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Why did I have an abortion and can I conceive again?

Q: I am a 25 years old housewife and my husband is 33 years old. Last year I missed my periods so I checked for pregnancy using the pregnancy kit available in the market which had to show 2 lines when urine was dropped on it. As one line was dark while the other was light in colour, I went for urine test in a clinic which showed negative result. Subsequently I went for a journey where I exerted myself a lot. On coming back I still did not get my periods so I repeated the test and it showed 2 dark lines this time. The test at the clinic was also positive. The doctor did a scan to see whether the embryo and heart beat were visible as she said it was 6 weeks. But it was not visible and only the pregnancy sac was seen. She asked me to wait for a few more days but still the embryo was not visible and only the pregnancy sac was seen. She gave me some drugs to abort the pregnancy which was successful and following this I got my periods regularly. My blood group is 0 negative and my husbands is A positive. My menstrual cycle is for 2 days with normal flow, sometimes even for 1 & 1/2 days. The doctor gave me an ANTI-D injection for the abortion because of my negative blood group. What could be the reason for the missed abortion and when can I plan pregnancy again? Was this abortion done because I bled during my periods or this type of bleeding is normal?

A:I am sorry to hear what happened to you. From what you have written it appears to be an anembryoic pregnancy meaning that the embryo was never really formed. It was a failed attempt of nature to make a foetus. This happens typically when an abnormal egg mates an abnormal sperm or vice-versa. This is purely by random sampling. There are millions of sperms in each semen specimen and only one mates the egg. 10 to 30% of all sperms in a normal male are abnormal and probably an equal number of eggs are abnormal. If one of these abnormal eggs or sperms mate the foetus would be abnormal and it will not survive. Nature does not keep in the womb an individual which is not designed to live 70 odd years on this planet. Most abnormalities at the time of conception result in an early abortion. Not only are these abortions unavoidable they are not preventable and even if we could prevent them (which we cannot) we would not like to prevent them as they would in all probability result in an abnormal child which we all know is a great tragedy. There is a natural selection (basic Darwinism) and only the healthy foetuses are allowed to grow. As you saw on ultrasound there was an empty sac (the foetus was not really formed). Do not blame yourself, one of the commonest myths about pregnancy is that exertion causes abortion. The truth, on the other hand, is that the people who are most active during pregnancies have the most normal pregnancies and childbirth. Physical exertion cannot and does not cause an abortion and bed-rest does not prevent abortions (and bed rest is indeed harmful to a pregnancy). The pregnancy test becomes positive as soon as you miss a period and is positive because of a pregnancy hormone in the urine called HCG and is not related to the fetus being present. Even if some placental bits are present or any fetal tissue is present in the body the pregnancy test would be positive (which is what happened in your case). In 97% of the foetuses destined to abort, bleeding occurs after the foetus is already dead/not formed (as is clear from the Ultrasound) and the bleeding is a sign of abortion not a cause. So on no account medication at this stage would help. It is as ridiculous to treat this type of bleeding with hormones (and nearly universally prescribed bed-rest!) and vitamins as giving these medicines to revive a dead person. So please do not think that you aborted because of exertion. No amount of exertion, sex, travel, mode of travel or diet can cause an abortion. Well if this does not cause an abortion what does? The answer to that is that modern medicine does not have an answer to that. All we know is that these early abortions do occur in nature and we cannot prevent them and in all probability it is the abnormal conception which is excluded by nature. Scanty periods, Rh negative or any other such thing did not cause your abortion! You can plan your next pregnancy as soon as you are psychologically and emotionally prepared for it. There is no medical reason to wait and even if you conceive in the next cycle it would be OK medically speaking. There is no need to do any elaborate tests or take precautions, your chance of carrying/aborting the next pregnancy is almost the same as your first pregnancy. Having had one previous abortion is not a higher risk for a second abortion. Please have faith in nature and live a normal life. I am telling you this because as soon as you become pregnant again all the concerned people (including some old doctors) will put a lot of restrictions on you in form or diet / travel/ sex/ and work etc. You may also be put through a battery of tests which reveal little and cost a lot. This in an attempt to find something to be blamed as a cause and to do something in order to prevent a recurrence. In fact you may be asked to take bed rest! but as I explained none of these things are required. Live your life normally and get a scan done at 11 weeks (earlier if you have vaginal bleeding).

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