At least 10 percent of all pregnancies will end in miscarriage, usually in the first 13 weeks of pregnancy. The experience can be different for everyone, but understanding the process of miscarriage and what to expect may help you cope physically and emotionally.
How is a miscarriage diagnosed?
If you are having any signs of miscarriage, like bleeding during pregnancy, or severe pain, you should see your doctor or midwife. They can perform an exam and order tests based on your symptoms, how far along you are in pregnancy, and other factors.
You will most likely have a vaginal exam. Your practitioner will check the amount of bleeding as well as the condition of your cervix. If you are bleeding and your cervix is still closed, you may be having what is called a threatened miscarriage, which means there is a chance you may not lose the pregnancy.
Your practitioner may also order an ultrasound, depending on how far along you are in your pregnancy. An ultrasound will be used to look at the source of the bleeding, the contents of the uterus, and the condition of your other organs, like your ovaries and fallopian tubes. Sometimes, bleeding is caused by other problems, like a subchorionic hemorrhage, or bleeding under the placenta, that may or may not lead to pregnancy loss.
You may also have a blood test done to measure the amount of human chorionic gonadotropin (hCG) in your blood. This test is usually repeated in two days because the amount of hCG in a normal, healthy pregnancy essentially doubles every two days in early pregnancy. If the hCG is increasing the expected amount, it is a good indicator of the viability of your pregnancy, even very early on.
Is there treatment for a miscarriage?
In most cases, there are two main choices when it comes to miscarriage. One is to wait it out and let the process progress naturally as your body passes the pregnancy tissue. The other is to intervene to speed up the process. This can be done with medication or via a surgical procedure called dilation and curettage (D&C). If there is heavy bleeding, certain medical conditions, or infection, a D&C may be recommended over other options.
What is it like to let the miscarriage progress on its own?
Waiting for the process to finish naturally can take a couple of weeks. Typically, the process of bleeding and cramping will slowly continue to build until you reach a point where you spend a few hours with fairly painful and severe contractions. These contractions are a sign that your cervix is dilating and your body is expelling the pregnancy tissue from the uterus.
You can expect the bleeding to be heavier than your normal monthly period. Some people find a miscarriage to be more painful than labor; others, however, may find that the physical pain is not that bad. You should talk to your doctor or midwife about options for relieving pain during a miscarriage. Most people will return to their normal daily activities as they continue to have some minor symptoms like bleeding and slight pain.
What is it like to take medication to speed up the process of miscarriage?
Taking medication to speed up the process of miscarriage usually doesn’t change the experience significantly, with the exception that the medication decreases the amount of time it takes for all of the tissue to be expelled.
What is it like to have a dilation and curettage (D&C) procedure?
A D&C is usually done in a surgical center. You will either be given general anesthesia or a regional anesthesia. The procedure itself is usually quick — around 15 minutes. You will spend more time in pre-op and post-op than in the actual procedure. You can expect to feel physically better after the procedure, especially if you were experiencing painful cramping and a large amount of bleeding. You may still experience some cramping and spotting to light bleeding after the surgery.
What can I expect after a miscarriage?
Typically, the healing period lasts up to a week and may include cramping and bleeding, depending on the type of treatment you received for the miscarriage. Your practitioner will give you a list of warning signs to watch for, like bleeding through more than two pads per hour or fever. You will usually see your normal menstrual cycle return within a month to six weeks. If you want to try to conceive again, there is generally no waiting period.
What should I keep in mind about my mental health?
While much of the miscarriage discussion is centered on the physical aspects, it is important to note the emotional toll miscarriage can take on you as well. Not everyone experiences the same emotions during and after a miscarriage. Sometimes there is no emotional response; other times, the loss can lead to depression or other mental health issues.
Some say your response is related to how far along you were in your pregnancy or how long you spent trying to conceive. However, this is not always true. Everyone will have their own reaction, and it’s important to remember that your response is personal and normal. If you are struggling in the aftermath of your miscarriage, it is a good idea to consider counseling or support groups so that you can get the help you need to process this often difficult event.
How can my partner help me?
A partner can be an important person during pregnancy loss. Many partners say they feel helpless during the physical process — they can’t really help with the pain or bleeding. The emotional comfort a partner can provide, on the other hand, can be extremely helpful, whether that be holding your hand, rubbing your back, or just being with you.
If you are the partner in this scenario, ask what you can do to be helpful. But remember: The miscarriage can also have a significant emotional impact on you, even if you aren’t experiencing the physical symptoms. In addition to helping to care for your partner, it’s important to take steps for your own mental health needs as well.
Early Pregnancy Loss. FAQ090. American College of Obstetricians and Gynecologists (ACOG). August 2015.
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Robin Elise Weiss, Ph.D., LCCE, CLC, AdvCD(DONA) is a childbirth educator, doula, founder of Childbirth.org, and the award-winning pregnancy and parenting author of “The Complete Illustrated Guide to Pregnancy” and more than 10 other books. Between her nine children, teaching childbirth classes, and attending births for more than two decades, she has built up an impressive and practical knowledge base. You can follow Robin on Twitter @RobinPregnancy, Instagram, and Facebook.