High risk for miscarriage?

If you've never tried to fall pregnant you probably have never even given your menstrual cycle a second thought. The less often it comes, the quicker its over the better, right? Wrong! However, you're more than likely one of the 60% of women who have fallen pregnant and miscarried early, as this is more the norm than most people think.

Get your body in shape before you conceive

Think about your group of friends; you can probably name a few women in your near circle who have miscarried. With the incidence so high, women should really understand their bodies and get themselves in tip-top health shape before conceiving; however sometimes these little miracles are sent to the lucky few as surprises when they least expect it!

Almost 50% of pregnancies end in miscarriage

Statistics confirm that almost 50% of pregnancies will result in a miscarriage due to irregularities, usually chromosomal, that Mother Nature in her wisdom deems not viable. Many other factors have been shown to be causes of a miscarriage, including low progesterone levels as one of the most common.

Chromosomal defects; physical or structural problems within the uterus (septa or fibroids) or cervix (incompetency) [Interestingly, multiple d & c's have been shown to weaken the cervical os (opening) thus creating an incompetent cervix that may need a stitch to hold a pregnancy]; immune disorders including Antiphspholipid antibodies that cause clotting of placental blood thus compromising the circulation to the developing embryo. Antinuclear antibodies that are present in some autoimmune disorders like Lupus; and immune reactions where the mother's immune system attacks the developing embryo due to the father's DNA seeming foreign (this is usually naturally prevented).

Other reasons include infections (mostly severe ones like syphilis, mycoplasma, toxoplasmosis and malaria, but NOT a normal upper respiratory infection); exposure to environmental hazards; severe kidney or heart diseases; uncontrolled Diabetes and Thyroid disease; radiation; and certain medications, especially a commonly prescribed skin drug.

Lifestyle factors also play a role in miscarriages, which include drinking alcohol, smoking, recreational drugs and excessive exercise.

Your menstrual cycle provides clues to your reproductive health

Although one would probably have thought of some of these risk factors, there are clues to be found in your menstrual cycle that may show risks for a future miscarriage. Does it not make sense to start with your cycle and work from there instead of presuming that everything is fine and only finding out when it is too late? There is a very high percentage of women (and men) with reproductive health problems; one can no longer just presume that there is nothing wrong with either partner.   

Symptoms of abnormal cycles

What worries me is that most of my patients who have risk factors, don’t even know it, and what's worse, have been told by doctors that this is a normal cycle! Here's a heads up: very heavy bleeding or a bleed that is too light and too short, clotting of your menstrual blood, lots of pain (or even any for that matter) especially in the lower back, breast tenderness, premenstrual moodiness, bloating…what else do we suffer from…headaches, runny tummies or constipation... all of these symptoms, although incredibly common, are NOT NORMAL! We are not cursed as women to go through hell every month, suffering immense pain and discomfort because Eve took a bite of the apple!

If our systems are well balanced, a period should be a very easy time of the month, with a few days (about 4/5) of menstrual flow, a good clean bleed with no clotting or any of the symptoms mentioned before! That's right, no breast tenderness, no pain and most exciting of all NO MOOD SWINGS!

Insufficient progesterone can cause a miscarriage

The most common culprit that compromises an early viable pregnancy is a clotty bleed. Clotting, clumping, bits, chunks that look like pieces of liver (this has regularly been described to me), fibrous, stringy bits…all of this is considered clotting. When any of the above are present in a bleed, this indicates that there was not sufficient progesterone in that cycle to mature the lining of the uterus (endometrium) correctly, putting you already in the "low progesterone" risk group. This is unbelievably common, and I regularly hear ladies saying that they thought that was good, that they were cleaning out all the lining, this is not the case.

In the first half of your menstrual cycle, estrogen is responsible for maturing the egg and follicle as well as for laying down the uterine lining (endometrium). What gets laid down, however, under the influence of estrogen, is a thick, dense, clotty, smooth-surfaced lining that is not in the correct format to receive an embryo for implantation and growth. After ovulation, progesterone gets released from the remaining follicle (now called the corpus luteum) and this is the critical time where the progesterone must mature the thick, dense, clotty estrogen lining and produce a large, fluffy and well matured lining. It should have minute 'fingers', called villi containing the vital blood vessels that begin the growth of the placenta, after implantation of a fertilised embryo, which falls into this blood-vessel-bed like a seed into soil.  

After fertilisation of the egg, the developing embryo begins the release of a hormone, Beta Human Chorionic Growth Hormone (Beta HCG for short) which tells the corpus luteum to carry on its production of progesterone. This further matures the lining and is responsible for the beginnings of the placental growth. Good levels of progesterone are vital to develop a good blood supply to the implanted embryo.  

Hormonal imbalances are to blame

When our hormones are out of balance, as is very commonly the case, the maturing of the egg and the development of the corpus luteum are both negatively affected. This compromises both the viability of the egg, as well as the integrity of the uterine lining. If you have a clotty menstrual cycle, the lining is compromised and may allow the initial implantation and growth of the embryo to begin. However, as soon as the incredible demands for growth of the baby begin around the 7th gestational week, the circulation cannot sustain it and the embryo does not receive enough nutrients to continue growing. Fact: most miscarriages occur between 7-9 weeks, this is more than likely the reason why.

As soon as the embryo stops growing, so the levels of BHCG start declining. This drop in hormone levels sends a message to the corpus luteum to begin the decline in progesterone production. As progesterone starts to fall, the blood vessels in the uterine lining begin to lose their integrity, start twisting themselves off (as before a menstrual bleed) and begin blocking off oxygen and nutrient supply to the embryo, thus furthering its demise. This begins a miscarriage.

Miscarriages are often nature's way of dealing with imperfection

Sounds scary and almost cruel, doesn’t it? But nature has an incredible way of quickly and efficiently dealing with less than perfect creations. Remembering that success of the human race demands a survival of the fittest, if the embryo or its growth is seen to be less than fit, nature will decide to end things now and start all over again.

Balance CAN be restored

There may be other factors in your cycle that can give a qualified practitioner clues as to other imbalances in your body and most of our patients are astounded as to the speed at which they see and feel results as their cycles noticeably change. Balance can be restored. Just because you have low progesterone now does not mean that you will 'suffer' with it indefinitely. Following the right nutritional, lifestyle and natural medicine regimen will allow your body to correct the imbalances and restore optimal reproductive and all-round health. I use Homoeopathy, Naturopathy and Traditional Chinese Medicine, including Acupuncture in an all-round holistic approach to healing and balance. Reflexology is also a wonderful adjunct to treatment.

Be informed to prevent suffering the trauma of miscarriage

Author info: Dr. Catherine Knight (formerly Morris)

Dr Catherine Knight is a Homoeopath and Acupuncturist, practising in Durban. In her busy practice (focusing on female and children's health) and as a mother of 2 (Kiara 9 & Keanan 6), she has been faced with nearly all childhood maladies. After following a purely natural approach to treating her entire family, she is proud to admit that her children have only ever had natural medicine and are fantastically healthy. Catherine is passionate about educating people in natural medicine and its uses in managing day to day health, naturally. She also owns and formulated a new range of Homeopathic medicines, perfect for babies, children and adults. Visit www.docmorris.co.za or email docmorris@docmorris.co.za