Has she had any miscarriages or abortions

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A miscarriage (spontaneous abortion) is when a pregnancy ends before the woman is 6 months pregnant, while the baby is still too small to live outside the mother. This is common and often happens before the woman even knows she is pregnant

It is usually difficult to know why a miscarriage happens, but some causes of miscarriage are preventable. Malaria, sexually transmitted infections, injury, violence, and stress can all cause a pregnancy to end.

Sometimes miscarriages happen because a woman has been near poisons or toxic chemicals. For example, women who work on farms often breathe or handle pesticides which can cause miscarriage. These women have more miscarriages than other women.

Some miscarriages can be prevented by treating women for illness and infection and by helping them avoid chemical poisons and violence. But some women have one miscarriage after another, and you may not know why. Get medical advice to find the cause and to help her carry this pregnancy all the way through .

Women who work with pesticides or other chemicals are more likely to have miscarriages.


Many women use plant medicines and other remedies to regulate or bring on their monthly bleeding, or prevent or end a pregnancy. These remedies may be safe, but ask the woman if she has ever had a problem — such as pain, heavy bleeding, or infection — after using any plant or any kind of medicine.

If some person, or the woman herself, does something to her body to end a pregnancy, we call this an abortion. Where abortion is legal and available, a woman can have a safe abortion that will not usually -

endanger her future pregnancies. There are 3 kinds of abortion that can be safe:

• Vacuum aspiration. A health worker uses a machine or manual vacuum aspiration (MVA) syringe to empty the womb (see Chapter 23). If vacuum aspiration is done correctly, it is usually safe .

• D&C (dilation and curettage). A health worker empties the womb by scraping it with a sterile instrument A woman who has had more than

3 D&C abortions may have scar tissue on the womb that can make a later pregnancy difficult. Get medical advice.

• Medication Abortion. The woman takes medicines that end the pregnancy and empty the womb . The medicines that are known to be safe and effective for this purpose are mifepristone followed 2 days later by misoprostol . See page 485 to learn how these drugs can be used safely.

In places where abortion is illegal, a woman trying to end a pregnancy may harm herself or turn to someone who does not give abortions safely. Unsafe abortions can cause heavy bleeding, serious infection, infertility, or even death See Chapter 22 to learn how to help a woman after an unsafe abortion

A woman who was sick, injured, or bled heavily after any kind of abortion may have scars in her womb that could cause problems in this pregnancy or birth It is probably safest for her to give birth in or near a hospital or medical center

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