PETALING JAYA: Miscarriage, although common, remains a deeply misunderstood and often silent tragedy, affecting 15.9% of Malaysian women of reproductive age.
With the majority occurring in the first trimester, a health expert is calling for greater awareness, timely medical intervention and emotional support, not only for women but also for families and caregivers navigating the loss.
Taylor’s University School of Medicine obstetrics and gynaecology associate professor Dr Anitha Ponnupillai said between 75% and 80% of miscarriages occur in the first trimester.
She added that one in five pregnancies ends in miscarriage, although the actual figure may be higher due to unreported cases.
“Miscarriage refers to the spontaneous loss of pregnancy before the foetus becomes viable, usually before 20 to 28 weeks. While some women recover quickly, others experience prolonged grief and guilt, which can affect their overall well-being,” she said.
Anitha stressed that a deeper understanding of miscarriage – both medically and emotionally – is crucial in helping individuals build resilience and restore hope for future pregnancies.
Maternal age remains a significant risk factor, with chromosomal abnormalities increasing the likelihood of miscarriage from 6.4% in women under 35 to 23.1% in those over 40.
She said one in 100 women experiences recurrent miscarriage, often without a known cause, but noted that with specialised care, the chances of a successful pregnancy could reach 75%.
Medical conditions such as diabetes, thyroid disorders, polycystic ovary syndrome and blood-clotting issues, as well as lifestyle factors such as smoking, alcohol or drug use, and obesity also contribute to the risk of miscarriage.
Anitha underscored the importance of dispelling common myths, including the false belief that normal activities such as exercise or intercourse can cause miscarriage.
“That’s simply not true,” she said.
Typical warning signs include vaginal bleeding, ranging from spotting to a heavy flow accompanied by abdominal cramps or severe pain.
“Bleeding may persist for about two weeks, with the heaviest flow occurring within the first two days. Even mild spotting should prompt immediate medical attention,” she advised.
Diagnosis is generally confirmed through clinical history, physical examination and an ultrasound.
She explained that different types of miscarriage require different forms of care.
A complete miscarriage results in full expulsion of pregnancy tissue, while an incomplete miscarriage leaves tissue behind that may require medical or surgical removal.
A missed miscarriage, in which the foetus stops developing but no immediate symptoms occur, is often only discovered during a routine scan.
In contrast, a septic miscarriage, which involves infection caused by retained tissue, is a medical emergency marked by fever, pain and foul-smelling discharge.
If pregnancy tissue is expelled at home, Anitha recommended collecting it in a clean container and bringing it to the hospital for examination.
Physically, miscarriage can result in heavy bleeding, infection, pain, trauma to reproductive organs and, in some cases, the need for additional surgery.
Septic miscarriage, in particular, can affect future fertility.
She said follow-up care within two weeks is vital to monitor both physical and emotional recovery.
Ovulation typically resumes in two weeks, with menstruation returning within four to six weeks.
It is advisable to wait for at least one full cycle before attempting to conceive again.
