finally ready to share some pictures with you from our maternity shoot.  I hope you enjoy them.Read more: Maternity Photo Shoot With Urbanvox

Bio Oil For Stretchmarks

I’ve used a variety of oils in my pregnancy to try to keep the skin on my belly from stretching too much, but the first oil I ever used was Bio Oil for stretch marks, a lovely red/burnt orange coloured oil that always makes me think of cinnamon.

During my first pregnancy I used Bio Oil every day, and only developed stretch marks in the final few weeks … but they went away again soon after Ameli was born. Annoyingly, as my bump grew, I only used oil on the bits I could see – the top of the bump – and not below my bump and the difference in skin tone post pregnancy between the regularly moisturised part and the unmoisturised parts are astounding. You’re welcome to try it for yourself, but I don’t recommend it.  During this pregnancy I’ve been very careful to nourish the skin above and below the belly button and right down into the groin area, especially as baby’s head has descended much earlier this time.

So what is Bio Oil and where do you find it?

Well, Bio Oil is quite chemical rich and the main down side of it is that the oil base is a mineral oil (paraffinum liquidum) and a few other unpronounceable words. However, if you use ‘regular’ beauty products, this shouldn’t be a problem for you. It also contains Calendula Oil, Lavender Oil, Rosemary Oil, Chamomile Oil, Vitamin A, Vitamin E, and Helianthus Annuus Seed Oil.

There’s been a fair amount of research around Bio Oil too, which you’d expect with a product that makes huge claims about effectiveness. The sensitivity research showed none of the 21 subjects with known skin sensitivities had any adverse reactions to Bio-Oil, and that it had a reaction value of 0.03 over the test period. Basically, Bio Oil performed better than deionized water.

Bio Oil was also tested on 38 women to see the effectiveness of the product and there were statistically significant results after only two weeks evident in 95% of the ladies. After 8 weeks, all subjects showed improvement in the reduction of scars.

You can find Bio Oil at your local chemist or online pharmacy and for a product that works, and lasts for ages, it’s really well priced at under £10, in my opinion.

 

 

Pushing During Childbirth – Spontaneous Or Directed?

Despite having had an amazing home water birth with my first child, and having watched a few feature film lengths of birthing videos on youtube and around the web, whenever I think of childbirth, I still have the mental image of legs up in stirrups and nurses and doctors and pale looking fathers urging a screaming mother to ‘push, push,push!’ Such is the level of our indoctrination by TV, really!

The reality can and should be much different though. For a start, when a woman has sensation in her lower body, (i.e. hasn’t had strong pain medications) she knows all too well when to push. In fact, it’s physically impossible not to push. Your body just does it and there’s no stopping it.  The picture you see on TV is what happens when the mother-to-be has had an epidural and can’t feel the natural urges to push.  You then have a nurse, midwife or doctor looking at a screen to monitor when the contractions have started, and telling the mother to push.Read more: Pushing During Childbirth – Spontaneous Or Directed?

Does A Newborn Need Additional Vitamin K?

(Q16 on the birthplan: Would I like my baby to be given a vitamin K injection?)

During my pregnancy with Ameli, I learned everything I could about everything pregnancy and birth related! I wrote a book full of notes, typed it all up and kept it with my birth plan so that if I had to have a justification for my decisions at any point, I’d have it on hand. I was blessed with an amazing midwife who didn’t even question my choices, so I never needed them, but here are my notes on Vitamin K… maybe you’ll find them useful. These notes formed the basis of my decision and are only intended to provide reference materials to start you off on your own research.

Vitamin K is routinely given because:

“The problem of bleeding into the brain occurs mainly from 3 to 7 weeks after birth in just over 5 out of 100,000 births (without vitamin K injections); 90% of those cases are breastfed infants because formulas are supplemented with unnaturally high levels of vitamin K. Forty percent of these infants suffer permanent brain damage or death.”Linda Folden Palmer, DC in International Chiropractic Pediatric Association Newsletter September/October 2002 Issue

Vitamin K may be needed when:

  • Premature clamping of the umbilical cord deprives babies of up to 40% of their natural blood volume, including platelets and other clotting factors
  • The use of vacuum extractor or forceps causes bruising or internal bleeding, which uses up the baby’s available clotting factors
  • Antibiotics are used in the birth, as they inhibit the baby’s generation of clotting factors.
  • C-Section

There are alternatives to a vitamin K shot:

For breastfed infants, an oral vitamin K preparation (Konakion MM) given in 3 doses of 2mg at birth, 7 days, and 30 days of life results in higher plasma vitamin K concentrations than a single injected dose at birth (although my current midwife doesn’t agree with this statement). The preparation must be Konakion MM, which contains lecithin and glycocoholic acid; vitamin K require emulsification and the presence of bile salts for its absorption.

For formula fed infants, formula contains enough vitamin K that no supplement should be necessary.

Arguments against the routine use of vitamin K – three main observations (Falcao):

Vitamin K1 Injection (Phytonadione Injectable Emulsion, USP) (10 mg/mL)

Nature seems to go to a lot of trouble in regulating the baby’s vitamin K levels: the level at birth gradually rises over the eight days following birth to a higher level. It is almost as if nature very specifically wants the baby to have a specific level of clotting factors at birth, followed by a higher level of clotting factors a week after the birth.

This may be related to the fact that in a physiological birth, where the baby gets all the blood from the placenta, the baby’s blood is a little thicker; this is especially true in the 72 hours following birth, since the babies naturally become a little dehydrated until the mother’s milk changes to a higher volume flow, so the blood is thicker.

There has been some association between vitamin K injection and childhood leukaemia. (Parker) Theoretical observations are that precise levels of vitamin K are required to regulate the rate of cell division in newborns and that excessive levels of vitamin K disrupt this regulatory process, thus increasing the possibility of leukaemia and other childhood cancers. (While a few studies have refuted this suggestion, several tightly controlled studies have shown this correlation to be most likely1,2.The most current analysis of six different studies suggests it is a 10% or 20% increased risk. This is still a significant number of avoidable cancers.3)

Follow up research indicated that the leukaemia might have been related to mercury used to preserve the vitamin K solution. Further research in 2003 found that there was no definitive link between childhood leukaemia and Vitamin K, but also that ‘small effects cannot be ruled out’.

Research shows that babies who contract meningitis are more likely to die if they have higher clotting factors. It’s not clear whether this is due to genetic factors or whether it applies to all babies who receive vitamin K. ( I can’t find any actual links to this research, despite it being mentioned all over the web!)

The warning label on Vitamin K injections is pretty scary too:

Severe reactions, including fatalities, have occurred during and immediately after the parenteral administration of Phytonadione. Typically these severe reactions have resembled hypersensitivity or anaphylaxis, including shock and cardiac and/or respiratory arrest. Some patients have exhibited these severe reactions on receiving Phytonadione for the first time. The majority of these reported events occurred following intravenous administration, even when precautions have been taken to dilute the Phytonadione and to avoid rapid infusion. Therefore, the INTRAVENOUS route should be restricted to those situations where another route is not feasible and the increased risk involved is considered justified.

Dangers of excess Vitamin K:

When a baby is born gently, without any intervention, antibiotic, or trauma, and no apparent bruising, and is breastfed, there is no need for Vitamin K. Administering vitamin K to these babies – especially if they are formula fed – can lead to excess Vitamin K, which in turn may lead to newborn jaundice.

Signs Suggesting Need for Vitamin K after birth:

  • bleeding from the umbilicus, nose, mouth, ears, urinary tract or rectum
  • any bruise not related to a known trauma
  • pinpoint bruises called petechiae
  • black tarry stools after meconium has already been expelled
  • black vomit
  • bleeding longer than 6 minutes from a blood sampling site even after there has been pressure on the wound
  • symptoms of intracranial bleeding including paleness, glassy eyed look, irritability or high pitched crying, loss of appetite, vomiting, fever, prolonged jaundice.

(This list is written by Jennifer Enoch. Midwifery Today. Issue 40.)

Natural alternatives:

Keep the umbilical cord attached until it stops pulsing. Do not cut it prematurely, as average transfusion to the newborn is equivalent to 21% of the neonate’s final blood volume and three quarters of the transfusion occurs in the first minute after birth. (As Vitamin K doesn’t cross the placenta, this should make no difference to Vit K levels, but will help with iron levels etc.)

When breastfeeding (or just before starting), make sure to eat plenty of leafy greens or take a vitamin K supplement – vitamin K does not cross the planceta in pregnancy, but does enter breast milk in feeding. Anti-acids (used for heartburn) decrease the absorption of Vitamin K in the body – bare this in mind if you have lots of indigestion during pregnancy and be sure to increase with Vitamin K intake from around 38 weeks of pregnancy, as this will help prevent against haemorrhaging too.

Nettles are rich in Vitamin K – made into a tea you’ll get everything you need. Otherwise try a Nettle soup.

Conclusion:

My conclusion on this sensitive matter, based on the information available to the public and its potential impact on my own family, is thus:

Nature says a baby doesn’t need large amounts of Vitamin K, but that delayed cord clamping and the transfer of oxygenated blood gives the child enough resources to cope with the effects of a ‘normal’ birth. If the mother has been consuming Vitamin K in some form or another, it will immediately begin transferring through her colostrum, which is rich in Vitamin K and breastmilk and by eight days of age, baby will have the ‘right’ amount of Vitamin K (and since formula is fortified with vitamin K, formula fed babies shouldn’t require it at all) – since the disease it is meant to prevent doesn’t tend to occur until between 3 and 7 weeks I personally question the need for the injection.

At the same time, bleeding kills almost 2 in 10,000 babies, and this is the closest I could find to statistics as to deaths from the injections ** although we know that they have occurred. It says so on the label.  So really, the conclusion is inconclusive.

Every parent has to make their own decisions on this, but for me and mine, we’ve decided against vitamin K injections unless something in the birth necessitates it. We’ve also decided to follow natural alternatives, such as breastfeeding and a high maternal Vitamin K intake and to keep a close eye on the signs of bleeding as described above. 

** The FDA database contained a total of 2236 adverse drug reactions reported in 1019 patients receiving vitamin K by all routes of administration. Of the 192 patients with reactions reported for intravenous vitamin K, 132 patients (69%%) had a reaction defined as anaphylactoid, with 24 fatalities (18%%) attributed to the vitamin K reaction. There were 21 patients with anaphylactoid reactions and 4 fatalities reported with doses of intravenous vitamin K of less than 5[emsp4 ]mgs. For the 217 patients with reactions reported due to vitamin K via a non-intravenous route of administration, 38 patients had reactions meeting the definition of anaphylactoid (18%%), with 1 fatality (3%%) attributed to the drug.

 

References:

 

L. Parker et al., “Neonatal vitamin K administration and childhood cancer in the north of England: retrospective case-control study,” BMJ (England) 316, no. 7126 (Jan 1998): 189-93.

 

S.J. Passmore et al., “Case-control studies of relation between childhood cancer and neonatal vitamin K administration,” BMJ (England) 316, no. 7126 (Jan 1998): 178-84.

 

E. Roman et al., “Vitamin K and childhood cancer: analysis of individual patient data from six case-control studies,” Br J Cancer (England) 86, no. 1 (Jan 2002): 63-9

Further Reading: 

 

Labour Plan Or Checklist For A Homebirth

I’m not a list person. There’s something about spending time making a list that irritates me. It takes my hubby about as long to make a to-do list as it takes me to just do the stuff on the list. Yet, when it came to my last pregnancy and labour, I made a list long before the day of things to do when contractions start.

This list will differ from person to person, but I thought I’d share it with you, in case you’re not sure what to do ‘next’.

In Hollywood, your waters break in a great gush and everyone rushes off to hospital in a mad dash. In reality, very few women’s water’s break in the shopping centre, on the train or as you’re about to set off on holiday. Of course it does happen, but for the most part, in real life, you have time – if your waters even break before contractions start!

Without further ado, my list for what to do when I go into labour if you’re having a homebirth:Read more: Labour Plan Or Checklist For A Homebirth

What Does The Birth Partner DO At A Birth?

What does the birthpartner do at the birth?

That’s a really simple question, actually, with a ridiculously difficult answer, because the variables on it depend on the birthing woman, the environment, the birthing assistants, experience, relationship and about as many other things as you can imagine!

*For the purpose of this post, the birth partner is assumed to be the dad, but can be anyone the birthing mother wants or needs!

Never the less, men, especially, often find themselves completely hands off and lost when it comes to the birth of their babies. You only have to watch an episode of One Born Every Minute (which I strongly recommend as a contraceptive, but not as birth instruction!) to see how dads can feel uninvolved and at a loss when it comes to childbirth.Read more: What Does The Birth Partner DO At A Birth?

Positions For Labour And Childbirth

(Q6 on my birth plan – positions for labour)

(Q9 I would like to be in the following position to give birth:)

I sat in a hospital waiting room during my first pregnancy, waiting to see someone when a couple came in looking for labour ward. Her waters had broken and they were trying to find out where to go. They waited for the receptionist, and while doing so, were looking at the posters on the wall. The one just beside me had a whole variety of labour positions depicted in pictures. The woman said to her partner, “Hey, look here. You can have the baby in all these positions. You don’t have to lie down.”

My jaw dropped.

I’m sorry if this sounds judgemental, but I struggle to fathom how you can get to that point in one of the biggest occasions in your life and not know something as simple as labour positions.  Especially when your position during labour can have such a huge impact on your experience of childbirth.

Humans are the only mammals that try to give birth on their backs. It’s illogical as it defies gravity.

In The Business of Being Born, Michael Odent, the reknown doctor from France, explains why doctors want women on their backs – it makes their job of observing and interfering much easier.  He shows, in the video, the best position for a woman, which has him low down –hard on his back, but better for the labouring woman.

In reality, the best position for a labouring woman is the one she’s comfortable in. I spent most of my pregnancy with Ameli practicing squatting so I could give birth in that position. When it came down to it though, I found having my back out of the water to be excruciating and ended up delivering in the pool, sitting bolt upright. An illogical position, but a perfect one for me.Read more: Positions For Labour And Childbirth