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Coronation Street recently drew attention to the important and distressing subjects of pregnancy loss and infertility. Many viewers were moved to tears when the landlady of the Rover’s Return, Toyah Battersby’s surrogate lost her baby.

As a proud Lancastrian myself, the soap is very close to my heart and I’m impressed with the way they reflect the health experiences that many people suffer. Viewers of the soap have watched as Toyah has struggled with fertility issues with her partner, failing to conceive through IVF. In the end, they turned to surrogacy to fulfil their dream of having a baby.

From mid-pregnancy, your baby’s movements are their way of communicating with you. In the programme, Toyah’s surrogate hadn’t noticed the baby kicking for a while and attended for a scan, sadly this showed that the baby had died in the womb. Toyah said:

“The baby was there on the screen, clear as anything, head, hands, fingers and toes but no heartbeat.”

I welcome anything that increases understanding of the heart-breaking loss of a baby. Every pregnancy loss is painful, but late miscarriage after the mother has felt the movement of the baby can be particularly difficult to deal with.

Most miscarriages happen in the first trimester, before 12 weeks, so after this stage many couples start to relax. However, as many a fifteen percent of miscarriages occur later, between 15 and 24 weeks. In my practice, we see a patient every month that is having to suffer a late loss and it is one of the most upsetting and challenging parts of my job.

Very often we don’t fully understand the reason for late miscarriage, but some things can increase the risk. The good news is that if we diagnose these early we may be able to prevent problems occurring.

Cervical Insufficiency: Weakness of the neck of the womb can make it more likely to open up early in pregnancy. This can be caused by surgery to the cervix, such as for abnormal cells on a smear test. It can also be due to birth trauma or in an in-built tendency.

If your healthcare team are aware of the risk, they can scan the cervix to spot any changes and start hormone therapy with progesterone pessaries to decrease the risk of miscarriage. Also, a special stitch can be placed around the cervix early in pregnancy, known as Cervical Cerclage to prevent premature dilation.

Infection: Any severe infection can increase the risk of pregnancy loss. Urine infection spreading to the kidneys, septicaemia and bad gastroenteritis can all increase the risk of miscarriage. Pelvic and vaginal infections can be a particular problem because they may spread to the womb, inflame the membranes and can kick off contractions. That’s why I tell my patients to get medical help if they are feverish and unwell or have if they notice an unpleasant discharge.

Illness: Chronic health conditions like diabetes, thyroid disorders, high blood-pressure and kidney disease can all increase the danger of miscarriage. Getting medical assessment and support very early in pregnancy can make a real difference. Even better, see your doctor when you are trying to conceive.

Medications and Treatments: Some drugs, herbal remedies and essential oils can trigger pregnancy loss. It’s important to get expert advice before taking any medications and that includes ‘natural’ and over-the-counter treatments.

Problems with the womb: Sometimes the shape of the womb can affect the attachment of the placenta or the healthy growth of the baby. You could have been born with a different womb shape or you may have developed muscular growths called fibroids, if this has caused a miscarriage in the past, it’s worth seeing a gynaecologist to consider whether surgery could make a difference before planning any further pregnancies.

Twin and Multiple Pregnancies: The extra size and weight of multiple pregnancies can put extra pressure on the cervix, and increase the risk of premature deliveries and loss.

Genetic problems and fetal abnormalities: Some late miscarriages are caused by problems with the baby’s chromosomes, or developmental abnormalities that are sadly incompatible with life. Chromosomes are the building blocks of our genes, so problems can mean that a baby is unable to develop normally. Most women go on to have successful pregnancies in the future, I know this isn’t consolation for the loss, however I hope that information may be reassuring.

Without knowing all the details, it’s impossible to say what caused Jacqui, Toyah’s surrogate, to lose their baby. But in my experience, after a late miscarriage, couples may be offered tests to help understand what caused the loss. This can include a post-mortem examination or autopsy, which is difficult and distressing to consider but can help couples understand the reasons for the loss and to discover whether preventative treatment may prevent problems in future pregnancies.

Toyah was too distressed by the miscarriage and worried about her partner turning to alcohol to share the news with Peter. I would always recommend talking to your partner if possible because it can be a very lonely and stressful time.

If you can’t share your news, remember that you are not alone. I have found the Miscarriage Association to be an excellent source of information and support. They say that although losing a baby in pregnancy can be a deeply distressing experience – it shouldn’t be a lonely one. Check-out their website, or contact them for help and a listening ear, over the phone, in a support group or online.

Find out more:

The Miscarriage Association
Tommy’s Miscarriage Research
SANDS the Stillbirth and Neonatal Death Charity
Research into Cervical Insufficiency

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