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Young Parents (Singapore) - - THE BABY YEARS -

I’m ex­pect­ing again af­ter a mis­car­riage, but the stres s of de­liv­er­ing a healthy baby has put me on edge. What’s the risk that I may mis­carry again?

Af­ter one mis­car­riage, stud­ies have shown there is a 14 to 21 per cent chance of a re­peat mis­car­riage.

But to keep things in per­spec­tive, up to 20 per cent of all preg­nan­cies end up as losses. So the risk of mis­car­ry­ing is not higher than other ex­pec­tant mums, given that you had one pre­vi­ous mis­car­riage.

Only 1 per cent of women will have re­cur­rent mis­car­riages (that is, three con­sec­u­tive preg­nancy losses), and these may be due to ge­netic or im­muno­log­i­cal prob­lems.

It is not un­usual to feel anx­ious or para­noid in your sit­u­a­tion, as there is a con­stant worry that the emo­tional trauma may oc­cur again. Hav­ing a sup­port­ive spouse and fam­ily may help al­le­vi­ate your anx­i­ety.

Try to do things that nor­mally re­lax you and avoid stren­u­ous ac­tiv­i­ties or ex­er­cises un­til the end of the rst trimester. Once you reach 10 weeks of your preg­nancy, the chance of a preg­nancy loss is greatly re­duced.

It is also im­por­tant to know that based on sci­entic stud­ies, there is no ev­i­dence to show a link be­tween stress and mis­car­riage.

How many C-sec­tions can a mum safely have?

There are no set rules. Stud­ies show that the risks in­crease af­ter a third C-sec­tion, al­though re­search has yet to de­ter­mine the ex­act num­ber one can have and be con­sid­ered safe.

Each re­peat C-sec­tion may be more com­pli­cated than the last and also takes longer. That’s be­cause women who have re­peat C-sec­tions are at a higher risk of bleed­ing, in­fec­tion, blad­der and bowel in­juries, as well as scar tis­sue form­ing af­ter each surgery.

Risks of ex­ces­sive bleed­ing in­crease with the num­ber of re­peat C-sec­tions. This, in turn, boosts the risk of need­ing a hys­terec­tomy (re­moval of the uterus) and the need for blood trans­fu­sions.

There is also a higher chance of pla­cen­tal prob­lems such as prae­via (pla­centa sited very low in the uterus) or acc­reta (the pla­centa im­plants into the mus­cle layer of the uterus). Both prob­lems heighten the risk of mas­sive post-de­liv­ery bleed­ing, ne­ces­si­tat­ing a hys­terec­tomy.

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