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SingHealth

singhealth.com

About SingHealth

SingHealth is a healthcare provider that offers services to clinical specialties, a network of acute hospitals, national specialty centers, polyclinics, and community hospitals. The company is based in Singapore.

Headquarters Location

Third Hospital Ave,

Singapore, 168753,

Singapore

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Latest SingHealth News

Healing from miscarriage: What women need to know about pregnancy loss, medical leave and emotional recovery

Nov 22, 2022

I am no stranger to miscarriage, having suffered two consecutive miscarriages before having my first child in 2009. My first pregnancy was a surprise – I had discovered myself pregnant at Week 7 and promptly bled the following week while working at an event. The second happened months later and as I crossed into the second trimester at Week 13, I discovered the foetus had no heartbeat while at the obstetrician-gynaecologist’s office. Needless to say, I was devastated. The loss happened close to Christmas and we were looking forward to sharing the news with our family and friends. These losses forever changed my views on fertility, the pregnancy journey and baby loss. WHAT IS A MISCARRIAGE? A miscarriage is the loss of the pregnancy from the time of conception up to 24 weeks of gestation. According to SingHealth, miscarriages are fairly common, with most of them happening before Week 12 of the pregnancy or within the first three months. Miscarriages are also called “spontaneous abortion” or a naturally occurring symptom, which cannot be controlled. Approximately 10 to 20 per cent of known pregnancies may end in miscarriage. It’s important to note that many women are unaware that they are pregnant when these miscarriages occur. Related: For pregnancies lost between 12 to 24 weeks, they are called second trimester miscarriages. After 24 weeks, a late miscarriage occurs with a stillbirth or intrauterine foetal death. The most common signs of a miscarriage are when the woman finds herself spotting or sees fluid or tissue being passed out. She may also experience some abdomen pain or cramps, or a dull pain in her lower back. Many times, in the case of missed miscarriage, when the embryo stops developing but the body behaves as if the pregnancy is still ongoing, few or none of these symptoms occur, so even if you experience any, it may not indicate a loss at all. WHAT CAUSES MISCARRIAGE? HOW MANY TYPES ARE THERE? There is no exact cause for miscarriage but more than half of all miscarriages are due to chromosomal abnormalities which hamper the normal growth and development of the embryo. Many of these disorders or defects happen by chance and do not affect future pregnancies. Causes of miscarriage include chromosomal abnormalities, womb abnormalities, hormonal deficiencies, an incompetent cervix, health conditions such as autoimmune disease, among others. (Photo: iStock/fizkes) Other causes of miscarriage include womb abnormalities, hormonal deficiencies, an incompetent cervix, and other genetic health conditions such as autoimmune disease. Another cause is when a blighted ovum occurs – this is when a fertilised egg is implanted in the womb but never develops. In a missed miscarriage, some pregnancy symptoms may lessen but one often finds out during a scan with the ob-gyn as they try to locate a heartbeat. This loss is more common and more often than not, there is nothing one can do to prevent it. A unique cause is an ectopic pregnancy. This is when a fertilised egg implants itself on the outside of the womb, or lodges in other places like the cervix, or one of the Fallopian tubes. When this occurs, the pregnancy would not be viable and will require a medical procedure to remove the implanted egg. This reduces it from causing further harm to the woman’s reproductive organs. Related: Recurring miscarriages can also happen and in such cases, doctors would assess the health of both parents. Dr Kelly Loi, medical director at Mount Elizabeth Hospital Fertility Centre tells CNA Women: “Only 1 to 2 per cent of women experience such consecutive loss, that is, the loss of two, or more pregnancies. Further investigations will help assess the couple’s fertility, and medical history. With the appropriate care and management, many go on to have successful pregnancies.” TREATMENTS FOR MISCARRIAGE Depending on the type of miscarriage, treatment options will differ. For some, after ultrasound scans and understanding the symptoms, ob-gyns may let nature take its course and let the foetal tissue be expelled from the body on its own. Depending on the type of miscarriage, the doctor may let the foetal tissue be expelled from the body on its own, prescribe medication to start the process or do a medical procedure to remove tissue from the womb. (Photo: iStock/Hispanolistic) However, in the case of a missed miscarriage or a late one, doctors may prescribe treatment by medication to kickstart the process. Otherwise, a medical procedure called the dilation and curettage (D&C) is done. This is classified as a medical abortion to remove the tissue from the uterus. ROAD TO RECOVERY – PHYSICAL AND EMOTIONAL Either one of the above treatments requires the female body to recover both physically and emotionally. According to Singhealth, most recovery from miscarriage requires physical rest. Singhealth also says the recovery journey depends on the overall health and physical condition one was in prior to pregnancy. Post-miscarriage, women are encouraged to refrain from any sexual activity, from using tampons or partaking in strenuous exercise for at least two weeks. Dr Loi added: “Physical recovery can be faster than the psychological one. Every woman will react differently and have varying emotions, depending on her personal medical and fertility history.” Losing a baby leads to wide and complex emotions in both the woman and her partner: Shock, numbness, grief, despair, guilt, shame, anger and even anxiety. (Photo: iStock/Supeepich Sudthangtum) For early miscarriages, the woman’s normal menstrual cycle should resume after four to six weeks and this would allow the couple to try conceiving again. For miscarriages that occur late in trimester, medical assessment is important to diagnose any underlying conditions and treat them, to reduce risks of repeat miscarriage. Late miscarriages also mean the uterus requires more time to contract back to its original size. This process could take two to three months. Dr Adaline Ng, Senior Principal Clinical Psychologist from Better Life Psychological Medicine Clinic, told CNA Women that baby loss leads to a wide and complex range of emotions. “Each person’s measure of that loss is different. The emotions a woman (and her partner) can have range from shock, numbness, grief, despair, guilt, shame, anger and even anxiety. “She may start to question herself if she did anything to cause the loss. Sometimes she may view herself as a failure – towards their unborn baby and to themselves or loved ones, as she views herself as less of a woman.” It is this gamut of emotions that Dr Loi refers couples under her care to see a psychologist post-miscarriage. She reasoned: “Everyone grieves differently following a miscarriage and each person requires various forms of support. It has been well-recognised that women and their partners who have suffered pregnancy loss are at risk of prolonged severe psychological reactions, including post-traumatic stress disorder.” Related: Dr Ng added: “Psychological recovery does not occur in a linear fashion. Sometimes, the shock and emotions of the loss may abate over time, with slight triggers that may bring about tinges of guilt or sadness.” One common example is when couples come to terms with their loss. However, as they begin to feel better, they could construe the process of grieving as “forgetting” their lost baby and be consumed by guilt. Dr Ng advised both women and their partners to seek professional help if the intensity of feelings takes over one’s normal ability to function. Another sign to seek help is when the loss creates anxiety over one’s health, leading to unhealthy and uncontrollable behaviours aimed at protecting the health of others and their own. The process of understanding loss requires processing emotions which may be uncomfortable, as it requires one to confront those feelings, rather than suppress them. “Talking to friends or other women who have experienced baby loss will provide perspective and immeasurable support during this difficult time,” she added. Related:

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SingHealth Frequently Asked Questions (FAQ)

  • Where is SingHealth's headquarters?

    SingHealth's headquarters is located at Third Hospital Ave,, Singapore.

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