Dear Doctor: I am 26-years-old and have failed to conceive to term. I have never used any form of family planning. In 2008, I conceived and carried my pregnancy up to eight months and two weeks when I got abruptial placenta. I was operated on and lost the baby. When I tried again in 2010, I got a miscarriage at three months. I consulted a gynaecologist who carried out different tests, including hormones, ultra sound, blood group and rhesus factor on my husband and I. We were given a clean bill of health and I was advised to relax, which I did. I conceived last year in March and miscarried again in June. When I inquired from a gynaecologist, still everything was normal. What is wrong with me?
— Irene B.

Dear Irene: Medically, an abortion is when one loses her pregnancy before it is 28 weeks. This may be induced or spontaneous. At eight months and two weeks, you had what should be called a premature delivery. A woman’s pregnancy may be going on well only for the placenta to prematurely separate from the womb denying the unborn foetus oxygen and food as well as removal of waste putting its life in danger. That is most likely why your baby died. The mother’s life is also in danger from the likelihood of bleeding.
The cause of the so called Abruptio placenta is unknown though mothers with high blood pressure in pregnancy, alcoholics, smokers and others may be at risk. One having three or more consecutive early pregnancy losses is said to have had habitual abortions and the time of loss may provide a clue about the cause. Unfortunately, in many cases the cause may even with the best tests never be found making early pregnancy loss a frustrating experience for both patients and doctors.

Lifestyle practices such as alcohol, drugs or drug abuse, smoking, worrying too much, sedentary lifestyle and eating fatty foods among others have to be ditched to improve pregnancy outcomes. The good thing is that you are seeing a gynaecologist and for the best follow up you need not change him or her but rather consult often even when not pregnant. At 26 years, you could be at the peak of fertility and it is likely you will get pregnant and carry your pregnancies to term.
Male factors may also be responsible for recurrent spontaneous miscarriages and for this and better psychological support; you require visiting your gynaecologist with your partner, so that if required, tests may also be carried out on him.