Not every woman who comes to pregnancy counseling at the gynecologist’s office or to give birth asks this question aloud. But unspoken, it is as much on the tongue of every expectant mother as the question of whether it will be a boy or a girl. The concern about the well-being of the coming child becomes particularly urgent when a miscarriage or stillbirth or even a malformation (formerly also called a miscarriage) has to be lamented among acquaintances. And after all, almost all women have heard of this at one time or another.
Causes of miscarriage and premature birth
During pregnancy, the fetus is examined at regular intervals for possible diseases and malformations. In most cases, this can detect a potential miscarriage at an early stage. Nevertheless, it must be said right away that far fewer sick or stillborn children are born today than 30 years ago. Especially the increasingly better stable social conditions in our time (in contrast to only post-war Germany) have ensured ever healthier and stronger children. In addition, the health protection of pregnancy counseling and the timely examination of pregnant women at the gynecologist plays an important role in the early detection and treatment of problematic cases during pregnancy. Although infant mortality and infant malformation have declined sharply in Germany in recent decades, there are still three major groups of infant deaths:
1. infantile diseases before birth
2. miscarriage and premature birth
3. birth defects of the child
Any illness of the mother can also be dangerous to the unborn child. This is especially true for febrile illnesses, such as kidney infections, influenza or pneumonia. But also quite silent illnesses, such as diabetes, certain blood diseases, even a blood characteristic of the parents known as Rh factor can bring danger to the child without the mother having to notice anything about it. Most importantly, disorders of maternal metabolism can harm the child.
Symptoms, signs, and complaints
Such disorders can be detected quite early enough, either by an increase in blood pressure, protein excretion in the urine or swelling of the feet and hands. With timely examination by the well-organized pregnancy checkups at the doctor’s office, it is also possible to start treatment early, and damage to the child, which can threaten it especially in the second half of pregnancy and cause it to die before birth, can definitely be avoided. Poor social conditions (e.g. smoking, alcohol and drug consumption during pregnancy) are often responsible for miscarriages and premature births. We want to leave aside the problem of morally questionable abortion and infanticide. Healthy family and housing conditions and proper and healthy pregnancy nutrition can prevent these damages. Damage today is hardly caused by malnutrition, but mainly by inferior selection and quality of food with low nutritional value. In short, those who eat only cola, chips and instant noodles during pregnancy can harm not only themselves but also their child. A lack of natural vitamins and protein, minerals and trace elements can be just as damaging as fatty and overly abundant food or a one-sided diet. Although hardly anyone in Germany goes hungry today, many young people suffer from malnutrition or nutritional deficiencies because of the poor quality food processed in fast food. A maternally disturbed development of the organs or also the blood composition can be damaged in such a way that the pregnancy cannot be carried to term. Too rapid a succession of births also sometimes leads to premature births or miscarriages. Finally, excessive age of the parturient is occasionally the cause of premature birth or infant death. The child born too early is known to be harder to raise at the beginning. It tends to drink and digest more poorly, is prone to respiratory problems, needs a lot of warmth and often pure oxygen. In addition, it is defenseless against almost all pathogens. Fortunately, today there are the well-known “incubators”, so that even here the small babies do not have to die of weakness of life as in former times. The great importance of the social situation for expectant mothers is recognized by our social legislation in Germany.One of the most noble tasks of pregnancy counseling is to make full use of the legal possibilities for every expectant mother for the benefit of her and her child. However, this is only possible if the woman comes to her gynecologist with confidence.
Complications
A fetus or fetus is an embryo in in pregnancy after formation of internal organs. Development begins in the 11th week of pregnancy and ends with birth. Click to enlarge. Let us now turn to the last point, the birth injury of the child. The importance of birth injury is usually overestimated. Every careful statistic proves that all the other dangers already mentioned claim more child losses than the actual birth injury. Nevertheless, it must be taken into account. Especially the incorrect position of the child, such as transverse position and breech position, but also the incorrect position of the placenta and the birth of twins endanger the child and to some extent the mother. Most irregularities can be detected before birth. Timely referral to a special maternity clinic can eliminate the dangers for mother and child. However, timely detection must precede timely admission, which can only be ensured by regular visits to the gynecologist or pregnancy counseling. Does the pregnancy consultation with the specialist serve only the welfare of the child? Of course not! We would like to emphasize in all clarity that intensive preventive health protection primarily benefits the mother herself. However, maternal well-being is also a necessary prerequisite for the birth of a healthy, life-fresh child. Both are served by counseling through its social and medical assistance to the expectant mother, if she makes regular use of it. We have put the child’s well-being in the foreground because an old gynecological experience says: In caring for their child, mothers are tireless and ready to make any sacrifice. The mother’s love knows no limits for the child’s well-being, while the mothers often lack the most necessary for themselves. Of course, pregnancy counseling is there for the pregnant woman and wants to preserve her health first and foremost. Therefore, it is certain that only the health and welfare of mothers can guarantee healthy and healthy children. That is why we want to urge every expectant mother: Go to your gynecologist or pregnancy counselor on time and regularly, and see the doctor immediately if something is wrong, so that you do not even have to reproach yourself because of your child.
When should you go to the doctor?
In case of miscarriage and premature birth, it is usually necessary to see a doctor immediately. This may prevent the death of the baby and also the death of the mother. Unfortunately, if treatment is not received, the child will die in most cases. At the first signs of miscarriage and premature birth, the emergency doctor should be called or the hospital should be visited. Usually, the affected person recognizes these symptoms by very high blood pressure or sudden swelling of the hands and feet. However, the symptoms can also be detected during a regular examination, so that the complaints can be treated at an early stage. These examinations are mainly carried out by the gynecologist and should always be attended. Bad living conditions should also be prevented in order not to endanger the well-being of the unborn child. For this reason, a visit to the doctor is also necessary if the patient suffers from mental health problems or addiction. With early diagnosis and treatment, many complaints can be limited. However, in the case of miscarriage and premature birth, no general statement can be made about the further course of the disease, as it depends on the exact circumstances of the mother.
Outlook and prognosis
After a miscarriage, another pregnancy is possible in most cases, but the risk of another miscarriage is slightly increased. If a woman has already suffered several miscarriages, the likelihood of a pregnancy without complications drops to about 50 percent. In general, the prognosis depends strongly on the cause of the miscarriage: Hormonal imbalances or infections can usually be treated well; in the case of some genetic defects or diseases, the child often cannot be carried to term despite medical artistry.Complications of miscarriage, such as severe bleeding or injury to the uterus, sometimes result in permanent infertility. Severe infections or the long retention of the dead fetus in the womb can, in the worst case, result in blood poisoning and thus the death of the mother. Babies born prematurely now have a realistic chance of survival from as early as 24 weeks’ gestation, thanks to major advances in neonatal medicine. However, children born at this early stage of pregnancy can expect complications such as brain hemorrhage, lung disease or severe infections. About a quarter of all premature babies with a birth weight of less than 1,500 grams show developmental disorders such as movement disorders, hearing and vision impairments, behavioral abnormalities or a disturbance in mental development later in life.
Follow-up
After a miscarriage, a curettage is usually performed to remove the dead fetus and placental debris. After the curettage, a follow-up visit is held. The woman concerned should keep this appointment without fail, as this is the only way to ensure that the dead tissue has been completely removed and that no inflammation has occurred in the abdomen. Women who decide against a curettage and in favor of natural rejection after a miscarriage, must absolutely pay attention to symptoms that indicate possible complications. These include pain in the abdomen, bleeding and fever. As soon as a patient observes such symptoms, she should immediately visit her gynecologist or the nearest hospital. Even if the abortion was without complications, a subsequent gynecological examination is strongly recommended. In this case, too, the attending physician must make sure that the dead tissue has been completely shed. For many women, a miscarriage is not only physically but also emotionally stressful. In these cases, it is important that the affected woman does not shy away from seeking the help of a psychologist. The costs are usually covered by the health insurance. In the case of a premature birth, the aftercare measures for the mother are generally no different from those required for a normal birth.
What you can do yourself
A miscarriage or premature birth cannot always be stopped. However, in some cases, a woman can help prevent a miscarriage or delay the date of delivery by taking an active role. With regard to miscarriage in the first three months of pregnancy, it is important to take alarm signals such as sudden or severe period-like pain as well as bleeding seriously and to contact the attending gynecologist promptly. Here, the principle applies that it is better to see the doctor once too early than too little. In addition, both physical and mental rest is important, especially if there is a known tendency to miscarriage. Alcohol, smoking and hot baths should be avoided. Infections such as fungus in the vaginal area or cystitis should also be prevented if possible or treated at an early stage before they can endanger the pregnancy or the baby. If the aim is to avoid premature birth at an advanced stage of pregnancy, this is also often achieved by consistent sparing. Particularly in the case of a too wide open cervix, sports activities and lifting heavy loads are counterproductive. Taking magnesium supplements may also help to prevent the onset of labor too early. However, it is important that the pregnant woman use such home remedies only in consultation with a gynecologist or midwife.
