Could My Third Miscarriage Have Been Prevented?

There is nothing easy about losing a baby, whether it's for the first or the third time - but repeated losses are especially painful. What's even worse is when you find out that one or all of the miscarriages you've experienced could have been prevented due to an undiagnosed medical condition.

If you experienced your pregnancy loss in the second trimester, it could have happened because of an incompetent cervix. While there are many reasons for recurrent miscarriage, when it happens in the second trimester, an incompetent cervix can be the cause almost 25 percent of the time, according to the American Pregnancy Association.

What Is An Incompetent Cervix? 

Also referred to as cervical insufficiency or sometimes as a weakened cervix, an incompetent cervix is the term used to describe a cervix that opens prematurely. Throughout pregnancy, as the baby grows and gets bigger, it puts pressure on the cervix, eventually culminating in the dilation that leads to labor. But for women with an incompetent cervix, this happens prematurely, before the baby is fully ready to be born. While it is a rare condition, its effects can be devastating.

How Do Doctors Check For An Incompetent Cervix? 

For decades, a woman had to lose two or three babies before she could be a candidate for diagnoses and treatment of an incompetent cervix. Today, doctors can use what's called a serial sonogram to check for a mother's cervical length and ensure it is at the normal length of at least three centimeters. They can also continue to monitor cervical length to see if there is evidence of shortening during pregnancy and, if so, know they need to take action.

What Are The Warning Signs Of An Incompetent Cervix? 

Unfortunately, there are very few, if any, warning signs or symptoms. However, if a woman has a cervix that's two-and-a-half centimeters or less in length, she may have an incompetent cervix. Likewise, if she has membranes protruding into the internal parts of the cervix (what's called the endocervix), that can be another sign of a problem. More importantly, if a woman has had a previous miscarriage, and she dilates and delivers, or ruptures her membranes, without any labor pains, she needs to be checked out. She may have cervical insufficiency.

What Are The Complications Associated With Cervical Incompetence?

An incompetent cervix can lead to several complications, including:

• Second-trimester miscarriage – One of the most serious risks, as the weakened cervix may open too soon, leading to pregnancy loss.
• Preterm birth – If the cervix opens prematurely but the baby is viable, it can lead to early delivery, increasing the risk of complications like respiratory distress syndrome, infections, and developmental issues.
• Infection (Chorioamnionitis) – The premature opening of the cervix can allow bacteria to enter the uterus, increasing the risk of infection for both the mother and baby.
• Preterm Premature Rupture of Membranes (PPROM) – The amniotic sac may break too early, leading to a higher risk of infection, preterm labor, or pregnancy loss.
• Low birth weight and related complications – If a baby is born prematurely due to an incompetent cervix, they may face challenges like underdeveloped lungs, feeding difficulties, and long-term health issues.
• Emotional distress – Recurrent pregnancy loss or preterm labor can lead to significant emotional and psychological stress for expectant mothers.

What Are Other Causes Of Recurrent Miscarriage?

Miscarriage can occur for many reasons beyond cervical incompetence, often due to underlying medical conditions or genetic factors. One of the most common causes is chromosomal abnormalities, where the developing embryo has missing or extra chromosomes, preventing a successful pregnancy.

In some cases, a molar pregnancy occurs, where abnormal placental tissue grows instead of a viable fetus, leading to pregnancy loss. These genetic issues are typically beyond a person’s control and are the leading cause of miscarriage in the early pregnancy stage.

Certain health conditions can also increase the risk of miscarriage by affecting the mother’s immune system and circulation. For instance, blood clotting disorders can interfere with blood flow to the placenta, depriving the developing baby of oxygen and nutrients. Similarly, excessive activity of natural killer cells — immune cells that normally help fight infections — may mistakenly attack a pregnancy. Additionally, thyroid antibodies associated with autoimmune conditions can disrupt hormone levels, further complicating a healthy pregnancy. In cases where blood clots form in the placenta or umbilical cord, the baby may not receive the support it needs to thrive. 

Identifying and treating these conditions early can improve the chances of carrying a pregnancy to term. If doctors fail to diagnose any of the above and it results in a miscarriage, it may be a case of medical malpractice. 

When Are Recurrent Miscarriages Medical Malpractice? 

Any time a woman experiences consecutive miscarriages, especially in the second trimester or without a clear explanation, doctors should investigate what is causing recurrent miscarriage. Conditions such as cervical incompetence, chromosomal abnormalities, blood clotting disorders, thyroid issues, or immune system dysfunction can contribute to pregnancy loss. 

If a routine ultrasound reveals concerns like poor fetal growth, uterine abnormalities, or placental issues, further testing (including blood tests, ultrasounds and imaging, and cervical and uterine evaluations) is crucial to identify risk factors that could threaten a healthy pregnancy. Failing to explore these possibilities can have serious consequences, and healthcare providers have a responsibility to discuss potential risks and available treatment options with their patients.

If you believe your miscarriage was caused by an undiagnosed or improperly treated condition, you should contact Ross Feller Casey for a free case evaluation from an experienced medical malpractice attorney.

Ross Feller Casey handles all of its cases on a contingency basis. That means you will not pay anything until a financial recovery is made in your case.