Miscarriage

A miscarriage can be a very testing time in the life of a woman. All the excitement and anticipation of pregnancy, despite its own trials and difficulties, can be dashed with the onset of a miscarriage and replaced with feelings of fear, sorrow, and even anger. One can feel out of control and tearful, unsure of what to do next. It is important, as with every other aspect of life, that we are equipped with the knowledge that will help us through such a test. The following are some frequently asked questions which you may find useful, insha Allah.

What is a miscarriage?

A miscarriage is the death of a baby before 24 weeks gestation. If a baby dies after 24 weeks, it would be termed a stillbirth. There are different ways in which a miscarriage may happen. Sometimes the womb completely empties itself, but at times, some tissue is left behind which needs to be removed by doctors. Sometimes, the baby dies in the uterus but is not miscarried. In this case, you may be offered a minor operation to evacuate the womb or offered pills to start the miscarriage. Alternatively, you may wait to allow the miscarriage to happen naturally.

How do I know I’m having a miscarriage?

Bleeding

The most obvious sign of miscarriage is vaginal bleeding. However, it is important to state that not all bleeding during pregnancy is due to miscarriage, and many pregnant women who have bleeding go on to deliver healthy full-term babies. In saying this, if you are not sure, then get it checked out. If you are bleeding profusely, soaking more than one sanitary towel per hour, you should seek urgent medical advice.

Other discharge

At the onset of miscarriage, women may also have increased vaginal discharge or loss of tissue.

Cramps/aches

Some women also experience a dull ache in their lower back and/or cramping in the abdomen, which will vary in degree from woman to woman.

If you have any of these symptoms, it is important to speak to your midwife or the Early Pregnancy Unit at your hospital.

What caused my miscarriage?

It is natural to question and to wonder what caused a miscarriage, which  affects approximately 20% of pregnancies. Miscarriages happen for many reasons, but often the cause is unidentifiable. Some of these include genetic, uterine or hormonal abnormalities, reproductive tract infections, and tissue rejection. For more information on the possible causes of miscarriages, please visit the NHS website.

However, knowing the cause will not necessarily ease the pain and grief that is being felt. We can assure ourselves by remembering that Allah is the All-Knowing and knows what is best for us. He is the forbearing, merciful Lord of the universe, who loves us and loves for us to turn to Him. Allah gives us tests in life, granting us the opportunity to become His beloved servants. Allah will never forsake His righteous servant when he or she turns to Him.

Is miscarriage bleeding nifaas?

Nifaas is the impure blood which flows from a woman’s body following the birth of a child. While in the state of nifaas, a woman is not permitted to pray (salah), fast (sawm), or circumambulate the Ka’bah (tawaaf). She is also not permitted to have sexual intercourse during this period. The question arises as to whether the bleeding/loss of tissue during a miscarriage is considered to be nifaas, thus rendering the above mentioned actions forbidden.

There are different opinions on when a foetus is considered to be a child, resulting in the bleeding of a miscarriage being classed as nifaas. The following is one opinion taken from islamqa.info:

If a woman miscarries, the bleeding that follows is not regarded as nifaas (post partum bleeding) unless the miscarried foetus had developed human features such as a head, hand, foot and so on.

Human features do not appear in the foetus before eighty days of pregnancy, because the Prophet (peace and blessings of Allah be upon him) said: The creation of any one of you is put together in his mother’s womb for forty days, then he becomes a ‘alaqah (a piece of thick coagulated blood) for a similar period, then he becomes like a chewed piece of flesh for a similar period, then Allah sends an angel who is enjoined to write down four things, and it is said to him: Write down his deeds, his provision, his lifespan and whether he is doomed for Hell or destined for Paradise. Then the soul is breathed into him.” Narrated by al-Bukhaari, 3208.

This hadith indicates that a human being goes through a number of stages during pregnancy. For forty days he is a nutfah (mixed drops of male and female sexual discharge, for the next forty days he is a ‘alaqah (a piece of thick coagulated blood), then for forty days he is a mudghah (a lump of chewed flesh), then the soul is breathed into him after one hundred and twenty days have passed.

Human features begin to appear at the mudghah stage, not before that, because Allah says (interpretation of the meaning):

“O mankind! If you are in doubt about the Resurrection, then verily, We have created you (i.e. Adam) from dust, then from a Nutfah (mixed drops of male and female sexual discharge, i.e. the offspring of Adam), then from a clot (a piece of thick coagulated blood) then from a little lump of flesh — some formed and some unformed (as in the case of miscarriage) — that We may make (it) clear to you (i.e. to show you Our Power and Ability to do what We will)” [al-Hajj 22:5]

From this verse it is known that the mudghah may or may not have human features.

Ibn Qudaamah (may Allah have mercy on him) said: If a woman sees blood after passing something in which there were human features, then it is nifaas. This was stated by Imam Ahmad. But if she see that [bleeding] after passing a nutfah or ‘alaqah, then it is not nifaas. End quote from al-Mughni, 1/211.

Shaykh ‘Abd al-‘Azeez ibn Baaz (may Allah have mercy on him) said: If a woman miscarries something in which human features are visible, such as a head, hand, foot and so on, then she is in nifaas, and comes under the rulings on nifaas, so she should not pray or fast and it is not permissible for her husband to have intercourse with her until she becomes pure or until forty days have passed.

But if there are no discernible human features in that which is passed by the woman, and it is like a piece of meat with no features, or it is blood, then that comes under the rulings on istihaadah (non-menstrual vaginal bleeding) and not the rulings on menstruation, and she has to pray and fast in Ramadan, and she is permissible to her husband, because she comes under the rulings on istihaadah according to the scholars. End quote from Fataawa Islamiyyah, 1/243.

Shaykh Ibn ‘Uthaymeen said:

The scholars said: If something is passed in which human features appear, then the blood which is passed after it emerges is regarded as nifaas, during which the woman should not pray or fast and her husband should avoid intimate relations with her until she becomes pure. But if what is passed is not formed, then the bleeding is not regarded as nifaas, rather it is irregular bleeding which does not prevent the woman from praying or fasting or anything else.

The scholars said: The minimum time in which human features may appear is 81 days.

And Allah knows best. Taken from islamqa.info

In summary of this opinion, if the miscarriage happens before 81 days of gestation, then the bleeding would not be considered nifaas, and you would be required to pray and fast as usual, and sexual intercourse is permitted. Please note that this is 81 days (11 weeks and 4 days) after conception, not the date from which your pregnancy has been dated (which is roughly 2 weeks before conception). Therefore, you would be in a state of nifaas if the miscarriage was happening after 13 weeks and 3 days.

What other Islamic rites do we have to perform for our child?

In addition to the washing, shrouding and janazah, if the baby died after 120 days, s/he should also be given a name, and an aqeeqah should be performed on their behalf. If the baby cried after birth, then s/he should have all above mentioned rites performed, and the child may also take possession of wealth bequeathed or inherited, inherit, and be inherited from. Allah knows best.

My wife is heavily grieving the death of our child. What can I do or say to comfort her?

It is important to let your wife grieve in her own way, but you can help by gently consoling and reminding her that your child is in Jannah waiting for you. Try to avoid rushing her into ‘getting back to normality’ – it will happen in its own time. Remind her that Allah is close to her, ready for her supplications, ever-comforting in times of distress. Sit and make dhikr and du’a together. Hold her, wipe away her tears, and make her feel that you are always by her side.

How soon after a miscarriage can I have intercourse?

Following a miscarriage, you may bleed for a few weeks. As a Muslim, you must firstly establish whether this bleeding is nifaas (see above), in which case sexual intercourse would not be permitted. If it is not nifaas, then you are permitted to have intercourse. However, it is best to wait until you have finished bleeding, to reduce the risk of infection. Doctors may advise you to wait until you have had your first period.

If you have lost your baby, it is common to feel strange about the intimacy of your sexual relationship. Be sure to communicate these feelings with your husband, allowing him to try and understand how you are feeling. If you are uncomfortable with resuming sexual intimacy straight away, try and find other ways of being close to each other.

I had a miscarriage. Is it likely to happen again?

After someone has had a miscarriage, it is natural to feel anxious about future pregnancies ending in miscarriage too. However, the vast majority of women who have a miscarriage go on to have a successful pregnancy the next time round. If you are worried, it is best to talk to someone you trust about how you are feeling. Most importantly, make du’a to Allah, and put your complete trust in Him.

How soon can we try again?

Although doctors suggest that you wait until your cycle returns to normal, there is no medical need to wait before trying for another pregnancy if you both feel that you are ready. In fact, some studies have shown that women who conceive within six months of a miscarriage stand better chances of a healthy, successful pregnancy than those who chose to wait longer than this. In saying this, there is no rush. If you need time to grieve the death of your child, allow yourself this time. The next pregnancy will not replace the last one.

Does miscarriage mean I will find it hard to conceive again?

Miscarriage does not make it harder to conceive again.

May Allah bless you with children who are the coolness of your eyes. Ameen.