recurrent miscarriage (RPL)

This devastating condition is also known as ‘Recurrent Pregnancy Loss’ (RPL) and is associated with reproductive problems with the parents, resulting in the loss of viable pregnancies. According to scientists from the Monash Institute of Medical Research and Sydney's St Vincent's Hospital, 5% of women will suffer two miscarriages or more.

The recurrent miscarriage figures in NZ start from 3 miscarriages and are defined as being after ‘3 or more early miscarriages (before 13 weeks), not necessarily consecutive, but all pregnancies must be by the same partner, or 2 late miscarriages (13 - 20 weeks)’ which affects between 2%-3% of women. Only 1%-2% of these women do not go on to have a family according to statistics from various sources. The internet information can be confusing because in American they use two definitions of multiple miscarriage: Recurrent Miscarriage is; 3 consecutive losses (causes - immunological, haematological, physiological etc.). Recurrent Pregnancy Loss is; two miscarriages and is positively correlated to maternal/paternal age (i.e. egg/sperm quality). The first may be treated for, the second may eventually require IVF screening tests and development of a viable egg outside the womb - especially when time is running out i.e. either partner is over 35 years of age.

Even with a second miscarriage, it is not generally a precursor to future problems and there is a 72% chance that a third pregnancy will be fine. However, if you wish to take positive action, have some basic diagnostic tests done and treated when appropriate. It could be helpful and prevent further trauma, especially if the miscarriage is with the same partner and you suspect that you or he suffer from one or more of the listed ‘Why Miscarriages Happen’. You may need to be persistent and ask around for a medical professional who agrees. After three consecutive miscarriages, testing is essential as chances of a normal pregnancy are only 43%.

In many cases of recurrent miscarriage, the reason is found; however in around 50%, nothing is ever discovered as the definitive cause. In one research study on this 50%, no specific treatment was offered except asking participants to remove as many stress factors as possible in their lives. How this was achieved is not described and the resulting 80% success rate is controversial. Scientists have also identified the gene NOS3 which appears to trigger repeated unexplained miscarriages in some women. (There is ongoing research around this so you may wish to follow the latest information yourselves.)

Meantime, individuals have their own body rhythm, family history, stresses and circumstances. You may wish to address those that can be altered and make life style adjustments to help yourself such as experimenting with relaxing techniques, avoiding as much stress as possible, eating organic foods, perhaps stopping work or shortening your hours and generally coddling yourself to whatever level you feel comfortable. It would only need to be for a short period and could be life changing.

Miscarriage is also self correcting to some degree with a spontaneous cure rate of 30%-50% so there is hope. Women who have suffered as many as six or seven miscarriages, can and do still go on to have a successful pregnancy which has happened in our group. We also know of women with as many as 17 miscarriages who have had babies but that is not a situation that many would have the tenacity, courage or will to endure.