October is Pregnancy and Infant Loss Awareness Month

October is Pregnancy and Infant Loss (PAIL) Awareness Month. The pregnancy loss movement traces its beginnings to 1988 in the USA. In October 1988, President Ronald Reagan set October as the month to raise awareness on Pregnancy and Infant Loss. In his words,

 “When a child loses his parent, they are called an orphan. When a spouse loses her or his partner, they are called a widow or widower. When parents lose their child, there isn’t a word to describe them. This month recognizes the loss so many parents experience across the United States and around the world. It is also meant to inform and provide resources for parents who have lost children due to miscarriage, ectopic pregnancy, molar pregnancy, stillbirths, birth defects, SIDS, and other causes.”

President Reagan envisioned a month set apart to honour the lives of babies who left too soon, as well as to recognize the loss that their parents face. At the heart of PAIL awareness month, is the need to support grieving parents and to help the community better understand pregnancy and infant loss and how it affects parents across the world.

What are the different types of Pregnancy and Infant Loss?

Types of pregnancy loss

According to The Miscarriage Association, there are different types of pregnancy losses. Miscarriage is the most common type of pregnancy loss, affecting 1 in every 4 women. Other forms of losses include an ectopic pregnancy, a molar pregnancy and a stillbirth.

Miscarriages

A miscarriage occurs when a foetus dies during early pregnancy. This typically occurs before week 20 of the pregnancy. It is also known as a spontaneous abortion. We have shared a lot more information on miscarriages, including the different types of miscarriages such as:

  • Missed miscarriage
  • Threatened miscarriage
  • Inevitable miscarriage
  • Incomplete & complete miscarriages
  • Recurrent miscarriage

Get more information on this topic in our previous blog post by clicking the link below:

Read More: Miscarriages: Types, Symptoms and Treatment

Miscarriages are one of the most common forms of pregnancy loss

Ectopic Pregnancy

An ectopic pregnancy is defined as a pregnancy that develops outside the uterus. In fact, the word ectopic refers to been ‘out of place’. According to statistics shared by The Miscarriage Association, 1 in 80 pregnancies will be ectopic. In most cases, ectopic pregnancies develop in the Fallopian Tubes (the tubes provide the site of fertilization between the egg and the sperm), and are sometimes referred to as tubal pregnancies. In a few rare cases, the pregnancy develops in the abdomen, presenting a life-threatening condition for the mother.

Ectopic pregnancies can be very scary, and in the section below, we share risk factors and some of the symptoms to look out for.

Risk Factors for an ectopic pregnancy

The exact reason why ectopic pregnancies occur is not known, but there are certain factors that increase the risk of getting an ectopic pregnancy. These include:

  • Having had an ectopic pregnancy before
  • An infection in the female reproductive system, especially one that affects the ovaries, fallopian tubes or the uterus
  • Previous surgery done on the fallopian tubes
  • Endometriosis
  • Previous abdominal surgery
  • Women who have experienced fertility issues.
Symptoms of an ectopic pregnancy

As mentioned above, an ectopic pregnancy presents a life threatening emergency for the mother. This is because the pregnancy cannot develop normally since the fallopian tubes (and any other part of the body besides the uterus) can never stretch to accommodate the growing embryo. If the ectopic pregnancy is not treated, it may cause the tubes to burst open.

When it comes to the symptoms of an ectopic pregnancy, it is important to mention that some women will not exhibit any conspicuous signs. Others on the other hand, will experience symptoms that can easily be confused for other conditions such as inflammation of the appendix or even a runny stomach.

Listed below are some of the most common symptoms of an ectopic pregnancy:

  • Excruciating abdominal pain, especially on one side of the lower abdomen.
  • Pain that radiates in the shoulder, neck or rectum.
  • Diarrhoea that is sometimes accompanied by vomiting.
  • Experiencing periods of dizziness.
  • Vaginal bleeding that is remarkably different from the usual period blood.
Treatment of an ectopic pregnancy

In many ectopic pregnancies, treatment involves the use of either medication or surgical operation. This is done to remove the pregnancy tissue as well manage any bleeding internally.

Medication is usually given when the pregnancy has not advanced too far, and the fallopian tubes have not ruptured. The medication prevents the growth of embryonic cells and allows for absorption by the body.

Surgical treatment is required in many ectopic pregnancies. Sometimes, both the developing embryo and fallopian tube are removed, particularly when the tubes are damaged or ruptured.

Molar Pregnancy

A lesser-known from of pregnancy loss is referred to as a molar pregnancy. By definition, this occurs when an abnormal fertilised egg undergoes implantation in the uterus. This is then followed by the rapid growth of the placental cells, which in turn occupy the space where the embryo cells would typically grow.

A molar pregnancy, as explained by The Miscarriage Association, is also referred to as a ‘hydatidiform mole’, a term used to describe the mass of fluid-filled cells. Since a molar pregnancy is not viable, it is not possible to carry it to term. There are two types of molar pregnancies: partial or complete.

A partial molar pregnancy occurs when fertilization occurs between two sperms and one egg, alongside abnormal placental cells. The foetus may be formed, but it will not survive owing to the genetic makeup present. A complete molar pregnancy on the other hand, the placental tissue creates an abnormal mass of cells, and the fertilized egg typically has no genetic material.

In both cases, the imbalance of genetic material makes it impossible for the pregnancy to be carried to term, thus resulting in pregnancy loss for 1 in 600 pregnancies.

Read more: Pregnancy Timeline – Here is how your body is changing during the three trimesters

Symptoms of a molar pregnancy

In a number of cases, women do not have any obvious symptoms of a molar pregnancy. Additionally, the elevated levels of hCG (this is the hormone that pregnancy kits will use to test) means that a woman’s body will present with the usual signs of pregnancy. Symptoms to look out for, however, include:

  • A missed period and a positive pregnancy test
  • Vaginal bleeding that is different from period blood. Notably, this bleeding may also contain cysts which look like tiny grapes upon discharge from the body.
  • Feeling sick and nauseous
  • Symptoms similar to those of a miscarriage.
Diagnosis and treatment of a molar pregnancy

If your doctor suspects that you have a molar pregnancy, an ultrasound will be used to tke pictures of the uterus. This is done alongside a blood test to determine the levels of the pregnancy hormone (hCG), and is particularly important because molar pregnancies cause the amount of hCG to rise rapidly compared to healthy viable pregnancies.

Treatment of a molar pregnancy includes a process known as dilation and curettage ( D&C) to get rid of the molar cells from the uterine wall. Your doctor will them make regular follow-up to monitor hCG levels and rule out the presence of molar cells. This is important as the continuous growth of molar cells in the uterus has been linked to a rare form of cancer.

Still Birth

A still birth occurs when the baby dies in the womb past the 20th week of pregnancy. Most women who experience stillbirths do so before labour, but a small fraction of them happen during labour and delivery. Some of the risk factors associated with stillbirths include:

  • Having experienced a previous stillbirth
  • Women who smoke and/or use drugs
  • Obesity/ Diabetes/ High blood pressure/ Preeclampsia
  • Trauma or injuries sustained during pregnancy eg a fall or a car accident
  • Preterm labour
  • Birth defects and genetic conditions affecting the baby

The most common symptom of a stillbirth is the reduction or cessation of the baby’s movements. Others include cramping, vaginal bleeding and pain. Birth options available after a stillbirth include labor induction, Dilation and Evacuation as well as a C-section.

Dealing with pregnancy and infant loss

Pregnancy loss is devastating, regardless of when it occurs during pregnancy. Allowing women who have experienced this loss to grieve alongside their families is one of the ways we can help them process their emotions and grief. It also helps to have support around. Joining support groups and connecting with others who have gone through similar experiences provides safety and support for affected women. In Kenya, resources following pregnancy loss include Still A Mum and Empower Mama.

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