Miscarriage

What is miscarriage?

Miscarriage is when you lose your pregnancy within the first five months or twenty weeks.

Miscarriage is actually very common. About fifteen percent of positive pregnancies end in miscarriage, and another fifteen percent of pregnancies end in a heavy or late period – before they’ve even been discovered. The medical term for miscarriage is “spontaneous abortion” – as opposed to an “elective abortion” or a medically necessary “therapeutic abortion.”

I’m pregnant and having bleeding. How do I know if it’s a miscarriage?

Bleeding in the first trimester is so common it affects half of all pregnancies.

But not all bleeding is the sign of an impending miscarriage.

Light spotting in the first trimester is pretty common. What’s known as “implantation bleeding” happens when the fertilized egg implants itself into the uterus lining, stimulating the placenta to form. Other bleeding can happen randomly, such as spotting after intercourse, or blood on the bathroom tissue after wiping yourself. This kind of spotting light cramps and is normal in the first stages of pregnancy.

But if you’re having bright red bleeding that doesn’t stop and soaks a pad in an hour, you may be having a miscarriage. In this case, you should call your doctor. Miscarriage generally has intense cramping, similar to severe menstrual cramps or even a “mini-labor.”

“Give yourself lots of extra time after a miscarriage before trying to get pregnant again.”

With a spontaneous miscarriage, the cramping and bleeding tend to build over several hours, at which point you may pass pregnancy tissue: a large blood clot mixed with white, grey, or yellow material. You may even see what looks like an embryo. Once you pass the pregnancy tissue, the bleeding usually goes back down to a normal menstrual level. A spontaneous miscarriage is usually over within 12 hours, but the post-miscarriage bleeding can last up to a week.

Sometimes a miscarriage starts but doesn’t finish. This is called a “missed abortion or miscarriage” or an “incomplete miscarriage or abortion.”

What Causes a Miscarriage?

If you’ve had a miscarriage, you’re probably asking, “Why did this happen? Did I do something wrong? Or, did I forget to do something that could have prevented it?”

The fact is, most miscarriages are completely out of our control. Over ninety percent of miscarriages are caused by some error in development — that we could not have prevented. Most development errors happen with the embryo’s chromosomes or genes. Either the embryo got too many chromosomes, or not enough, or there was a problem with the chromosomes’ structure. Miscarriage can also be caused by development problems with the spine, brain, heart or other major organ systems.

The list of other causes of miscarriage is too extensive to address here, so I suggest you talk to your doctor regarding your specific situation.

Medical Intervention for Miscarriage: When is it necessary?

If an embryo dies but doesn’t pass out of your body, you may need medical help. If it fails to pass, retained pregnancy tissue can cause excess bleeding and infection. There are three options:

OPTION 1: Wait

Give yourself some extra time. It can take two weeks or more for a failed pregnancy to pass spontaneously.

OPTION 2: Medication

A prescription drug can bring on the “mini-labor” stage of miscarriage. “Cytotec” or “Misoprostol” is a medication that softens the cervix and causes the uterus to contract, which expels retained pregnancy tissue. Your medically-assisted miscarriage will start within twenty-four hours of taking the medication, and it lasts the typical six to twelve hours of a spontaneous miscarriage. If the medicine doesn’t work, you will need a suction D&C.

OPTION 3: Suction D&C

A third option is a suction D&C: an out-patient procedure done under anesthetic. Suction, similar to a medical vacuum, removes all the pregnancy tissue from the uterus. The main advantage of a suction D&C is it gets the process completed quickly and efficiently.

Choose the option that works best for your situation and circumstances.

Regardless of how the miscarriage is completed, it’s best for you to wait 3-4 cycles before attempting conception again. If you get pregnant too soon after a miscarriage, the risk of recurrent miscarriage is slightly higher.

To summarize, we saw that miscarriage is common, light spotting is normal during early pregnancy, but heavy bleeding with cramps is probably a miscarriage. If your spontaneous miscarriage didn’t complete, you can wait, use medication, or get a D&C.

How Do I Cope With Miscarriage?

Miscarriage can be devastating, whether you planned the pregnancy or not. If you strongly wanted this pregnancy, you probably have all kinds of hopes and dreams pinned to its success. Even if you didn’t want to be pregnant, you may still feel grief. Miscarriage causes mixed feelings with relief, grief, and sadness all competing in your heart and disturbing your equilibrium.

After a miscarriage, the physical symptoms of pregnancy go away quickly. Breast tenderness, nausea, cramping and bleeding all stop or subside. But they may be replaced by other sensations. You may feel physical symptoms of loss and sadness, like chest pain, pain in the arms or “empty arms syndrome”, or a feeling of emptiness in the stomach or pelvis. You may have hot flashes or mood swings as your hormones drop.

It is incredibly important to let yourself grieve, without judgment. Decide whether you want to share your loss openly with family and friends, or keep it private. Grieving with friends and family is often more comforting than grieving alone. Some people honor the pregnancy loss with a formal ceremony or memorial.

Fathers may experience pregnancy loss just as acutely as mothers, but in different ways. While they lack the physical symptoms, the loss of hopes and dreams can be just as acute as for mothers.

Don’t pressure yourself on a time frame for grieving. You may process the loss in a matter of weeks, or you may take months. The more advanced your pregnancy was before miscarriage, the longer the grieving period. If your grief seems to be taking longer than expected, you may be going through post-miscarriage depression. I recommend you talk to your doctor or midwife.

After a miscarriage, try not to get pregnant for at least two to three menstrual cycles.

To summarize, we saw how miscarriage can be caused by genetic and developmental problems, how important it is to end unhealthy habits for a healthy pregnancy, why you need to let yourself grieve at the pace and in the ways that work for you, and how long to wait before trying to get pregnant again.

Certain Habits Increase The Risk of Miscarriage

To reduce the likelihood of miscarriage, we need to change certain habits.

Tobacco and Marijuana

Smoking increases the risk of miscarriage by twenty percent for each half pack inhaled a day. The toxins in cigarette smoke also cause the placental vessels to constrict, resulting in poor fetal growth throughout pregnancy. With the legalization of marijuana, its use during pregnancy is on the rise. More evidence about the effects of marijuana use and pregnancy is emerging, and the evidence is concerning: marijuana use during pregnancy appears to double the risk of miscarriage and fetal death. For more on this, see my post: Marijuana and Pregnancy.

Alcohol

Did you know that two drinks a week doubles the risk of miscarriage? And that daily drinking in the first trimester triples the risk? Fetal alcohol syndrome, a If you want a healthy baby, don’t drink when you’re pregnant.

Meth and Narcotics

Cocaine, methamphetamines, and other street drugs are known to cause miscarriage. Make sure your pregnancy is drug-free!

Be Healthy BEFORE Pregancy

Being overweight or having diabetes, high blood pressure and other illnesses all increase the risk of miscarriage. So shape up to give your baby the best chance!

You may be wondering if there’s something you did to cause the miscarriage. If you’ve taken good care of yourself, it’s unlikely you caused the miscarriage by anything you did or didn’t do. Miscarriage is not caused by having sex, working, exercising, or lifting weight. So please don’t blame yourself!

Learn more about your pregnancy with my book, DIY Baby! Your Essential Pregnancy Handbook