Talk:Miscarriage/Archive 1

Misc

"In the past, a frequently used euphemism for miscarriage was to say that the mother "lost the baby". This phrase is not as popular in current times, because there is less of a cultural stigma on discussing issues related to reproduction, and because some people feel that it carries the connotation that the expectant mother was, somehow, at fault for the miscarriage."

I don't see evidence of any of those points having any validity. This seems like, rather than inserting useful information, this is more somebody inserting their PC opinion into the article. In each miscarriage that I've known about, the phrase in question is exactly the term that has been used to describe it. The idea of it connoting responsibility on the mother's part never occurred to me until I read this article. I'm erasing the paragraph. Mr. Billion 19:10, 8 Mar 2005 (UTC)

My wife and I have been going through fertility treatment for almost three years now and have experienced three miscarriages. In conversations among friends who've gone through the same experience, as well as at group counseling sessions, the families I've met generally refer to it as a miscarriage, though it's not uncommon to hear that they've "experienced a loss." I've never hear any of them argue one way or another for these terms; I think they just use what's most comfortable to them. I imagine all of us who've gone through this are comfortable with the term "loss" because it's captures the grieving element. But I haven't heard anyone avoid the term because they think it suggests the mother is (or feels) at fault. I think almost all women feel that it "their fault" even though that's usually not the case. Time and time again you hear in counseling "what did I do wrong? Could have I done anything to prevent it?" It's a normal part of the grieving process.... --Acarvin 20:16, 13 December 2005 (UTC)

It is unfortunate this article only perspective is medical. Management of pregnancy loss is not ONLY about removing a dead thing and surrounding tissues. There is always a psychological consequence of a loss and it the physical and psychological consequences of several miscarriages should be explored for the article to become a decent resource. Anthere 23:51, 2 May 2005 (UTC)

The grief section- neutral?

"From the moment a woman becomes pregnant she starts to bond with her unborn child." Um, I don't think this is physically possible. If many women do not know they are pregnant when they have a miscarriage as pointed out earlier in the article (and indeed many never know and chalk it up to a heavy period) then how on earth can they be bonding with the child? I have also added the fact that people do indeed induce miscarriages and may therefore welcome one to the grief section- there are people who really do not want children and do not mourn a miscarriage; it is, after all, the same result as having an abortion, which many women elect to do. --Dandelions 17:53, 28 September 2005 (UTC)

Dandelions - What a horrible thing to say. Miscarriage is NOT abortion! People that have abortions need to use contraception. They ELECT to have an abortion - no woman "elects" to have a miscarriage. I think you would find if you actually spoke to women that have had miscarriages that all of them suffer with grief and would never actually welcome a miscarriage or the feeling it brings. You are also reading the article out of context, it is quite obvious that if the woman doesn't know she is pregnant then there is no bonding, I don't think that is suggested here. There are also a lot of women that monitor their cycle and find out they are pregnant BEFORE their period is actually due, which would put them in the category of feeling like they are having a heavy period when their period is due when they are actually aware that they are miscarrying. You need help with empathy and compassion. I think this is a subject that you need to stay aware from in the future. I truely pity any woman that crosses your path. 203.164.19.57 (talk · contribs).

Will you please avoid personal attacks? You also deleted Dandelion's post - please do not refactor material without consensus, especially if you are attacking exactly that material.

Dandelion is quite right in asserting that a woman can only bond with a child when she knows she's pregnant, and some women (e.g. the ones that have abortus provocatus) do not bond for one reason or the other. JFW | T@lk 15:55, 20 November 2005 (UTC)

I agree with Dandelion. It is limiting to say that a miscarriage (if the pregnancy is known) only induces grief. I have friends who have had miscarriages and were relieved, some were glad, as they did not want the pregnancy. Contraception is not 100% effective. A person who reads this miscarriage entry should not be led to believe that there is something wrong with a person who does not feel grief after a miscarriage. Compassion does not apply to only certain people, personal attacker above. I made minor edits to include more responses as normal. Whole Shebang 02:41, 13 December 2005 (UTC)

Perhaps the article needs to say something to the effect that women (and their partners) who are looking forward to parenthood experience grief. I'm sure there are cases where women who didn't want to be pregnant in the first place don't experience grief, but for women who do want to be pregnant, it's often one of the most traumatic experiences in their lives. That's certainly been the case for me and my wife. I know there are exceptions, of course, but generally speaking, couples who were happy to have been pregnant take the loss with much grief , anger and a sense of helplessnless. --Acarvin 20:20, 13 December 2005 (UTC)

First of all, medically miscarriage is often called 'spontaneous abortion'. So in that sense it is an abortion. Secondly even if the pregnancy was not planned, the woman can feel very bereaved. My friend experienced this. As soon as the couple decide to keep the embryo, they will start bonding and planning their life for the arrival. But I agree, there are women who are relieved if they were not happy about the pregnancy (one ther friend lost her fetus at 20 weeks, but she was relieved as it was an accident). Every case is different. As I have experience of miscarriage myself, I feel people should be made more aware of how common tbis is, and how bereaved, sad and angry a lot of the women feel. Often you don't get any support. Often people (friends, family, colleagues) make comments about 'it being nothing yet anyway' and 'it is better if it end this way then having a handicapt child'. This does not help the woman or couple but just causes more pain.—The preceding unsigned comment was added by Ebosman (talk • contribs) 12:28, 27 July 2006 (UTC)

Frequency chart

A chart of length of pregnancy and frequency of miscarriages would probably be helpful for many people.

Experience

I think the information added to this section of this edit is important - the article was missing the basic description of symptoms, investigation and likely treatment. However:

• Some of this duplicates the more techical discussion on the various types later (not necessarily bad - WP articles often have repeatition with later sections elaborating and giving greater detail than the opening overview sections)
• There is already a later section of 'Management' which is unecessary splitting of the topic.
• 'Experience' is a weak term, and not used as standard in other health related articles.
• This article needs the addition of section headings of 'Symptoms', 'Investigation' and moving the 'Management' section up.
• However this would make the 'Causes' section seem out of place

- ideas anyone of how to reorder this article both for some logical sequence but also keeping a general overview at the start (I tried a few ways but none seemed satisfactory) ? David Ruben ^Talk 04:32, 20 January 2006 (UTC)

Habitual abortion (N96)

The section on Habitual Abortion may be misquoting statistics from the study that it references.

Above posted by User:199.1.42.30 14:48, 16 May 2006

External links

There seem to be quite a few grief sites in the external link section. I'm concerned that we don't really have a way to evaluate the quality of these sites in order to include only the best ones. And there are entirely too many of them to allow every miscarriage grief site to be included.

I'm wondering if we should just delete all the grief sites and only include informational webpages in the external links section? Lyrl ^Talk _Contribs 19:40, 3 September 2006 (UTC)

Although the quality of the sites may not have been evaluated, as one who has experienced several miscarriages, I found the grief site links very useful. I think that one or two grief sites should be allowed to stay on the list.

—Preceding unsigned comment added by 128.187.164.25 (talk • contribs) 22:28, 4 October 2006

If included support sites are listed merely as examples, then this is not an appropriate use of external links. A website should be included under EL for fair specific reasons: it is mentioned in teh article, it specifically adds information to a level not appropriate directly within wikipedia, it is a major organisation (e.g. UK or US national organisation). But to cherry pick just a select few is unfair on other non-icluded websites and not the purpose of external links - wikipedia is not a directory service (that's what learning to perform a search on Google et al is about). So my twopence of opinion is delete non-notable (i.e. no national recognistion by media, government or the relevant specialist bodies) support sites. David Ruben ^Talk 22:20, 4 October 2006 (UTC)

A little ambigious

About 30% of fertilized eggs are actually lost before the woman knows she is pregnant and may only be noticeable by slightly increased blood loss.

Does this include only miscaried or born babies as well ?---- Xil/talk 21:15, 18 December 2006 (UTC)

Of embryos that are created, at least 30% never implant in the uterus. There is no way to detect pregnancy before implantation, so the woman involved would never know she had conceived. (The statement in the quote above about increased blood loss is false and I have removed it from the article.) Lyrl ^Talk _Contribs 02:04, 19 December 2006 (UTC)

Before implantation - should this article address that?

Some sources consider an embryo that does not implant (and therefore could not have been detected with the normal pregnancy tests) to still be a miscarriage. (Search for the term "before implantation" on the following pages: [1] [2] [3] [4]).

Should rates of fertilization-but-no-implantation be addressed on this page? Lyrl ^Talk _C 14:38, 2 January 2007 (UTC)

Miscarriage can be caused by Thrombophilia

I am trying to raise awareness of the dangers that genetic blood clotting disorders such as Factor V Leiden and Prothrombin 20210A (both of which I have) cause to women and unborn babies.

1 in 40 women have one or more of these disorders and many of them don't know. I know from experience within my family that these disorders cause miscarriage. So many women have lost multiple babies when it could have been prevented.

I have created a small website with the help of my husband which I hope will be a help to women in my situation.

My web address is www.thrombo.co.uk

84.64.101.251 13:02, 26 February 2007 (UTC)

Term Mother rather than woman

On one occasion I think the term Mother rather than woman is more suitable in the text. Does anyone agree or disagree with the small changed I've made--McNoddy 07:35, 23 May 2007 (UTC)

"Woman" is used five other times in this article. If it is appropriate in those instances, I see no reason why it isn't appropriate in this case. Terminology should be consistent throughout an article in order to enhance readability. Whether "mother" or "woman" is preferable isn't really in dispute here — either are acceptable — but, the precedent seems to be toward defaulting to "woman," and I see no cause for switching, especially only in one case. It's sort of the same thing with B.C./A.D. vs. B.C.E./C.E. and British/Canadian spelling vs. American spelling. Unless there's a completely valid reason to defer to a particular system in an article (as in, the article is about a British actor, book, etc., so we defer to British/Canadian spelling), then, generally, we stick with whatever convention got there first. -Severa (!!!) 08:10, 23 May 2007 (UTC)

The article been worded better improves the text and changing the word from woman to mother in this case is suitable, unlike in the other cases woman pops up in the page.--McNoddy 08:47, 23 May 2007 (UTC)

The text in question has remained unchanged for a year. When there is an established terminology convention on an article, it isn't appropriate to simply make changes which do not adhere to that convention, especially if there is no real cause for making those changes. It introduces inconsistency and inconsistency is not some to aim for when trying to write The Perfect Article. Your explanation that this wording would be "more suitable" is too vague to justify changing established terminology in a single case. How would it be more suitable? It might be helpful for you to explain your thoughts in greater detail. -Severa (!!!) 09:01, 23 May 2007 (UTC)

I've explained it pretty much the way I see it, there is no bigger explanation than what I have already told you, short and sweet. That is your opinion and your entitled to it, try thinking outside the box.--McNoddy 10:45, 23 May 2007 (UTC)

With all due respect "thinking outside the box" does not generally include accepting that a phrase is "more suitable" with no further explanation. Why do you find it more suitable? And be aware, as the content has stood for over a year, it is de facto the consensus phrasing, and the onus is on you to persuade or convince others that your preferred change is preferable - if you cannot do so, you are editing against consensus. I have restored the previous verbiage, as you have as yet not convinced anyone your change improves the article in any way. KillerChihuahua^?!? 11:43, 23 May 2007 (UTC)

Not everyone see's eye to eye and with all due respect back at you, the term mother is used for women who are pregnant it's suitable and more descriptive of the situation that there in. The way it's worded is pretty bland (lacking in special interest, individuality)--McNoddy 13:57, 23 May 2007 (UTC)

A "mother" is defined as "A woman who conceives, gives birth to, or raises and nurtures a child." Therefore, either usage is correct, "woman" or "mother." I find it problematic that there have been concerted efforts by some at Wikipedia to stamp out all uses of the word "mother" in connection with a woman who carries a fetus or embryo. This strikes be as an NPOV problem. Likewise, there have been concerted efforts at Wikipedia to stamp out all uses of the word "human" in connection with a fetus or embryo. So, I'd just like to say that I agree with McNoddy. The word "mother" can be used sometimes, and the word "woman" can be used sometimes, but it is a POV problem to demand that the word "mother" never be used.

By the way, what is the male parent of an embryo or fetus supposed to be called?Ferrylodge 14:45, 23 May 2007 (UTC)

The question is not "would mother be an accurate term" but "is mother a prefereable term" to use in this place in the article? Further, in some useages, mother is reserved for one who has given birth - a pregnant woman is not a mother, but an expectant mother - which does address accuracy. There being several objections to the change, and at least one objection to the accuracy, there is not consensus for making this change. Finally, your claims that there is a concerted effort on another article is 1) nonsense 2) accusatory and 3) completely irrelevant to this article. KillerChihuahua^?!? 15:42, 23 May 2007 (UTC)

It is nonsensical what has occurred at other articles, and I agree that my saying so is accusatory. As for relevance, we disagree.Ferrylodge 15:47, 23 May 2007 (UTC)

Also, you are rewriting the English language when you say that, "a pregnant woman is not a mother." The word "expectant" is an adjective. The word "mother" is a noun. If I see a "red balloon" that does not mean that I do not see a balloon. If I see an expectant mother, that does not mean that I do not see a mother.Ferrylodge 15:59, 23 May 2007 (UTC)

The term "woman" is not inaccurate by any means. However, a specialized usage of the word "mother", one that isn't the typical use, has to be employed for "mother" to be used accurately. There is also controversy surrounding the term "mother", while all parties can agree (or compromise) with "woman". The word has stood in the article, and I find no compelling reason to change it. After a woman has a miscarriage, who still calls her a "mother"? -Andrew c 15:42, 23 May 2007 (UTC)

After a wife dies, who still calls the widower a husband?Ferrylodge 15:45, 23 May 2007 (UTC)

McNoddy clarified why he thinks the term "mother" is more appropriate, as, in his assessment, the current wording lacks "individuality." Others note concerns over the accuracy of the word "mother" as applied to this case. Is there a term which satisfies both concerns, or a descriptive term which "woman" could be appended with so it doesn't seem as generic, or overly broad (al least, that's how I interpret McNoddy's comment)? I don't know if it's possible, but, I say brainstorming is worth a try. Any ideas? -Severa (!!!) 19:08, 23 May 2007 (UTC)

Sev, while your attempts to compromise are laudable, I'm not sure that it is appropriate, necessary, or desireable. Knowing that I'll repeat some of what has already been said, here are my thoughts:

1. I disagree that the term Mother is appropriate. Dicdefs aside, I (and probably most others) consider a Mother to be "...a woman with a child". A pregnant woman has the potential to become a mother, but a miscarriage, almost by definition, ends that potential (at least in that specific case).
2. As previously mentioned, when an article is well-written and has been as stable as this, I'm very, very reluctant to make changes, even minor ones, until I've seen much more significant proof that a change is necessary.

Would the proposed change help, in any way, to raise this article from "B" to "GA" class? I think not, and therefore, I oppose. Doc Tropics 20:28, 23 May 2007 (UTC)

What is the male parent of an embryo or fetus supposed to be called?Ferrylodge 22:17, 23 May 2007 (UTC)

If "dicdefs" are put aside, must we also put aside dozens of state and federal laws, such as this one? Is it not obvious that a uniform refusal by Wikipedia to use the term "mother" in this context is a POV problem?Ferrylodge 22:22, 23 May 2007 (UTC)

Not at all a POV problem. If you've understood the responses, you'll understand that those who disagree with you regard the current version as technically accurate. Also, because WP is international, we don't generally refer to "state and federal laws" (which country's laws would we use?) at all, unless they are relevant to a specific legal point. POV is simply not the issue. Doc Tropics 22:33, 23 May 2007 (UTC)

I agree that the current version is technically accurate. It would also be technically accurate to replace the term "woman" with the term "adult female organism" wherever it occurs in this article. However, that would be foolish. Since you would like to dismiss English-language dictionaries and English-language laws, I suppose there is really no objective resource that I can use to convince you that exorcising the word "mother" from articles about pregnant women is a POV violation.Ferrylodge 22:56, 23 May 2007 (UTC)

Especially when you use inflammatory and inaccurate phrasing such as "exorcising" - it would be far more accurate to describe your posts as attempts to "exorcise" the term "woman" - since that is the current term, and you are seeking to change it. That you are failing to gain consensus for your desired change does not somehow turn the person wanting the change around into those happy with the current consensus phrasing. Dragging in dictionaries and laws which do not even enter into the issue fails to muddy the waters enough to see that you're simply not persuading anyone the change would be an improvement. KillerChihuahua^?!? 23:04, 23 May 2007 (UTC)

Leaving the term "woman" five times out of six is hardly "exorcising" the word "woman" from the article.Ferrylodge 23:07, 23 May 2007 (UTC)

At this point I think that the points raised by McNoddy and Ferrylodge have been given all the attention that they need. Ferry's claims have been sufficiently refuted and there is a strong consensus against changing the text. Since there is nowhere productive for the discussion to go, I suggest we consider it "Closed" and move on. I know for a fact that at least 3 of us have better things to do than rehash unproductive arguments. Doc Tropics 23:45, 23 May 2007 (UTC)

Yes, and at least 2 of us have better things to do than reiterate the obvious.Ferrylodge 00:21, 24 May 2007 (UTC)

Perfect! We finally have common ground we can agree on : ) Doc Tropics 00:29, 24 May 2007 (UTC)

Half of pregnancies miscarried

The claim that "up to half of all pregnancies end in miscarriage." was inserted in this diff. Looking at the citation to the website of an insurance company, they seem to cite a March of Dimes factsheet and an NIH news release. The NIH news release says "...at least one-third of all embryos fail", which is what this article currently claimed - lower than half. The March of Dimes factsheet does say "As many as 50 percent of all pregnancies may end in miscarriage" and cites a study published in the New England Journal of Medicine (PMID 3393170). The study says, "The total rate of pregnancy loss after implantation, including clinically recognized spontaneous abortions, was 31 percent." Again, this is what this Wikipedia article already said - and is still lower than half.

I don't have access to the full text of the New England Journal of Medicine article, so I can only speculate where the MoD 50% claim came from. My best guess would be that is including embryos that are created but fail to ever implant - a category this Wikipedia article does not currently cover (although I have considered adding it - see #Before implantation - should this article address that?). So for now, at least, I am going to remove the claim that up to half of pregnancies end in miscarriage. I believe that it should only be re-added as part of a discussion on embryos that fail to implant. (If anyone is interested in writing such a discussion, they may find useful material at Early pregnancy factor#Infertility and early pregnancy loss.) Lyrl^Talk _C 02:01, 3 July 2007 (UTC)

Needs section on risks to woman

The page speaks nothing of associate risks to the woman when miscarriage happens--such as infection if parts of the aborted fetus are not expelled or complications resulting from the D&C. Does anyone have any sources from which this info can be added?LCP 17:56, 18 September 2007 (UTC)

The "Forms and types" section does cover septic abortion, calls it "a grave risk to the life of the woman," and provides a wikilink to sepsis. The management section also mentions the benefit of watchful waiting avoiding "the side effects and complications possible from medications and surgery". These risks may need to be reworded and/or repositioned in the article to be more clear to readers, but they are spoken of. The vacuum aspiration article has a "Complications" section that is sourced, and the sepsis article seems to be decently sourced, also. Lyrl^Talk _C 21:13, 18 September 2007 (UTC)

Causes

A study suggest that certain sport activities may increase the risk for a misscarriage (Study: M Madsen, T Jørgensen, ML Jensen, M Juhl, J Olsen, PK Andersen, A-M Nybo Andersen:Leisure time physical exercise during pregnancy and the risk of miscarriage: a study within the Danish National Birth Cohort IN BJOG: An International Journal of Obstetrics and Gynaecology (OnlineEarly Articles). doi:10.1111/j.1471-0528.2007.01496.x). Shouldn't this be included in the article? cu Cyrus Grisham 09:55, 27 September 2007 (UTC)

We should also include that eating chocolate is correlated with a lower risk of miscarriage. But like the exercise study, the chocolate studies were retrospective and susceptible to bias - a cause-and-effect relationship has not been firmly established. I've thought about adding a "correlations" section (below the "causes" section) for things like exercise and chocolate that are suspected to be related to miscarriage, but not proven. It's not something I've gotten around to, though, and I'd be more than happy to see someone else put something together. Lyrl^Talk _C 22:47, 27 September 2007 (UTC)

I really like this suggestion. It accomplishes three things. It serves the reader by giving her all of the available information. It lets the reader know which information is most reliable. It reduces editorial bias, by which some editors would altogether exclude information that, although likely, is not eminently certain.LCP 16:52, 14 November 2007 (UTC)

Hi everyone, I thought it was important to add that progesterone supplements are not effective in preventing miscarriage once conception's occurred. Added a reference to a 1996 British Medical Journal study that said as much.Scrapple 17:02, 12 November 2007 (UTC)

I suspect that progesterone supplements are way overprescribed: many doctors don't seem to be able to get past the CD21 testing for progesterone, which assumes ovulation on day 14 and will falsely identify as "deficient" any woman who happens to ovulation earlier than CD13 or later than CD15 (both very common occurrences). Were a study to be designed that correctly tested for progesterone deficiency in the 6-8 days past ovulation window, I believe it would have different results than the BMJ study. Lacking such a study, however, I agree the BMJ article is an important addition. Lyrl^Talk _C 01:39, 14 November 2007 (UTC)

Apart from perhaps variations in when a women ovulates, also need consider the cycle length on the cycle testing actually undertaken. So even if ovulation does occur 14days prior to menstruation and normal cycle length of 28days, if test undertaken on a cycle that just happens to run at 30days, then progesterone result is meaningless. Always need hold off advising on a progesterone blood test result until can find out when the impending period actually occured (then can start question assumption of "ovulation on day 14" - but in practice with ultrasound scans not available and basal body temperature too fiddly, I agree this is generally not considered) David Ruben ^Talk 03:14, 14 November 2007 (UTC)

Some women have good luck with OPKs. Basal temperatures from everything I've seen in the charting message boards I frequent are quite reliable, however a significant number of women who have allergies that cause mouth-breathing, or who have trouble staying awake enough to hold the thermometer correctly will get erratic oral temperatures. A few women have thermal shifts small enough even the normal day-to-day variations in oral temps will make the shift difficult to see. Vaginal temping is an excellent solution in all these cases, but of course many women are not willing to try that. Aside from my personal affinity for charting systems, David's approach seems both very simple and very accurate. Lyrl^Talk _C 12:21, 14 November 2007 (UTC)

Ratio of miscarriages seems high

Article says 15 percent - which seems way too high. -St|eve 06:08, 5 August 2005 (UTC)

No this rate is correct. 20% have bleeding in first 20weeks and in all 15% do miscarry. I'll add the BMJ referrence to the article. -David Ruben 21:06, 5 August 2005 (UTC)

this ratio is particularly bad in our specees.authers have far better statistics.our big brain and low genetic diversity is to be blamed,or something like that.--Ruber chiken 18:37, 23 May 2006 (UTC)

I would like to see something on rates of miscarriage in twin pregnancies - I don't know enough about it to do it myself but am pregnant with a (so far) surviving one of an initial twin pregnancy, and came here to see if there was anything on the survival rates if one twin miscarries.

This statement: Up to 78% of all conceptions may fail, in most cases before the woman even knows she is pregnant. references this article: [5] but I cannot find where in the article that statement is supported. Could someone help me out? Lyrl 22:48, 5 June 2006 (UTC)

A miscarriage of a fetus is very rare compared to a miscarriage of an embryo.Ferrylodge (talk) 03:40, 17 March 2009 (UTC)

---

Pregnancies and Their Outcomes

• In Alaska, 14,060 of the 141,000 women of childbearing age become pregnant each year. 71% of these pregnancies result in live births, and 14% result in abortions; the remainder end in miscarriage.
• Alaska has the 30th highest teenage pregnancy rate of any state. Of the 1,770 teenage pregnancies each year in Alaska, 66% result in live births and 19% result in abortions.
• Alaska’s teenage pregnancy rate declined by 34% between 1992 and 2000.

source: http://www.guttmacher.org/pubs/state_data/states/alaska.html --Stefanbcn (talk) 00:15, 5 September 2008 (UTC)

Removal of "Oral sex & semen exposure" paragraph

I have deleted this paragraph for two reasons.

First, I have looked over the sources for this paragraph, neither of which makes any apparent such claim. There's a New Scientist article that I can't read in full without subscribing, but which makes no such claims in its introductory paragraphs. Then there's a survey extract which relates to protection from pre-eclampsia, not miscarriage. There is also, in the abstract, nothing to suggest that oral sex is the key means of acquiring "seminal priming": http://www.jrijournal.org/article/S0165-0378(03)00052-4/abstract

The paragraph was also listed under "causes" (rather than, for example, "prevention"). If anyone is able to find a valid source that claims lack of oral sex is an actual cause of miscarriage, then feel free to cite it. I doubt any chances of success in this task.

What could be appropriate would be to list "immunological issues" as a potential cause of miscarriage. Istara (talk) 09:52, 25 February 2011 (UTC)

Premature birth

I had originally written the premature birth section to point out why the phrase "premature birth" might be used at a point in gestation that most sources would call it a "miscarriage". Thus the specific (cited!) reference to infants crying after being born at 16 weeks of gestation; even though that falls before the 20-week "cutoff" for not being a miscarriage, I don't think anyone is going to call something that results in a crying baby a "miscarriage".

The section has now been edited to discuss survival rates of premature births, which seems outside the scope of the "miscarriage" article. I gather there was something that struck the editor as not right about my description, but I don't think this was the most appropriate way to fix it.

Any perspectives from other editors on what should be done with that section? Lyrl ^Talk _C 02:49, 17 January 2007 (UTC)

As an obstetrician working in the UK I frequently deal with pregnancy loss. From a medical point of view, premature birth is used to describe babies delivered between 24 and 37 weeks. As for a baby crying at 16 weeks gestation, I find this completely unbelievable. The lungs at that gestation are simply not formed enough to permit breathing or air movement of any kind, lacking the cartilage and surfactant required to keep them patent. For a mid-trimester miscarriage at 16 weeks gestation the lifespan of these unfortunate babies is measured in seconds. There may be signs of life, such as heartbeat and small movements, but certainly not crying. I note the reference is from the presbytarian pro-life movement, I would have to treat anything produced by such a religious, openly biased organisation with extreme dubiaty, particularly with regard to such a sensitive issue as the viability of fetal life. The facts are that regardless of what the fetus does following it's expulsion it is called a miscarriage. If it survives the immediate delivery for several minutes then it would be classed as an early neonatal death. It doesn't matter what people's opinions are and what one person would or wouldn't call a miscarriage. Medico-legally and in terms of definition the appropriate word is miscarriage. 86.1.205.82 (talk) 11:24, 29 March 2008 (UTC)

Very sad that the Obstetrician(and we only have his word for it!) should use this talk page to make an outright religious attack on Christians.Maybe their reference is right.We need more Obstetricians who are willing to be openly identified as such to give us their views.This person goes against the so called neutrality of the Wikipedia.Rosenthalenglish (talk) 13:13, 29 March 2008 (UTC)

Not at all. This editor simply notes that the source used is biased. By noting this does not make the changes non-neutral. Gillyweed (talk) 23:45, 29 March 2008 (UTC)

Caffeine

Copied with permission from my talk page. Lyrl^Talk _C 12:40, 26 January 2008 (UTC)

I noticed that you - de facto - removed caffeine as a considered factor in the current understanding in the genesis of miscarriages. I do not like to go into an edit war, but here is my point:

Li's recent study (it may not be the last word) (as referenced in the NYT article, ref # 19) is the among the best we currently have and should be taken very seriously. You eliminated its point by just leaving it as a subject in "correlations", a section that obviously suggests that is just a unrelated linkage and that other factors are behind it (how do you know this?). The statement that half the patients were recruited after fetal death is not supported by the reference at all. Dr. Westhoff's personal opinion in the reference does not invalidate the study.

Li demonstrated not only that 200 mg are linked to double the miscarriage rate, but that there is a dose-response association. Why would you like to censor Li's findings? It may well be, ultimately, that there are other factors involved, but would it not simply be prudent to take this information seriously (adherening to the nil nocere concept) and not withhold it from the readers? Ekem (talk) 01:03, 24 January 2008 (UTC)

I agree that Li's recent study is among the best we currently have and should be taken very seriously. I disagree that acknowledging the partially retrospective nature (and therefore potential bias) of Li's study equates to withholding information from readers.

From the New York Times article: "At the time of the interview... 102 had already miscarried... Later, 70 more women miscarried." Technically, 59% of the miscarriages had occurred before the patients were recruited.

Li did not demonstrate a dose-response association. The miscarriage rates of women with zero caffeine intake and caffeine intake of less than 200mg/day were not different enough to be statistically significant.

The New York Times article states the study group had "an overall miscarriage rate of 16 percent... a typical rate." But 16% is not typical of prospective studies. The only prospective studies I have been able to find (PMID 10362823 PMID 12620443) both found 25% miscarriage rates by the sixth week LMP. A further number (around 8%) miscarry after the sixth week, for a total rate of around 33%. So by recruiting women who were (on average) already 10 weeks pregnant, Li's study missed a huge number of very early miscarriages, about half of the total miscarriages that occurred. This could affect his results in two significant ways: First, caffeine intake may show the same relationship to very early pregnancy loss as to later pregnancy loss, meaning it is even more harmful that Li's study suggests. Second, caffeine intake may show an inverse relationship to very early pregnancy loss compared to later pregnancy loss, so "saved" very early pregnancies could cancel out the "increased" miscarriage rate later on.

Is there precedent for a drug affecting very early pregnancy loss differently than clinical pregnancy loss? Yes, tobacco smoke. From this prospective study: "the group of women whose husbands smoked >=20 cigarettes/day had the highest prevalence of early pregnancy loss in the first conception (nonsmoking: 22 percent; <20 cigarettes/day: 20 percent; and >=20 cigarettes/day: 29 percent), [and] the lowest prevalence of clinical spontaneous abortion (nonsmoking: 8 percent; <20 cigarettes/day: 10 percent; and >=20 cigarettes/day: 4 percent)."

So, again, Li's study is one of the best available and should be taken seriously. But because it was not a prospective study, I believe the potential for bias is too high to present his results as established fact rather than the strong suggestion that they are. I'm not attached to the current formatting, though, if others have suggestions for reorganization. Lyrl^Talk _C 01:12, 25 January 2008 (UTC)

This is a complicated issue and it appears to me that the discussion is currently made without even having the primary source available, at least I have not been able to verify that the article has appeared in the January issue of the American Journal of Ob Gyn as the NYT indicated, - I have seen several press releases, a more comprehensive perhaps here: [6]. Where have you found the article itself to be in a position to critique its methodology?

Wikipedia is an encyclopedia and as such should provide verifiable information but not take personal interpretations in the scientific fray: when you place “caffeine” in the “correlation” you are making a judgment and saying this is an example of presumably spurious association. Li’s study is one of many that would caution a reader to come to that conclusion. Li' study is just lowering the bar, so the question should be how much caffeine may still be safe in pregnancy?

I do not understand your position that the study is invalid because women were studied posthoc; that is how most epidemiologic studies are conducted, just think of all the studies looking at links with cancer,

It appears to me from the data so far released that patients with > 200 mg caffeine had about a 100% increase in miscarriage rates, those with less caffeine exposure a 40 % increase, and those with no exposure were the zero controls: isn't there a dose - response?

It is my simple suggestion to place "caffeine" back into the discussion of putative causative agents, and include a reference to Li’s data which have been already discussed in the general media. I have no objection to the attachment of a qualifier attached if that appears appropriate and is referenced. Ekem (talk) 04:57, 26 January 2008 (UTC)

The New York Times article states the study "will be published on Monday": I'm assuming that's January 28th. I have critiqued the information provided by the New York Times article, on the assumption that the New York Times is correctly reporting relevant information. Should the NYT article turn out to have misrepresented the study in the areas I am concerned about, I will certainly withdraw my assessment.

I have added nausea and vomiting of pregnancy as well as exercise to the correlations section - I hope these will increase the credibility of the factors listed in that section. I certainly do not want to imply that these associations are spurious.

If an epidemiological study on cancer omitted half the patient population who died of that cancer, I think the results of the study could be questioned. Because such a large portion of miscarriages happen very early in pregnancy, unfortunately retrospective studies of miscarriage (unlike those of most other conditions) miss a significant amount of valid information.

From this Medscape article: the aHR of miscarriage for caffeine use less than 200 mg/day was 1.42, which was not statistically significant. The study was small enough that a 40% change in risk is likely to be the result of random variation. The study on exercise I've added to the article did show a statistically significant dose-response relationship, showed a much higher risk of miscarriage (up to triple the risk of non-exercisers) and the authors of that article still cautioned that their results were subject to bias because of retrospective data collection and should not be used to tell pregnant women to not exercise. I think my response to the caffeine study was biased by having read the exercise study first (here); seeing the similarities in data collection methods, my tendency is to treat their results with equal weights. Lyrl^Talk _C 13:42, 26 January 2008 (UTC)

As you predicted, the study came out today: [7], unfortunately all I get there is the abstract. It indicates that the study was done in a prospective manner, and that increasing doses of caffeine increased the risk of miscarriage (dose - response), but we may want to look at the full article.

The inclusion of other "factors" in the "correlation" section makes it better as "caffeine" now is not singled out as the only item. It should be clear that a "correlation" in this context is a connection under serious investigation and of concern, not some spurious event. Ekem (talk) 21:58, 28 January 2008 (UTC)

Environmental Toxins?

What exactly does the article mean when it mentions environmental toxins, and how are they a risk? --24.56.163.227 (talk) 04:36, 7 March 2008 (UTC)

Terminology and timeline

Even I as a GP doctor get confused by timelines and what gets defined as what & when, so I wonder if a table might help the terminology section. Note there are different definitions worldwide for "Stillbirth" (vs the term "Perinatal mortality").

	Gestational age from LMP (in weeks and 2 more than Developmental age)
Situation of fetus & pregnancy	2	6	11	20	23†	37	40 (EDD)	42
Prenatal development stage	Embryo		Fetus
Viability ?	Not viable				Viable
If vaginal bleeding is observed	Threatened abortion				Antepartum haemorrhage
Onset of spontaneous delivery	Early pregnancy loss	Clinical spontaneous abortion (aka "Miscarriage")			Premature labour	Term labour		Overdue
... and delivered alive					Premature birth	Delivery
... but then dies afterwards						Neonatal death
If died before delivery		Clinical spontaneous abortion		Stillbirth‡

^† Age of viability was 28 weeks before availability of modern medical intervention.

^‡ Definition of stillbirth varies by country. Australia 20 weeks, UK 24 weeks, US has no standard definitio and Canada uses "Fetal death" for all stages.

With the potential to confuse on this, I thought I would open for comment first, rather than just boldly adding to the article :-) David Ruben ^Talk 04:06, 30 March 2008 (UTC)

I think in the U.S. as early as 20 weeks is considered premature birth: from March of Dimes: "A pregnancy that ends between 20 weeks and 37 weeks is considered preterm." Ditto for the vaginal bleeding column. Is there some way to make that overlap in the table fuzzy?

Also, the viability line is not sharp it is is depicted in the diagram; there are many variables influence the death and disability risks of an individual preemie aside from gestational age at the time of birth. A few preemies as early as 21 and 22 weeks have survived, while the death rate for 24 and 25 weekers is still rather high. I don't know that viability is something that should be included in the table.

Otherwise, I really like the table. Lyrl^Talk _C 23:50, 31 March 2008 (UTC)

(Gulp re US 20 weeks) - Thanks for points, it is not of course a diagram but a table which has hard cell boundaries, so no "fuzzy" boundaries unless I convert this (once agreed) into a picture. The viability issue is the primary medical factor in understanding the table (at least from UK position). With the fall in this from 28 to 24weeks, the previous UK abortion law on "routine" abortions upto 28 weeks became anacronistic, given that it was apparent that fetus far younger could survive (allbeit with high morbidity rates). In 1992 the UK law changed, limiting most abortions to 24 weeks and defined still birth as interuterine death from 24 weeks. Also this drop had a knock-on effect on the issuing of the UK "Mat-B1" form which is the official certificate issued by doctors/midwives and used by woman to then notify their employers of their rights to maternity, with this being issuable from 20 rather than 24 weeks (issued before viability so that necessary paperwork can be done in time and a reasonable notice period given to employers).

I entirely agree that a very few survivals have now occured before 24 weeks, but in generally that is still exceptional and so there is a split in management between under 24weeks, which is still gynaecology (ie manage the woman) and after 24weeks which is obstetrics (manage a baby and a mother). Hence in vaginal bleeding, prior to 24weeks is seen as a threatened miscarriage and if contractions start and continue then outcome will be a non-surviving fetus, and if a catestrophic bleed starts then all measures just on sorting out the women. Whereas after 24weeks the term is antepartum haemorrhage, literally meaning before birth bleeding, and as this implies if managed well will be something that preceeds a successful emergency cesarian delivery (will well baby and what is then a mother). So if I see a woman who senses reduced movements of her baby at say 19 weeks, there is no point in my referring to labour ward for a midwife to help deliver a fetus (it is not going to happen), however if the same reduced movements felt at 26 weeks then I would direct her straight to the labour ward for assessment, and if concerns raised then emergency caesarian.

Of course 15 years ago, the cut off was probably 26 weeks, if not 28, as to what pragmatically could be achieved. But realistically a fetus at 20 weeks is not going to survive and be an independantly surviving preterm baby, and this in UK would not be seen as pre-term delivery but a lost pregnancy of a miscarriage. Again I agree survival rates have improved markedly in the last 10-20 years.

Recent Irish consensus paper: Vavasseur C, Foran A, Murphy JF (2007). "Consensus statements on the borderlands of neonatal viability: from uncertainty to grey areas". Ir Med J. 100 (8): 561–4. PMID 17955714. All would provide intensive care at 26 weeks and most would not at 23 weeks. The grey area is 24 and 25 weeks gestation. This group of infants constitute 2 per 1000 births.{{cite journal}}: CS1 maint: multiple names: authors list (link)

Sobering (none of this is pleasant) 1995 US paper PMID 8648459, and then look at a 2006 paper:Kaempf JW, Tomlinson M, Arduza C; et al. (2006). "Medical staff guidelines for periviability pregnancy counseling and medical treatment of extremely premature infants". Pediatrics. 117 (1): 22–9. doi:10.1542/peds.2004-2547. PMID 16396856. {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link) - see current survival table wherein survival 50% (value other papers suggests neonatologists consider the full rescussitation point) is still around 24-25 weeks which reflects decision whether to offer caesarian (generally not for fetal reasons until after 25 weeks) and this table of neonatologists rescussitation advice wherein level 3 is their neutral poistion whether they would or would not recommend rescussitation.

Finally this year Morgan MA, Goldenberg RL, Schulkin J (2008). "Obstetrician-gynecologists' practices regarding preterm birth at the limit of viability". J. Matern. Fetal. Neonatal. Med. 21 (2): 115–21. doi:10.1080/14767050701866971. PMID 18240080.{{cite journal}}: CS1 maint: multiple names: authors list (link) also concludes viability 24 weeks.

Anyway the purpose of teh table to to try and give an overview of theatended miscarriage vs APH, miscarriage expulsion vs onset labour etc, so yes will try create version with changing cut offs varying on circumstances and country. :-) David Ruben ^Talk 01:48, 1 April 2008 (UTC)

First stab at creating table image with "fuzzier margins for viability":David Ruben ^Talk 02:26, 1 April 2008 (UTC)

Wow, that's lovely! I'm really impressed with how you put all that information together. I look forward to seeing it in the article. Lyrl^Talk _C 23:57, 1 April 2008 (UTC)

Above now lost some silly extraneous words in left-hand column (I had "premature" and "term" inserted when they only belonged in relevant place to teh right), abbreviated 2nd footnote a little to get it to fit.

Only real shame over picture vs table is that can't have those nice wikilinks for teh various terms - oh, well. I'll insert into the article now. David Ruben ^Talk 01:12, 3 April 2008 (UTC)

There should be nothing in the "Not viable" and "....delivered alive" cell. ✏✎✍✌✉✈✇✆✃✄Ⓠ‽ (talk) 17:49, 8 June 2008 (UTC)

Beter table table in wiki:

		Gestational age from LMP (in weeks and 2 more than Developmental age)
		2	6	11	20	21	22	23	24†	25	26	27	28	29	37	40	42
Aspect of fetus and pregnancy	Prenatal development stage	Embryo		Fetus
	Whether fetus is viable	Not viable			(probably not)				(probably)				Viable
	If vaginal bleeding is observed	Threatened abortion			(probable miscarriage)				Antepartum haemorrhage
	Onset of spontaneous delivery	Early pregnancy loss	Clinical spontaneous abortion (aka Miscarriage)						Premature labour						Term		Overdue
	… and delivered alive								Premature birth						Delivery
	… but then dies afterwards														Neonatal death
	If died before delivery								Stillbirth‡

^† Age of viability was 28 weeks before availability of modern medical intervention.

^‡ Definition of stillbirth varies by country. Australia 20 weeks, UK 24 weeks, US has no standard definitio and Canada uses "Fetal death" for all stages.

--Voidvector (talk) 07:59, 30 August 2008 (UTC)

But then you lose the color shifting. I find the shaded colors to be helpful in showing the idea of viability as a continuum, rather than a sharp dividing line. Lyrl^Talk _C 02:06, 31 August 2008 (UTC)

Problem with this as a plain table is that some boundary lines are absolute (solid lines) as form definition ages of terms (eg "Term" pregnancy is 37-41, premature is under 37) whereas others have soft definition points (like non-vible to probably not viable at 20 weeks, which in turn drifts into Limit of viability (which ius the 50% survival point) to viability (when would expect most to survive at 28) - hence Lyrl's original critique of using a plain table. Likewise still birth as a number of alternative worldwide definition points, hence the semi-bold lines. The colour gradation is very deliberate indication that there is no hard and fast guarantee of survival point between 20 weeks and the point of term deliveries (from 37 weeks). Lastly the column widths were as near as I could make out proportional to the intervals in mentioning the number of weeks (some numbers hinted at in grey to help the reader appreciate the roll of weeks but not themselves definitions of any specific stages, plus a little typesetting license for clarity as well as fitting to common monitor page widths). David Ruben ^Talk 03:02, 23 November 2008 (UTC)

I've converted the image to SVG, see File:Pregnancy outcome terminiology.svg. I think the text needs a little tweeking, but the XML coding always seems to get me. -Andrew c ^[talk] 17:26, 8 April 2009 (UTC)

Image?

This topic is sensitive, but spurred by the discussion of images at Talk:Abortion, I thought I would look for images that could illustrate this article. http://www.flickr.com/photos/merelymel/1581515048/ This is an image of a coffin intended for a miscarried fetus, which I think may be suitable. Fences and windows (talk) 00:02, 17 March 2009 (UTC)

It would be suitable in the section Psychological aspects Fences and windows (talk) 00:05, 17 March 2009 (UTC)

How about this image instead? This article isn't a flashpoint for controversy, so maybe a realistic color photo (rather than a black and white drawing) would be okay.Ferrylodge (talk) 03:42, 17 March 2009 (UTC)

Added both. Fences and windows (talk) 07:41, 18 March 2009 (UTC)

Looks okay to me. Thanks.Ferrylodge (talk) 16:02, 18 March 2009 (UTC)

I think this is a sensitive topic, even if it is not controversial. I disagree with the use of the photo because I find a realistic photo accompanying an article about death to be inappropriate for any Wikipedia article. I will be on the lookout for a replacement image. In the meantime, I am fixing the caption, which is misleading. Caption currently states the image shows a "a complete miscarriage at about 6 weeks" but the file label states is is a picture of a human embryo at about 6 weeks, not a miscarriage. Benutzer41 (talk) 20:48, 13 October 2013 (UTC)

Just when you thought it couldn't get more complicated.

So, so terms I've been trying to sort out.

• Early pregnancy loss
• Miscarriage
• Spontaneous abortion (SAB)
• Molar pregnancy
• Ectopic pregnancy
• Chemical pregnancy

Now, we've got some conflicting defintions here. Some, would have you believe that EPL, miscarriage and spontaneous abortion are all the same thing. This source suggests that EPL is any loss before 20th week, and that a miscarriage, AKA SAB, which is also is one type of EPL, while molar pregnancy is another. This only mentions miscarriage, as a general sort of term while this agrees and gives a number of alternative defintions. Neither source says boo about EPL. this source brings up the term "chemical pregnancy" and suggests that miscarriage proper is only one type of several types of "pregnancy loss". This says EPL is before 12 weeks. There is still more to come, too.--Tznkai (talk) 15:34, 7 April 2009 (UTC)

The ACOG pamphlet is titled "early pregnancy loss" and discusses losses that occur early in pregnancy. I don't believe they are using "early pregnancy loss" as a technical term at all. Molar pregnancy is a disease that has to be surgically removed (and occasionally treated with chemotherapy) and as such is not a type of miscarriage (i.e. it is not a spontaneous abortion).

A chemical pregnancy is one which can be detected by urine or blood chemistry only (i.e. it never progresses to the point where it can be detected by ultrasound or physical examination). The current article already has references that use the terms EPL and chemical pregnancy to refer to miscarriages prior to the 6th week LMP.

While the book Fetal medicine uses the term EPL for any first-trimester miscarriage, for purposes of this article it seems easier to just say first-trimester miscarriage. Unless there is evidence that this definition of EPL is widespread, I don't see any usefulness to including it in this article. Lyrl^Talk _C 13:05, 11 April 2009 (UTC)

Human centric

We should cover spontaneous abortion in livestock as well- Brucellosis, Rift Valley fever, Bluetongue disease, Neospora caninum and other diseases, parasites and plant ingestion are all causes. In cattle brucellosis is also known as "contagious abortion." In pregnant livestock infected with RVF there is the abortion of virtually 100% of fetuses. (This from Wikipedia's articles.) These are serious issues for livestock, and the articles link either here or the main Abortion article. KillerChihuahua^?!? 22:26, 7 April 2009 (UTC)

I'm fine with this article being human centric if we cover the topic elsewhere. Spontaneous abortion (mammals) or some such.--Tznkai (talk) 22:31, 7 April 2009 (UTC)

Before Tznkai's comment, I started a section on it. I support splitting the section off to a new article once there's enough material.Ferrylodge (talk) 22:32, 7 April 2009 (UTC)

I agree with keeping this article human centric and moving this section to spontaneous abortion (mammals) or similar but I believe it is in the best interest of this article to do so before waiting for additional content on "other animals". — Preceding unsigned comment added by Benutzer41 (talk • contribs) 20:38, 13 October 2013 (UTC)

List of diseases

FYI, I started a List of diseases that may cause miscarriage. Another editor has elsewhere objected that: "If the relevant articles are properly written, there's no need for a potentially very misleading list of this kind upon which cursory readers who encounter it might mistakenly rely to their personal detriment."[8] Is the list misleading, can it be improved, and if not should all the info in the list be incorporated into this miscarriage article? The list seems okay to me, but maybe some disclaimers need to be added.Ferrylodge (talk) 19:50, 9 April 2009 (UTC)

I think I see what they're getting at, but I think that is useful information. I'd suggest userfying you list for the meantime. I'll try to think of a middle ground.--Tznkai (talk) 20:32, 9 April 2009 (UTC)

Je ne comprend pas "userfying". Parlez vous anglais?  :-)Ferrylodge (talk) 20:46, 9 April 2009 (UTC)

Copy the contents to User:Ferrylodge/List of diseases that may cause miscarriage--Tznkai (talk) 20:47, 9 April 2009 (UTC)

Or move, and CSD the redir which results as a cross-namespace redir. That would mostly make sense if there were multiple contributors to the page; if its just you, then copy, then CSD the (blanked) article. KillerChihuahua^?!? 20:53, 9 April 2009 (UTC)

(undent)Okay, the contents are now in oblivion.Ferrylodge (talk) 21:16, 9 April 2009 (UTC)

Call to change primary title of article to 'Spontaneous Abortion'

Miscarriage is a colloquial term for a spontaneous abortion. Furthermore spontaneous abortion is more descriptive and precise. From an etymological perspective the Latin origin is aboriri, which is often translated as 'miscarry.' More technically: ab- 'away, from' and -oriri 'be born' (Oxford American Dictionary). I therefore feel that it would be more appropriate to redirect 'miscarriage' to 'spontaneous abortion' rather than the other way around.

If there is no discussion in ten days I will make the change. Otherwise I hope there can be a consensus on what is most appropriate. Ibrmrn (talk) 17:50, 25 April 2009 (UTC)

The current title seems okay to me. We could certainly insert some info about etymology, just like in the fetus article.Ferrylodge (talk) 21:29, 25 April 2009 (UTC)

That may be the most appropriate action. I've been doing a little more reading and it seems that physicians try to use miscarriage over abortion to avoid the negative connotation that is often coupled with the word abortion. Still the goal here seems to be to have the most accurate article, not necessarily to reflect cultural norms. Why do you feel 'okay' with the current title Ferrylodge? Would you feel just as 'okay' with the proposed change? Are there any other opinions?Ibrmrn (talk) 22:23, 1 May 2009 (UTC)

Having done some reading here I agree that miscarriage is the term generally used. It is also the prefered nomenclature according to this document (2005) from the European Society of Human Reproduction and Embryology: [9]

"The traditional grouping of all pregnancy losses prior to 24 weeks as ‘abortion’ may have had pragmatic origins, but it is poor in terms of definition and makes little sense. The term abortion is also confusing for the patient. She may not realize that (spontaneous) abortion is not a termination of pregnancy because ‘medical abortion’ or ‘legal abortion’ is used in the same way." (see above link: Introduction - 2nd paragraph)

The title of an article should be understandable to the non-professional because an encyclopedia is for general use. The unborn baby is being carried in the womb during pregnancy and so miscarriage is the more correct term in my opinion. Early miscarriage is when the the loss is before 12 weeks, and late miscarriage after 12 weeks, according to:[[10]]. According to the ESHRE document linked to above, the term spontaneous abortion is to be avoided, and spontaneous miscarriage prefered. (see Table I) [11] In my opinion there is no need to change the redirect and we should keep the primary title as Miscarriage. User: DMSBel 62.254.133.139 (talk) 07:55, 16 February 2011 (UTC)

Moved to new section: If I may also comment from my perspective as a reader wanting to understand the topic - I find the term "spontaneous abortion" less than clear and don't think it's use helps comprehension. Are there any objections to the use of "spontaneous miscarriage" in place of "spontaneous abortion" in the article? User: DMSBel 62.254.133.139 (talk) 11:21, 16 February 2011 (UTC)

Ref for recurrent pregnancy loss

I fixed a dead link used as a ref for the rate of recurrent pregnancy loss. Reading through the guideline after I found the new url, I noticed it doesn't actually say anything about the rate of RPL. It looks like we need a new ref, if anyone is inclined to look for one. Lyrl^Talk _C 20:57, 25 June 2009 (UTC)

The recurrent pregnancy loss uses math rather than data. According to Mayo Clinic, (http://www.mayoclinic.com/health/miscarriage/DS01105/DSECTION=risk-factors) the percentage of a chance to have a second miscarriage is the same as the first, and it increases (rather than decreases) after that. Musikcat04 (talk) 05:51, 25 February 2011 (UTC)

Autoimmune diease / miscarriage

Lyrl, nobody nows whether autoimmune disease may cause miscarriage or vice versa. You deleted my sentences (that miscarriage may cause autoimmunity) because you felt that it was not supported by "experimental evidence". Well, the former reasoning also lacks such evidence, so why did you left it there? Or can you cite any experiments supporting that view? Science is not exclusively about experiments. Empirical evidence shows that miscarriage comes first, and autoimmunity may rise only several months or a year later. Moreover, autoimmunity shows a very strong female bias, certain types occur exclusively in women -- just like spontaneous abortion. These simple facts support the view you have deleted, and contradict the opposite view, that you left there. I intend hang on. Hope you think it over. Best, User:Lajos.Rozsa 11:39, 2. December 2009. (UTC) —Preceding unsigned comment added by 193.224.72.252 (talk)

I have modified the wording in the article to better reflect the current state of knowledge - simply that there is a correlation. Indisputably, women with some autoimmune diseases have difficulty carrying a pregnancy to term - see for example PMID 19816395. I believe that is the information most readers are interested in; I hope the new wording continues to convey that information while improving the technical accuracy of the sentence.

A review of the first page of hits on PubMed gave me the impression that there is no consensus about miscarriage causing autoimmune disease. If this article needs expansion on the topic, it would be better to cite a review article such as PMID 19842070 (a secondary source) rather than a single primary source (see Wikipedia:No original research#Primary, secondary and tertiary sources). Lyrl^Talk _C 03:01, 3 December 2009 (UTC)

=== Maternal gene defect in MTHFR possibly associated with recurring pregnancy failure A new-ish gene test can identify whether the mother has a defective form of the MTHFR gene. Methylenetetrahydrofolate Reductase (MTHFR) is necessary to convert folic acid to folate. At least 2 identified defects in the MTHFR gene, at 677 and 1298, reduce efficiency in the conversion to folate. Without sufficient folate, there is a risk to the fetus of neural tube defects like spina bifida. If a fetus begins to develop these conditions, there is a high risk of either miscarriage or birth defect. Pregnant women are told to take folic acid supplements to prevent the birth defects and miscarriage risks, but it hasn't yet become common knowledge that some women have an MTHFR defect and can't use the folic acid efficiently, so either additional folic acid or direct Methyltetrahydrofolate supplements like FolaPro (by MetaMetrix) are needed. If you or closely related women are experiencing repeated pregnancy failures (from failure to implant to stillborn), talk to your doctor about an MTHFR gene test. I'm posting this after my cousin and I have experienced a total of more than 10 failed pregnancies, and another cousin has had 3. The tragedy of all these miscarriages might have been lessened if we knew earlier that our family shares the MTHFR 1298 defect. — Preceding unsigned comment added by Cassiebabe (talk • contribs) 03:07, 23 March 2012 (UTC)

Diabetes and Miscarriage

While it is true that pre-existing diabetes does increase the risks during pregnancy, it is NOT true that gestational diabetes increases miscarriage risk. No study has ever found a correlation between the two. Pregnancy is naturally a high-glucose condition, where the level of sugars in the pregnant woman's bloodstream is elevated above those of non-pregnant people. For most people "diagnosed" with gestational diabetes, the only associated risk is birthing a larger baby. Most women can accommodate birthing large babies if they are able to move freely during labor and push in a position of their choosing. —Preceding unsigned comment added by 98.67.60.99 (talk) 19:08, 21 May 2010 (UTC)

General Risk Factors

I would like to address the part of this section on paternal tobacco use where the author says, "The husband study observed a 4% increased risk for husbands who smoke less than 20 cigarettes/day, and an 81% increased risk for husbands who smoke 20 or more cigarettes/day." After reading the referenced study "Paternal Smoking and Pregnancy Loss" regarding the research done in China, I can not determine where it says or indicates there is an "81%" increased risk [of pregnancy loss] for husbands who smoke 20 or more cigarettes / day. It struck me as rather odd for the risk factor to jump from 4% to 81% depending on whether or not a man smoked 1/2 a pack of cigarettes a day or a full pack.

http://aje.oxfordjournals.org/cgi/content/full/159/10/993

Judging from Table 2: Outcomes of prospective observation and prevalence of early pregnancy losses in Anhui, China, by husband’s smoking amount, 1996–1998, it seems as though the group of husbands who smoked over 20 cigarettes / day had 71 clinical pregnancies, of which 45 experienced zero pregnancy loss. That would mean 63% of those pregnancies were successful, correct? It's a bold statement to imply that the risk of a miscarriage increases 81% if the father smokes over 20 cigarettes / day. I just want to call attention to this statement so that maybe the author will make certain such a claim is legitimate or perhaps rephrase it. A woman's exposer to passive smoke and tea & alcohol consumption were also factors noted regarding pregnancy loss in this study. Whereas in the "Miscarriage" Wikipedia article one might easily conclude that the sole contributing factor to pregnancy loss among paternal smokers is chromosomal damage. —Preceding unsigned comment added by Atxgal (talk • contribs) 12:04, 24 June 2010 (UTC)

On the use of terms "spontaneous abortion", "missed abortion" etc.

If I may comment from my perspective as a reader wanting to understand the topic - I find the term "spontaneous abortion" somewhat less than clear and don't think it's use helps comprehension. Are there any objections to the use of "spontaneous miscarriage" in place of "spontaneous abortion" in the article? and likewise for "missed abortion" to "delayed miscarriage"(see [[12]]) User: DMSBel 62.254.133.139 (talk) 11:21, 16 February 2011 (UTC)

Looking back through the discussion in other sections, I hope my above comments will not complicate things (as I saw after posting that there had been quite a bit of discussion on the various terminology). In my view it would be good to differentiate between abortion and miscarriage by avoiding the use of the word "abortion" in primary terminology in this article (as far as possible) for purpose of clarity. Obviously it is still used as a medical term, but as the above link explains it is not always prefered. User: DMSBel 62.254.133.139 (talk) 14:00, 16 February 2011 (UTC)

It's worth bearing in mind that this article is not just about spontaneous abortion in humans, but about it generally in all viviparous animals. In non-human animals the term "miscarriage" is rarely or never used, and so too careful an avoidance of "abortion" may create confusion. Either way the term "spontaneous abortion" is actually very clear (what else could it possibly mean?). Also worth remembering that Wikipedia is not censored, and so "preference" should be a minor reason for the choice of term. Richard New Forest (talk) 14:25, 16 February 2011 (UTC)

The article is primarily about miscarriage in women and I think that is fine. There has been suggestion for a separate article on miscarriage in animals which would be fine too. I don't see why you bring up WP:NOTCENSORED? Did you read the linked to article? If you find it clear that's fine, however the clarity issue is one that has been raised by the European Society for Human Reproduction and Embryology. And I don't think that can be ignored. Perhaps unless there is a consensus it would be best to leave it as it is for now. I'll add a footnote though. The term "missed abortion" is less clear (ie. more liable to be misunderstood). 62.254.133.139 (talk) 14:51, 16 February 2011 (UTC)

No, I don't think that's right. An article "primarily about miscarriage in women" would be called Miscarriage in humans or some such. The range of this article is not restricted in that way – it just happens to have more material about humans than other animals. On the other hand if we do want to keep the range of the article to humans, it needs to be moved to a new title. Richard New Forest (talk) 22:35, 23 February 2011 (UTC)

DMSBel asked for my opinion because I commented about this previously. My opinion is that we would be most consistent with reliable sources if we use the word "abortion" in the first sentence, and then nowhere else except the sections titled "terminology" and "in other animals". This doesn't seem like a hugely important thing, even though it would be best if everyone agrees with me.  :-)Anythingyouwant (talk) 16:18, 16 February 2011 (UTC)

I have been thinking a lot about this. You're right it is not hugely important, and I'd rather not change it if it likely to create problems, though I am agreeance with your suggestion about where to keep it in and where to change it. I have added a sentence to the terminology section to indicate that an updated nomenclature has been proposed from within the medical profession. I am not sure how widely the updated terminology has been adopted, but I think it is fair to say that the "spontaneous abortion" term is still in use. Since that is the case it would be best to use it in the lead. Is it necessary to explain that it is synonymous with "spontaneous miscarriage"?. I know there has been discussion here previously and an attempt to differentiate terminology, which is important, but it seems to have got bogged down in trying to differentiate what (to my mind at least) seems to be at times almost synonymous phrases as though they have widely differing meaning. DMSBel (talk) 18:14, 16 February 2011 (UTC)

This article does not presently use the term "spontaneous miscarriage" and that's fine with me, because it's not a common term, and also it's redundant (all miscarriages are spontaneous).Anythingyouwant (talk) 18:44, 16 February 2011 (UTC)

Well yes, they are all spontaneous, it's just a matter of consistency. Should we just use "miscarriage" then instead of "spontaneous abortion"? There is also "threatened abortion". I think it would make more sense to use miscarriage in each instance that abortion is used, since miscarriage is already used in the article fairly heavily.DMSBel (talk) 19:02, 16 February 2011 (UTC)

Sorry, should have read the article more closely - I see that "delayed miscarriage" is mentioned as the alternative for "missed abortion". On second thoughts it seems better to leave things as they are.DMSBel (talk) 19:22, 16 February 2011 (UTC)

I have no problems with keeping the title miscarriage. Ibrmrn (talk) 16:18, 23 February 2011 (UTC)

The article says "In the recent past, health professionals used the phrase “spontaneous abortion” interchangeably with “miscarriage”. However, many women who have had miscarriages object to the term "abortion" in connection with their experience, because in everyday English the word is strongly associated with induced abortions. Use of inappropriate terminology may cause women to feel that their experiences are not being recognised or appropriately acknowledged." however there is no citation for this. Can this be cited please?108.15.50.162 (talk) 11:04, 5 June 2013 (UTC)

Rename to Spontaneous abortion

The following discussion is an archived discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. No further edits should be made to this section.

The result of the move request was: not moved. No support at all, and the common name is not disputed, reflecting the previous consensus. It seems likely that some or all of this edit should be reverted in the light of this. Andrewa (talk) 09:50, 25 May 2012 (UTC)

---

Miscarriage → Spontaneous abortion –

Rename to Spontaneous abortion.

• Support I think it is ridiculous that the whole article uses the term "spontaneous abortion", but the title of the article is "miscarriage". Either the article is renamed "spontaneous abortion", or if it stays with the current title of "miscarriage", than the text is changed back to "miscarriage" everywhere it currently uses "spontaneous abortion". 5.12.65.248 (talk) 23:46, 17 May 2012 (UTC)

• Oppose I disagree with your assertion. I do not find it unreasonable that the article is titled miscarriage but uses the term spontaneous abortion. — Preceding unsigned comment added by Triacylglyceride (talk • contribs) 02:53, 18 May 2012 (UTC)

Whoops, didn't realize it was that formal a motion... never seen one put up without the putter-upper indicating their support or opposition.

• Oppose per WP:UCN (use common names) and User:DMSBel's comments in a previous discussion of the title above. —  AjaxSmack  05:43, 19 May 2012 (UTC)
• Oppose The problem is not with the name but with the text of the article. It looks like someone has spent some time folding their idiosyncratic displeasure with use of the vastly more common name into the article text. Imagine if every article topic that had a scientific name began this way. Our article on sheep would begin thusly: "Sheep the unscientific name for Ovis aries..." and then Ovis aries would be used throughout instead of just plain sheep. The first sentence is absurd and it continues from there. This common name issue is not close here, e.g. this versus this.--Fuhghettaboutit (talk) 23:30, 24 May 2012 (UTC)

The above discussion is preserved as an archive of a requested move. Please do not modify it. Subsequent comments should be made in a new section on this talk page. No further edits should be made to this section.

Changes to lede and terminology in the article

I did some small changes to the lede, as suggested above - a partial revert of the edit of user:83d40m - but the article may still need changes in regard to terminology. I believe the use of "miscarriage" vs. "spontaneous abortion" should be consistent throughout the article. — Preceding unsigned comment added by 5.12.77.206 (talk) 17:33, 25 May 2012 (UTC)

This is a great improvement. I realise that most people don't see a lot of difference between miscarriage, which is an event, and "miscarriage", which is a term describing the event, but semantically there is a very significant difference, and failure to observe this distinction is often a warning of other problems with an article. On the other hand if we make the lead clear and logical, other problems often disappear. Andrewa (talk) 12:38, 26 May 2012 (UTC)

There were still inaccuracies and imprecision in the terminology section (eg not being clear on time of death and time of birth), and it was very UK-specific for something that differs so much in the English-speaking world and beyond. There were claims about women's views that aren't supported by the literature (as someone's inline comment queried), and some of the phrasing about women's reports of their miscarriages would be offensive to many (in relation to ultrasound). I think the table has too many inaccuracies to be kept in that form, and given the major international differences here, I wonder at it's desirability. Perhaps a more vague illustration would be better, or don't even try to bring precision into something that isn't precise. Really, people needed to be guided by the profession or relevant authority in their own country. Perhaps a collection of those would be better? I added some as in-line citations.Hildabast (talk) 20:51, 4 July 2013 (UTC)

Baby vs. fetus

I notice that the lede sentence of this article uses the split noun phrase "a baby... in the early stages of its development as a fetus prior to fetal viability (the stage of potential independent survival)."

This seems unnecessarily awkward and imprecise to me. Why not simply say "an embryo or fetus... prior to fetal viability (the stage of potential independent survival)."

Seems like it would cut down on unnecessary rephrasing ("a baby, when it was a fetus" is a bit like saying "a chicken, when it was an egg," or at best "a cat, when it was a kitten" -- in either case, you could just skip to the egg/kitten), be more precise (the current phrasing does not include "embryo"), and avoid POV.

Proposal: A miscarriage is the natural death of an embryo or fetus while it is still in the womb, prior to fetal viability (the stage of potential independent survival).

PS: I also replaced "its mother's" with "the," mostly because it looked more natural to me. Copy-editing grounds alone; I'm not pushing POV by removing it. Please consider the two edits separately in your feedback.

Triacylglyceride (talk) 19:22, 10 November 2013 (UTC)

Point taken--I split the sentences. Red Slash 00:46, 19 November 2013 (UTC)

Overall rates of miscarriage in introduction and epidemiology sections are on the low end

In both the introduction and epidemiology sections of the current Wikipedia article, it states that the overall rates of miscarriage are 30-50%. However, this estimated ranges seems low because I have seen rates as high as 70% proposed. Here is one recent human reproduction review article that gives an overall miscarriage rate of about 65%:

http://www.ncbi.nlm.nih.gov/pubmed/21050816

From the abstract of the article: "Establishing the proportion of fertilized oocytes and early human embryos that proceed to term may help policy makers in their evaluation of when the life of a new human individual begins and in determining the nature of protection to be accorded to it. The rate of spontaneous abortions, although increasing with age, overall does not exceed 15%. However, abortion rates refer only to 'clinical pregnancy', whereas early embryonic loss is more common than generally believed. Evidence of such wastage comes from many sources. Human fecundity rarely exceeds 35% and may be decreasing due to deterioration in semen quality. Embryological studies show that 50% of randomly recovered preimplantation embryos have severe anomalies. The study of sensitive markers of pregnancy, such as human chorionic gonadotrophin, indicates early embryo wastage in the order of 50%."

So in other words, about 15% of pregnancies in which the mother knows she is pregnant ("clinical pregnancy") end in spontaneous abortion. However, about 50% of fertilized eggs ("fertilized oocytes" or zygotes) "have severe anomalies" and thus there is "early embryo wastage in the order of 50%." Therefore, "human fecundity rarely exceeds 35%" or to put it another way, only about 35% of fertilized eggs naturally result in children, which means that about 65% of fertilized eggs naturally do not result in children.

71.93.120.216 (talk) 02:58, 17 August 2015 (UTC)AmateurAbortionResearcher

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Content

This "The term miscarriage implies a natural spontaneous loss of prenatal life that prematurely ends a pregnancy, whereas the term abortion is synonymous with the intentional termination of prenatal life and pregnancy. The average person recognizes this distinction and therefore care should be exercised when using the word abortion when speaking of a spontaneous miscarriage."

References

This ref is partly based on WP and thus is not a good source [13]. Also it duplicates content already in the article. Doc James (talk · contribs · email) 14:35, 27 September 2015 (UTC)

@Doc James: Some possibilities for replacement sources:

• <ref>{{cite book|last1=Greaves|first1=Ian|last2=Porter|first2=Keith|last3=Hodgetts|first3=Tim J.|last4=Woollard|first4=Malcolm|title=Emergency Care: A Textbook for Paramedics|url=http://books.google.com/books?id=2Z3cMX7owGwC&pg=PA506|date=2005|publisher=Elsevier Health Sciences|location-London|isbn=0-7020-2586-0|page=506}}</ref>
• <ref>{{cite book|last=Christiansen|first=Ole Bjarne|title=Recurrent Pregnancy Loss|url=http://books.google.com/books?id=dYQKAgAAQBAJ&pg=PT139|year=2013|publisher=John Wiley & Sons|location=Oxford|isbn=978-1-118-74918-0|page=139}}</ref>

--Fuhghettaboutit (talk) 15:52, 27 September 2015 (UTC)

Thanks and added a sentence on this social and cultural aspect. Doc James (talk · contribs · email) 16:11, 27 September 2015 (UTC)

Counselling

While the NIH list emotional support as a possible treatment it does not make any statement about benefit.[14]

The other ref says "The Cochrane Collaboration review [25] concluded that the current evidence is insufficient to demonstrate the superiority of counselling over no intervention... Despite the lack of convincing research evidence, most healthcare professionals who work with women who have miscarried believe support and counselling should be offered. Some women will cope well and not feel the need for counselling, whereas others may suffer intensely."[15]

So evidence for counselling is poor but still recommended. Doc James (talk · contribs · email) 06:00, 12 March 2016 (UTC)

Non human miscarriage

Why is this article so human focused? i understand theres a lot more known about human miscarriage, but i think a bit more than just a single paragraph on non human miscarriage is necessary.24.61.98.93 (talk) 01:29, 9 July 2016 (UTC)

We have one here Miscarriage#Other_animals Doc James (talk · contribs · email) 17:25, 10 July 2016 (UTC)

Not all pregnant people are women.

Some pregnant people do not identify as women. Also, some pregnant people are girls and not women. I propose that "people" is a better word to use if you want to include all people who could be or become pregnant, rather than the word "women." Triacylglyceride (talk) 02:27, 3 May 2017 (UTC)

WP is not the place where every controversial topic gets equal coverage and that only has to do with what citations can be found to support content. It is not equal time. Find the references that can be used to support what you want to written about any topic. Best Regards, Barbara (WVS) ✐ ✉ 17:43, 6 May 2017 (UTC)

We use female to mean XX and we use women to mean an adult with XX. The word women can mean both the sex and the gender. Here we are using it in the "sex" not gender" connotation. Doc James (talk · contribs · email) 18:51, 6 May 2017 (UTC)

I agree with everything that you said, but don't entirely see why you are saying it to me. An edit was made without discussion on a subject that is controversial -- replacing "people" with "women." I reverted it pending further discussion. Triacylglyceride (talk) 03:05, 8 May 2017 (UTC)

Ah okay. Am replying generally :-) Doc James (talk · contribs · email) 17:24, 8 May 2017 (UTC)

How many complete without intervention?

The article contradicts itself. At the outset it says "most" will complete without other intervention. Later, with a bare link source that seems inferior from the url, this becomes "approximately 50%" or something to that effect. I defer to those with medical expertise rather than change the latter to match the former. Yngvadottir (talk) 19:57, 3 June 2017 (UTC)

Where is the second occurrence? Can you quote the text you wish looked at? Doc James (talk · contribs · email) 00:47, 4 June 2017 (UTC)

I searched for the text "will complete" because there was an agreement error on the first occurrence, in the lede. That now reads: Most miscarriages will complete without additional interventions.<ref name=Ol2014/> I now see that the second instance refers to "early" miscarriages. It's: It is estimated about half of early miscarriages will complete on their own; in other cases, medication treatment or aspiration of the products of conception can be used to remove remaining tissue.<ref>http://www.babycentre.co.uk/a1039515/understanding-early-miscarriage#ixzz2x52G1IYu</ref> Yngvadottir (talk) 12:57, 4 June 2017 (UTC)

Adjusted the second bit. Doc James (talk · contribs · email) 03:39, 5 June 2017 (UTC)

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Changes

Grief and sadness are synonyms and thus we do not need both IMO.

Not sure why this was removed "In those under the age of 35 the risk is about 10% while it is about 45% in those over the age of 40. Risk begins to increase around the age of 30."?

Doc James (talk · contribs · email) 23:47, 10 September 2017 (UTC)

The content you refer to was not removed but incorporated and moved to the section on age and epidemiology. (Or at least that is where I thought I put it.) I don't think the percentages of any risk factor belongs in the first paragraph of the article when those details fit in better in the section on age. Grief and sadness are not synonyms, at least according to their WP articles. IMO this minimizes the impact of the event and does not reflect the content of the sources that I have found. Emotional and psychological impact are a huge part of all health-related events in Women's health. Best Regards, Barbara (WVS) ✐ ✉ 08:06, 13 September 2017 (UTC)

These refs lists them as synonyms[16][17][18]. One can expand upon the terminology in the body of the article. I have moved the section on psychological effects to the signs and symptoms section to give them more weight.

Have moved the age discussion to the 4th paragraph. Doc James (talk · contribs · email) 18:05, 13 September 2017 (UTC)

The good faith move is appreciated except that the emotional impact of miscarriage is not a sign or a symptom. And as good as a thesaurus might be, the terms of sadness vs. grief were defined by the sources. If referencing were a card game, I believe a medical review article trumps a thesaurus. Barbara (WVS) ✐ ✉ 07:06, 14 September 2017 (UTC)

Yes emotional effects of a condition are symptoms.

We paraphrase our sources and a thesaurus is fine for that. We should be writing the lead in easier to understand language than review articles. Doc James (talk · contribs · email) 23:15, 14 September 2017 (UTC) I

I couldn't agree more about writing in easier to understand language and will continue to do so. Yet 'grief' is a pretty easy to understand word. Saying a such an event creates sadness is like saying swimming makes you damp. Using 'sad' is trivializing the event. No woman that I have met, who speaks everyday language, has ever described her miscarriage as a condition and symptom that made her and others sad. This could be considered a form of life-long-research, yet I might be more familiar with the everyday language regarding this topic. The irony is that more than one of the sources I have encountered mention that clinicians do not take the emotional impact of miscarriage very seriously and seem to 'brush' it off without acknowledging the deep grief women and men feel afterward. This very same reaction by physicians and nurses actually intensifies the grief and adds to the risk of complicated grief, and serious depression.

I also realize that no matter how 'true' these statements might be and no matter how consensus might work (the pageviews for this talk page show some mild form of voyeurism on the part of others) I am constrained to refrain from editing the one word 'sad' into the more appropriate word 'grief'. It is unfortunate that I can't cite this mild, very mild, edit war over one word in the articles of Gender bias, Sexism in medicine. Best Regards, Barbara (WVS) ✐ ✉

I believe that either term would be acceptable; in my browser search “miscarriage grief” 111,000 results “miscarriage sadness” 43,700 results might persuade me that grief could be the better term to use.CV9933 (talk) 12:00, 16 September 2017 (UTC)

Sadness is more commonly understood than grief. We include (in fact I added) the emotional effects of miscarriage to the first paragraph of the lead of this article.[19] Doc James (talk · contribs · email) 17:59, 16 September 2017 (UTC)

In good faith, there needs to be a good reference on the assertion that 'sadness is more commonly understood than grief' assertion. Most people understand 'grief' pretty well - especially if they read the Wikipedia article on the topic! Sadness is an emotion, but grieving is a process. Also, if a father is effected months after the event, this could hardly be considered a symptom.

In addition, the article on grief describes sadness as an indicator of grief rather than a synonym by saying:

"Because grief responses can take many forms, including laughter, celebration, and bawdiness, in addition to sadness...[8][10]" and

"The signs and symptoms characteristic of complicated grief are listed as "extreme focus on the loss and reminders of the loved one, intense longing or pining for the deceased, problems accepting the death, numbness or detachment… bitterness about your loss, inability to enjoy life, depression or deep sadness, trouble carrying out normal routines, withdrawing from social activities, feeling that life holds no meaning or purpose, irritability or agitation, lack of trust in others."[28]"

Changing the title from "Emotional and psychological" to "Emotional" is significantly minimizing the real consequences of grief developing into a psychosis. Are you suggesting that responses (by women) to miscarriage are simply emotional? A psychosis may need treatment and can lead to suicide. An emotion probably doesn't. If a reader is informed that their response is simply emotional, the potential of developing a psychosis may not be considered. With so many reading this article every day, it is significantly misleading not to acknowledge that a serious, treatable condition can develop. Shame on us for suggesting that women are simply emotional in their response to miscarriage. I already know that there are non-medical, responses to events that men experience such as the removal of their prostate. Would these be simply be emotional? Would they not 'grieve' over something of themselves that has been lost? Best Regards, Barbara (WVS) ✐ ✉ 12:02, 18 September 2017 (UTC)

Sure here is a list of 1000 basic words. Sad is there grief is not.

Here is another list[20] Sad is present grief is not.

On this list of 850[21]. Grief is not.

Sure we can go with psychological effects as the heading. Doc James (talk · contribs · email) 18:47, 18 September 2017 (UTC)

I edited the title that I believe is appropriate. Ok - this is about the closest thing that I will ever write on talk page that could be misconstrued as an ad hominem comment. Did you even read ANY of my comments above? Best Regards, Barbara (WVS) ✐ ✉ 22:44, 20 September 2017 (UTC)

Yup I have read you comments but disagree with you. IMO the heading was fine before. Doc James (talk · contribs · email) 03:55, 21 September 2017 (UTC)

Treatment

" Treatment: None "

Is that okay ? Technical Peace (talk) 13:59, 25 September 2017 (UTC)

Not sure what you refer to? Doc James (talk · contribs · email) 22:06, 25 September 2017 (UTC)

I think they're referring to the sidebar which lists "none" as a potential treatment. I think it's okay, but possibly could be replaced with "expectant management"? Mvolz (talk) 09:43, 28 September 2017 (UTC)

I agree with you and will edit it. Triacylglyceride (talk) 06:35, 29 April 2018 (UTC)

Source

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4229790/

Barbara (WVS) ✐ ✉ 20:35, 31 October 2017 (UTC)

Looks decent. https://www.ncbi.nlm.nih.gov/pubmed/25395740 Doc James (talk · contribs · email) 00:23, 1 November 2017 (UTC)

tradition / ceremony / religious-beliefs section absent...

there is a clearly missing AT LEAST REFERENCE, to a seperate page for, if not also within the page (i think a seperate page would be more practical), a basic introduction to some of the transitory / metamorphisms / etc , in the variety of beliefs / practices in our histories.

tough titties if you find others' offensive to your own, obviously - no removals from contradictions of non-co-existance of all-humanities, etc, though. SEPERATE references, for seperate cultural soruces / origins, etc. — Preceding unsigned comment added by Vurrath (talk • contribs) 13:11, 2 January 2018 (UTC)

Not sure what this is trying to get across

"whereas other causes include both female and male factors."

Doc James (talk · contribs · email) 05:24, 22 March 2018 (UTC)

Toolbox issues

Just noticed multiple issues with the toolbox, not sure when they appeared.

- Risk factors: older parent -- I changed to risk factors: age. Having an older parent isn't a risk factor for having a miscarriage. Being >35yo is.

- Complications: sadness, anxiety, guilt -- this is just a weird thing to have front and center like this. I've never seen "miscarriage complicated by sadness" in a patient chart -- and the "complication" links to the article on "medical complications" specifically. Especially when it's something that can be complicated by hemorrhage and sepsis, it's just a weird thing to have there. I removed the line entirely.

- Prevention: prenatal care. Getting prenatal care doesn't prevent miscarriages. The citation specifically says that it doesn't. I removed the line entirely. If people really want something there, they can consider "in some cases, aspirin." I guess also myomectomy, polypectomy, cerclage, vaginal progestins can also prevent them.

- Treatment: changed "none" to "expectant management."

Triacylglyceride (talk) 06:40, 29 April 2018 (UTC)

Adjusted to being an older parent as being young is also age and is not a risk factor.

Yes psychological complications are still complications.

Yes prenatal care does decrease the risk per "Some ways to lower overall risk include: Staying in good health before becoming pregnant and getting regular care during pregnancy"

Expectant management is fine.

Doc James (talk · contribs · email) 05:45, 30 April 2018 (UTC)

I agree with Triacylglyceride that the emphasis on psychological sequelae is odd. First of all, the psychological complications depend significantly upon your culture. Sadness wasn't the typical reaction in the 19th century, and it isn't as common in developing countries. Before the widespread use of effective contraception, and when you don't have good access to modern medical care, the psychological reactions were (and are) more like relief (a probably unwanted or mistimed pregnancy ended) and fear (of the mother dying from the miscarriage). Second, in terms of overall importance, I think that things like "hemorrhage" and "infection" should be included.

As for prenatal care preventing miscarriage, I've got my doubts that it matters in >90% for miscarriages. The page you quote[22] cites only one source, which doesn't appear to say anything about that subject anyway. I'm also dubious about listing progestins, because I think the evidence may have tipped back the other way (at least for recurrent miscarriages). WhatamIdoing (talk) 09:22, 5 May 2018 (UTC)

As someone who deal frequently with miscarriages, relief is not a common emotion I encounter. Do you have references to back up your statement?

Guilt actually is very common and it is important to emphasize that the women did not do anything wrong to result in the miscarriage. So yah these things are important.

"hemorrhage" = "bleeding" and that is included under symptoms. Agree infection should be included. Will look for a reference.

Yes prenatal care may not make a different in many cases but the NIH states it does in some. Doc James (talk · contribs · email) 10:43, 5 May 2018 (UTC)

User:Doc James, given the country where you practice, I hope that all of your patients have "good access to modern medical care", and are living in a time that is after "the widespread use of effective contraception". If you want to learn more about what women experienced when they didn't live in the 21st century, or when they don't have access to a modern hospital in a developed country, then you might start with the first two sources in Miscarriage#Society and culture. WhatamIdoing (talk) 06:46, 1 June 2018 (UTC)