Mother’s Prayer Following A Miscarriage/Stillbirth
Stillbirth and miscarriage: where to get support
When the TV personality, Jack Osbourne, and his wife, Lisa, announced that they experienced a late-term miscarriage earlier this year, they were flooded with messages of sympathy from well wishers.
Singer, Lily Allen, was six months pregnant when she had her second miscarriage and asked her fans to say a 'little prayer' for her loss.
One in four pregnancies ends in miscarriage. Most happen in the first 12 weeks, but a small number of expectant mothers lose babies in the second or even third trimester.
The loss of a foetus is termed a miscarriage if it occurs before 23 weeks. After that time, it is a considered to be the stillbirth of a baby.
But it still remains the case that most people don't talk much about the loss of a pre-term infant.
Opening up about stillbirth and miscarriage
Ruth Bender Atik, national director of the Miscarriage Association, said at the launch of a recent campaign to encourage people to use the charity's helpline: 'Miscarriage affects many thousands of people throughout the UK every year, yet it's rarely spoken about openly.
'We know that talking about it can make a huge difference to the women, men/partners, families and friends affected by miscarriage.'
Susan Harper-Clark, 35, found it hard to hard to talk about her own feelings of grief and loss when she suffered two late miscarriages; one at 19 weeks in 2010 and the second at 22 weeks in 2011.
'It was just too painful at first. That said, my husband Graeme and I wanted people to acknowledge what had happened and I really appreciated their well wishes.'
Preventing miscarriage and stillbirth is one of the primary goals of doctors who look into why babies die in utero.
Professor Siobhan Quenby is a consultant at University Hospital Coventry and Warwickshire NHS trust.
After years of research, she has discovered that natural killer cells, which are present in ur bodies, are linked with repeated miscarriages.In one of her studies, 160 women who had a history of miscarriages were examined to see if they had high levels of natural killer cells in the lining of their wombs.
Those who were found to have high levels of these cells were randomly given either steroid treatment, which blocks natural killer cells, or a placebo once they became pregnant.
Women who had the steroid treatment were 20 per cent more ly than those on placebo to carry a baby to full-term.
However, Professor Quenby says that more work still needs to be done before steroid treatment can be rolled out on a larger scale.
Tests showed that Susan had what's known as an 'incompetent cervix,' despite being fit and healthy, and being free of risk factors such as smoking or a high BMI.
'After I got over the initial shock, I did find it hard to talk to people about what I had gone through.
'I found it easier to talk to some people than others and I felt that some people were embarrassed about the situation.
'Luckily, my husband is brilliant and I have a very close family. We helped each other get through it.'
Information on where to get support
The Miscarriage Association offers support in a number of ways.
'We are there to offer information. When things go wrong in pregnancy, there is often a great need for information about what is happening and what is ly to happen,' says Ruth.
'There may be questions about the physical process of loss and the options available; about what happens to the remains of a miscarried baby; about further tests or treatments; and especially about whether there is anything that can be done to reduce the risk next time.'
Staff needs to be supported too. Caring for women who've had an miscarriage or stillbirth can be emotionally demanding on health care professionals.
'We support medical staff and have a range of leaflets available, which can also be downloaded from our website. We have telephone support workers and a team of volunteers to offer peer support.
'This is combined with the support offered through our forum and pages.'
Support for future pregnancies
Although they were devastated after two miscarriages, Susan and Graeme were determined to keep trying to have a baby. After doing some online research, Susan contacted the charity, Tommy's, and was referred to the Preterm Surveillance Clinic at St Thomas' Hospital, London.
Under the team's care, she underwent an abdominal stitch, regular fetal fibronectin testing and cervical length tests, and gave birth to her son, Thomas, at 38 weeks in July 2012.
'It's an amazing feeling having little Thomas, but we'll never forget his two sisters, Emilia and Grace, who paved the way for him,' says Susan.
'As soon as he is old enough – he is 14 months old now – we will tell him about them and they will always be part of our family.'
Other people also read:
Miscarriage:The facts on miscarriage.
Stillbirth: The facts on stillbirth.
The Miscarriage Association: The Miscarriage Assocation offers help and support to people struggling with a bereavement.
Last updated 07.10.2013
Lies, Damned Lies, and Miscarriage Statistics
Trying to figure out your chances of miscarrying? Sadly, you are going to have a hard time finding good information.
Many websites claim to tell you your risk of miscarriage, citing statistics that look these:
Commonly reported chances of miscarriage by pregnancy week
But problems abound with their numbers.
Problem 1: These sites rarely provide their sources, so you cannot tell whether their information is reliable.
Problem 2: These sites do not breakdown miscarriage risk by other known risk factors, the mother’s age.
Problem 3: Nearly all these sites derive their statistics from just two small studies, one which tracked 222 women from conception through just the first 6 weeks of pregnancy, and another which tracked 697 pregnancies, but only after a fetal heartbeat had been detected–a key point, because heartbeat detection dramatically lowers the chances of a miscarriage.
The lack of good information frustrated me when I was pregnant, and I bet it frustrates you too. So I have compiled a summary of the best research on risk of miscarriage. Where possible, I break down the risk by…
Edit: I also have a new post on how morning sickness signals a lower risk.
Risk of Miscarriage by Pregnancy Week
Miscarriage risk drops as pregnancy progresses. The risk is highest early in the first trimester. Fortunately, for most women by 14 weeks their chance of a miscarriage is less than 1%.
Miscarriages rates declined between 6 to 10 weeks, according to a study of 697 pregnancies with a confirmed fetal heartbeat:
- 9.4% at 6 weeks
- 4.6% at 7 weeks
- 1.5% at 8 weeks
- 0.5% at 9 weeks
- 0.7% at 10 weeks
A similar study of 668 pregnancies with a confirmed fetal heartbeat between 6 and 10 weeks, found a similar decline in miscarriage risk by week:
- 10.3% at 6 weeks
- 7.9% at 7 weeks
- 7.4% at 8 weeks
- 3.1% at 9 weeks
But for women in their mid to late 30s and early 40s, these studies understate the risk. Even after confirmation of a fetal heartbeat, miscarriage risk remains high for women 40 and older through 12 weeks, according to a study of 384 women 35 and older.
Chance of miscarriage by 12 weeks but after confirmation of a fetal heart rate by the mother’s age.
Despite the higher risk for this age group overall, a normal ultrasound result from 7 weeks remains a promising sign. Women who entered the study in their 4th to 5th week of pregnancy had about a 35% risk of miscarriage. Women who entered the study later, and who therefore had a normal ultrasound and heartbeat at 7-10 weeks, had a risk under 10%.
Miscarriage Risk by Fetal Heart Rate
A fetal heartbeat often indicates a healthy, viable pregnancy. But a fetal heart rate that is too slow can instead signal an impending miscarriage.
The chance of a first trimester miscarriage varies by fetal heart rate, according to a study of 809 pregnancies. The lower the heart rate, the higher the miscarriage risk. (Normal fetal heart rates change with fetal age, so these tables break down the risk by pregnancy week.)
Up to 6 weeks 2 days gestation:
Chance of miscarriage by fetal heart rate up to 6 weeks 2 days of gestation.
Between 6 weeks 3 days and 7 weeks 0 days:
Chance of miscarriage by fetal heart rate at 7 weeks gestation
After 7 weeks, the fetal heart rate was at or above 120 beats per minute for almost all ongoing pregnancies.
Miscarriage Risk by Week Before Confirmation of a Heartbeat
Many women will not have an ultrasound and fetal heartbeat confirmation until sometime between 8-10 weeks. What are their chances of a miscarriage before that crucial piece of news?
In a large prospective study of 4,887 women trying to conceive, 4070 became pregnant. Their rate of miscarriage was 4-5% in week 6. By week 7, this risk fell to 2.5%. Rates hovered around 2% per week until week 13, when chances of a miscarriage dipped below 1%
Personal Risk Factors
Your personal characteristics and behaviors alter your miscarriage risk. The most important risk factor, as is well known, is the woman’s age: Miscarriage rates climb as women age, especially after the late 30s. The man’s age matters too, especially after they turn 40.
Risk of Miscarriage by the Woman’s Age
Anne-Marie Nybo Anderson, of the Danish Epidemiology Science Centre led the largest population-based study ever conducted on age and miscarriage. Anderson tracked every “reproductive outcome”– every pregnancy, miscarriage, birth, stillbirth, or abortion–in Denmark between the years of 1978 and 1992–ultimately tracking outcomes of over a million pregnancies.
What did she find? Miscarriage risk rises sharply during a woman’s late 30s and reached nearly 100% by age 45.
Risk of pregnancy loss by the mother’s age at conception.
Rates of ectopic pregnancy also rose with age:
Risk of ectopic pregnancy by the mother’s age
As did the chances of a stillbirth:
Risk of stillbirth by the mother’s age at conception
(In Anderson’s study, stillbirth was defined as a loss after 28 weeks. In the U.S., any loss after 20 weeks is usually considered a stillbirth)
Take heart though: as scary as the rise in stillbirths sounds, the risk remains under 1% through age 45.
Anderson’s study’s findings parallel those of another large and well-studied sample: U.S. pregnancies conceived via IVF.
Data from the Centers from Disease Control’s report on all 2010 IVF cycles.
Just as in Anderson’s study of Danish pregnancies, the uptick in miscarriage risk among IVF pregnancies begins at age 38.
Intriguingly, the overall miscarriage rates among IVF pregnancies is lower than in the Denmark sample. This is probably due to selection effects. Only some women manage to become pregnant through IVF, and embryos transferred during IVF are chosen early signs of normal development. Passing through these early hurdles ly ups the odds of a successful pregnancy.
Risk of Miscarriage by the Man’s Age
Researchers often ignore the man’s age when studying miscarriage. Most women marry men who are about the same age, so researchers have trouble teasing apart the effects of the woman’s age from the man’s age.
Fortunately, several studies have now included couples in which either the woman or the man is much older than their partner.These studies provide a clear and consistent picture: older prospective fathers raise the risk of miscarriage by about 25-50%. One study found an a 60% increase in the odds of a miscarriage if the father was over 40. Another reported a roughly 25% increase in the risk of miscarriage for fathers over the age of 35.
Other studies report similar effects; all showing most marked rise after age 40 (see here and here).
Risk by the Couple’s Combined Age
A young partner can offset some of your personal age-based miscarriage risk, especially if you are a man. Men whose partners are young, under 30, have relatively low chances of miscarriage regardless of their own age, according to large retrospective European study.
For women, alas, young partner only partially offset their age-based risk. Women over 35 with relatively young partners, under age 40, still face double to triple the odds of women in their 20s.
Older partners do, however, compound the risk for women in their 30s. A woman in her early 30s with a partner over 40 has roughly triple the odds of a woman with a partner the same age or younger.
Risk of Miscarriage After Confirmation of a Fetal Heartbeat for Older Women
On a more positive note, women in their late 30s and early 40s have a good chance of an ongoing pregnancy after confirmation of fetal heartbeat.
For women over 40, once a heartbeat has been detected at 7-10 weeks, the risk of a miscarriage falls to around 10%. After 20 weeks, the risk plummets to less than 1%.
Chance of miscarriage by 12 weeks but after confirmation of a fetal heart rate by the mother’s age.
How Does a Prior Miscarriage Affect Your Risk of Miscarriage?
Aside from age, the best predictor of whether a woman will miscarry is the number miscarriages she has already suffered. Most websites quote these statistics:
From these statistics, one prior miscarriage seems inconsequential; while just two prior miscarriages appears to dramatically raise your chances of another miscarriage.
Fortunately, these statistics are too dire for women who have had two prior miscarriages. The outcomes from a study over a million pregnancies paints a much more reassuring picture, at least for women who have had fewer than 3 prior miscarriages
Here’s the risk of a subsequent miscarriage for women who have never given birth before:
And for women who have given birth before:
The Bottom Line
In early pregnancy, miscarriage risk falls with each passing week, with significant drops around the 7-week mark, and again after the 12-week mark.
Your age, your partner’s age, and your number of prior miscarriages all affect your overall risk of miscarriage. Miscarriage risk rises dramatically after about age 37 for women, and age 40 for men.
Ammon Avalos, L., Galindo, C. and Li, D.-K. (2012), A systematic review to calculate background miscarriage rates using life table analysis. Birth Defects Research Part A: Clinical and Molecular Teratology, 94: 417–423. doi: 10.1002/bdra.23014
By Ruhaifa Adil
Bismillahir Rahmanir Raheem
Losing a baby is one of the hardest things any parent can go through. Even if the pregnancy lasted for only a few weeks, the grief a mother feels is incomparable. A mother does not love her baby only at first sight; she loves her baby even before she has seen it!
Here are some important guidelines for the Muslim mother who has had a miscarriage (losing a baby before 24 weeks of gestation) or a stillbirth (losing a baby after 24 weeks of gestation).
Accept Allah’s decision
A Muslim mother is un other mothers. Despite her grief, she accepts Allah’s decision and believes that He knows what is best. Though it may be prudent to find out if there was a medical condition for the miscarriage, do not forget that the ultimate reason for anything that happens is Qadar (predestination).
Remind yourself that Allah is All-Knowing and He knows what is best for us. Allah gives us tests in this life, granting us an opportunity to become His beloved servants. Allah has said: “And surely We shall try you with something of fear and hunger, and loss of wealth and lives and crops but give glad tidings to the steadfast.
Say Inna lillahi wa inna ilayhi raji’oon (To Allah we belong and to Him we will return)
The above verse is followed by this verse which says: “Who, when disaster strikes them, say: Indeed we belong to Allah, and indeed to Him we will return. Those are the ones upon whom are blessings from their Lord and mercy. And it is those who are the [rightly] guided.” (2:156-157)
The Messenger of Allah (sa) also said: “When the child of a person dies, Allah says to His angels: ‘You have taken the soul of the child of My slave?’ They say: ‘Yes.
’ He says: ‘You have taken the apple of his eye?’ They say: ‘Yes.’ He says: ‘What did My slave say?’ They say: ‘He praised You and said: Inna lillahi wa inna ilayhi raji’oon.
’ And Allah says: ‘Build for My slave a house in Paradise, and call it the house of praise.’” (Tirmidhi; reliable)
Dealing with feelings of grief
Though accepting Allah’s decision may bring you solace, your pain and grief may still feel unbearable! It is at this time that you need to console and remind yourself that your child is in Jannah (paradise) waiting for you.
Call out to Allah and supplicate to Him to ease your pain, for though you loved this child very much, remember that Allah loves you seventy times as much! Make dhikr and du’a for it will bring you comfort.
Reach out to your husband, family, and friends, and try not to isolate yourself.
Dealing with feelings of guilt
Sometimes it is hard to accept what has happened, and mothers tend to fall into a vicious thought process of what they may have done wrong to have lost the baby. At this time, remind yourself that if Allah means for something to happen, it will. Seek peace in knowing that Allah intends something better for you.
Know that Allah’s plans are grander than what the human mind can encompass, as seen in the story of Khidr in Surah Kahf. Remember this verse whenever you feel guilt creeping in: “No disaster strikes except by permission of Allah. And whoever believes in Allah – He will guide his heart. And Allah is Knowing of all things.
The reward for Sabr (patience)
“And Allah loves the steadfast (the sabireen – the patient ones).” (3:146)
As you go through this ordeal, remember Allah’s reward as promised by Him: “I have no reward except Jannah for a believing slave of Mine who shows patience and anticipates My reward when I take away his favourite one from the inhabitants of the world.” (Bukhari)
The Prophet (sa) also said: “By the One in Whose Hand is my soul, the miscarried foetus will drag his mother by his umbilical cord to Paradise, if she (was patient and) sought reward (for her loss).” (Ibn Majah: sound)
“…Indeed, the patient will be given their reward without account.” (39:10)
Reunion in the Hereafter
Remember: you will be reunited with your child in the Hereafter where this child will become a source of taking you to Paradise! Rejoice in the fact that this is a very temporary separation and you will soon see your beloved baby, who is in a place far better waiting to lead you to Jannah.
Rites of the baby
A mother provides everything for her child even if it is at the expense of her own needs.
Even though your grief is immense, you need to place your baby above it and make sure you fulfill his final rites.Scholars agree that if you miscarried your baby before four months of pregnancy, then no ‘aqeeqah needs to be done, nor does the child need to be named. Funeral prayer is also not incumbent before burial.
However if you have lost your baby after four months of gestation, then the soul has been breathed into him, hence he should be named, shrouded, and the funeral prayer offered. The baby should be buried with the Muslims, and the ‘aqeeqah should be done for him. (Reference: islamqa.info)
Rulings on post natal bleeding
As hard as this loss may be, again it is essential for the Muslimah to not forget her deen (religion).
You must continue to pray and fast if you miscarry your baby before the baby has developed human features such as a head, hand, foot, and so on.
However if the baby has human features then you are under nifas (post natal bleeding) and should not pray nor fast or have intercourse with your husband until you become pure or until forty days have passed.
Scholars have said that the minimum time in which human features may appear is 81 days. The 81 days refers to the actual pregnancy and not from your last menstrual cycle (which is used to date the pregnancy). (Reference: islamqa.info)
Take heart from the examples of the Salaf and Prophet Muhammad (sa)
When Ibn Umar’s child was sick, he was very distraught, yet he was smiling at the time of the funeral. When asked why, he replied: “This [death] was nothing short of mercy for him and when it was decreed by Allah Most High I was pleased with it.”
Umar Ibn Abd al-Aziz told his dying son: “I prefer for you to be in my balance of good deeds (through my sabr for your loss) than for me to be in your balance of good deeds.”
The only time Fudayl ibn Iyad was ever seen smiling was after the death of his child and his reply to those around him was: “Allah loved something and I love what Allah loved.”(Source: Ibn Nasir al-Din al-Dimashqi, Bardu al-Akbad an Faqd al-Awlad (“The Solace of Livers from the Loss of Children”).
Even the Prophet’s son Ibrahim passed away in infancy, and though he wept at his death, he said: “The eye weeps and the heart grieves, but we say only what our Lord is pleased with. We are grieved for you, Ibrahim.” (Abu Dawood; sound)
Anxiety for the next pregnancy
It is natural to feel anxious about future pregnancies ending in miscarriage too. Most women who have a miscarriage, however, go on to have a successful pregnancy the next time round.
Do not despair and remember the story of Zakariya (as) who had a child in old age when he supplicated to his Lord: “…O my Lord! Grant me from You, a good offspring. You are indeed the All-Hearer of invocation.
” (3:38) Supplicate to Allah; He is certainly the All-Hearer.
Ruhaifa Adil is a mother of four, a practising Muslimah, an avid reader, and a passionate writer. She works primarily as a trainer for mothers and teachers, advocating a multi sensorial, learner-centred approach, which she has learnt through her work as a remedial specialist for children with dyslexia.
She is also an author of English textbooks, the teachings of the Quran (currently under editing), and creative director of a Tafseer app for kids (soon to be launched Insha’Allah). Her latest project is Qutor.com, a website that helps connect Quran teachers and students.
© IIPH 2015
Photo credit: viralbus / Foter.com / CC BY-SA
About the author
Ruhaifa Adil is a mother of four, a practising Muslimah, an avid reader, and a passionate writer.
She works primarily as a trainer for mothers and teachers, advocating a multi sensorial, learner-centred approach, which she has learnt through her work as a remedial specialist for children with dyslexia.
She is also an author of English textbooks, the teachings of the Quran (currently under editing), and creative director of a Tafseer app for kids (soon to be launched Insha’Allah).