Miscarriage is a hard topic to discuss—no matter if you’re trying to get pregnant, are currently pregnant, or are one in four women who have experienced a miscarriage or pregnancy loss.
Even though it’s common, miscarriage isn’t often talked about, which can make those going through it feel uninformed and alone in the process. Here’s what to know about going through a miscarriage—why they happen, the signs of miscarriage, and what to expect if you’ve been told you are miscarrying.
What Is a Miscarriage?
A miscarriage, medically known as a spontaneous abortion, is when a pregnancy ends before the 20-week mark. As many as 10-20 percent of confirmed pregnancies end in pregnancy loss, with the number possibly being higher as many occur before a woman even knows she’s pregnant.
The majority of miscarriages occur because a genetic problem is present in the fetus, often due to an abnormal number of chromosomes present in the embryo. It’s important to note that in almost every case of early pregnancy loss, it is not the woman’s fault. While many women experience feelings of guilt, or attribute their pregnancy loss to something they did wrong or something that happened to them, miscarriage is usually a random event that simply can’t be prevented.
We’ll say it one more time: it is not your fault.
What Are the Signs of Miscarriage?
The most common sign of miscarriage is bleeding. It’s important to note that a small amount of bleeding in early pregnancy is common, but you should contact your provider if you experience any of the following symptoms during your pregnancy:
- Spotting or bleeding, with or without pain
- Noticeable fluid coming out of your vagina, even without pain or bleeding
- Tissue being passed from the vagina
- Severe abdominal pain or cramping
Your provider may want to conduct an ultrasound exam to measure the embryo and check its heartbeat. They might also examine your cervix to understand if it has begun to dilate. Dilation means that you’re more likely miscarry, also known as an inevitable miscarriage. They may also do a blood test to measure your hCG (human chorionic gonadotropin) levels, which is the hormone released during pregnancy. If the levels are low or decreasing, this can also indicate a potential pregnancy loss.
What Are Your Options if You’re Having a Miscarriage?
If your provider determines you have had a complete miscarriage, where all of the pregnancy tissue has already left your uterus, there’s nothing more to do medically. Simply rest and take care of yourself both physically and emotionally.
If you have an incomplete miscarriage or missed miscarriage, where your body has not yet removed your pregnancy, there are a few options on how to move forward.
- Non-surgical: If there are no signs of infection, your provider may recommend waiting to let the miscarriage complete naturally (known as expectant management). This can take up to two weeks, but could also take longer. In some cases, your provider may prescribe a medication that will help your body expel the tissue faster.
- What to expect: Bleeding will occur, with some being heavy. It can feel crampy, painful, and cause diarrhea and nausea. You may also pass tissue, large blood clots, and what’s known as products of conception. These could look like blood clots mixed with grey or white material, or like a fluid-filled sac. Ask a support person to be with you when you feel like you need them. This process can be physically and emotionally draining, and your loved ones will want to help you whenever possible.
- Surgical options: Your provider may recommend a medical intervention in the case of infection, heavy bleeding, or if your body wasn’t able to pass all of the tissue on its own. It’s important to discuss all of your options with your provider and proceed with whatever feels the most comfortable for you.
- Vacuum aspiration: This procedure can be done for very early miscarriages, and removes the contents of the uterus with a small suction device inserted through the cervix. Your provider will use a numbing medication to make you more comfortable, dilate the opening of the cervix and use gentle suction for a few minutes to remove tissue from the uterus. This can typically be done in your provider’s office. Ask a loved one to bring you to and from your appointment, as your provider may give you pain relieving or anti-anxiety medication during the treatment.
- Dilation and curettage (D&C): If your pregnancy was further along or you are bleeding heavily, this may be the best option. A D&C procedure is done in the hospital under anesthesia. During the procedure, your medical team will dilate your cervix, and use an instrument to remove the tissue from the uterus. Most women are discharged from the hospital after recovering for several hours. You’ll probably be given some pain medication to help with initial cramping, and you can expect light cramping, bleeding and passing some blood clots for several days, up to two weeks after the procedure.
What Happens After a Miscarriage?
No matter how your miscarriage happens, the same advice goes for anyone who’s had to experience it. Don’t use any tampons or place anything in the vagina for a minimum of two weeks after your miscarriage or procedure in order to prevent infection. Call your provider right away if you’re experiencing any of the following:
- Heavy bleeding (soaking through more than a pad an hour)
- Fever
- Chills
- Severe pain or cramping
Keep in close touch with your provider about any questions or concerns as you recover from your loss. Your provider may recommend testing your hCG levels to ensure that they are back at zero before trying to get pregnant again whenever you’re ready, mama. It’s important to remember that one miscarriage does not increase your chances for more in the future. Most women go on to carry healthy pregnancies to term after having a miscarriage.
If you’re currently experiencing, or have recently experienced a miscarriage, we are so sorry for your loss. Lean on your loved ones for help, take time to grieve and heal, and connect with others who have experienced similar losses if you feel up to it. Remember that you’re not alone in experiencing pregnancy loss, and sometimes sharing your emotions and story with others who understand can be cathartic.