Is It a Miscarriage? Signs and Risk Factors
Pregnancy is often a time of great joy and anticipation, but if you are suddenly experiencing worrisome symptoms, you may fear that you are miscarrying. How do you know for sure?
According to the American College of Obstetricians and Gynecologists (ACOG), about 10 percent of women will experience a pregnancy loss in the first trimester. This trimester is the most common time to suffer a pregnancy loss, though a few women will also experience a second-trimester loss. After 20 weeks, a pregnancy loss is generally referred to as a stillbirth and not a miscarriage.
Signs of miscarriage
If you experience any of the following, you should call your doctor or midwife immediately:
Bleeding from the vagina, even if the blood or discharge is tinged pink or brown. This may indicate the timing of the bleeding.
Cramps that are painful or are rhythmic, like contractions.
These are the most common signs of miscarriage and can occur together or separately. However, it is important to note that simply having these signs does not mean that you will absolutely lose the pregnancy. A small amount of bleeding and cramping early on in pregnancy is fairly common; it may stop on its own and cause no further problems.
Seeing your doctor is the only way to determine whether you are really at risk of miscarriage.
Treatments for miscarriage
If your doctor finds your cervix has begun to open, there is not much that can be done to prevent miscarriage. Bedrest was once prescribed but has been found to be ineffective. However, your practitioner may suggest it if you are feeling like you need to take some sort of action. But it’s important to keep in mind that your actions are unlikely to be the cause of a miscarriage — many early miscarriages are related to chromosomal abnormalities.
Giving your body time may be the best treatment for a miscarriage. It can often take up to two weeks to complete the process. Sometimes medication can be used to shorten this time period. If the body is not working toward completion or if there is a complicating factor, like infection, your practitioner may suggest a dilation and curettage (D&C) procedure to remove the pregnancy tissue from the uterus.
Types of miscarriage
While a miscarriage is the most common form of pregnancy loss, it means different things to different people. Some losses happen because the fertilized egg didn’t continue to develop, and yet it takes the body a few weeks to catch on to the fact that there isn’t a baby. This is known as an anembryonic pregnancy, meaning there is no embryo.
Sometimes the baby is growing and seems to be developing well, but the heart never begins to beat. You may never know this has happened, just that you start to bleed or cramp and lose the pregnancy.
Another less common scenario is to have the baby’s heart start to beat and then stops. This is harder to detect because you would have to see the heart beating via ultrasound fairly early and then see the absence of the heartbeat at a second ultrasound. Most women do not have this many ultrasounds. Once the heart starts beating, the risk of miscarriage decreases because this is a positive sign of a healthy pregnancy.
Risk factors for miscarriage
It is extremely unlikely that something the woman did caused the miscarriage. Most miscarriages occur because there is a chromosomal abnormality, which means that there was damaged or missing DNA when conception occurred. There is nothing that can be done to prevent this from happening. However, there are certain factors that put a person in a higher risk category for miscarriage than others:
Age: Women who are over 30 have a higher rate of miscarriage. Over the age of 40, the rate of miscarriage may be as high as 30 percent of pregnancies.
Maternal weight: Being underweight or obese can also add risk to a pregnancy.
Alcohol: Consuming alcohol is another modifiable risk factor.
There may also be slightly increased risks of miscarriage for women with jobs that require them to work at night or women who lift more than about 44 pounds.
Good preconceptional health care can be of great help in reducing some of these modifiable risks. It can also be helpful to know that even if you do experience an early pregnancy loss, most women go on to conceive a healthy baby and carry to term.
Early Pregnancy Loss. FAQ090 American College of Obstetricians and Gynecologists. August 2015.
Risk factors for miscarriage from a prevention perspective: a nationwide follow-up study. Feodor Nilsson S, Andersen PK, Strandberg-Larsen K, Nybo Andersen AM. BJOG. 2014 Oct;121(11):1375-84. doi: 10.1111/1471-0528.12694. Epub 2014 Feb 19.