Pregnancy Problems

Explaining What A Miscarriage Is (And Isn’t)

The one thing we all fear during early pregnancy is a miscarriage. My first pregnancy ended in a miscarriage at about 8 weeks.

It is a very emotional time for most women as your mood swings from the joy of being pregnant to the sadness of losing it so suddenly. One always questions why it happened and wonder if could you have prevented it. The biggest fear is whether it will happen again.

The best definition I could find that explains miscarriage in plain English is from Wikipedia:

Miscarriage or spontaneous abortion is the spontaneous end of a pregnancy at a stage where the embryo or fetus is incapable of surviving independently. Miscarriage is the most common complication of early pregnancy”.

It is a spontaneous event (we have no control over it happening) that occurs and it is called a miscarriage because it occurs too early in pregnancy for the fetus to survive outside the womb.

Why does a miscarriage occur?

Possible causes of a miscarriage includes fetal chromosomal abnormalities (accounts for 50% to 60% of miscarriages), low progesterone levels, bacterial or viral infections, diseases such as undiagnosed diabetes, autoimmune disorders or thyroid abnormalities, exposure to chemicals, drug or alcohol abuse, uterine abnormalities and the age of the woman at the time of pregnancy (over 40 = higher risk).

As I was in my early 30s, healthy with no bad habits, the only explanation for my miscarriage was a chromosomal abnormality.

A very early miscarriage, often in the 2nd to 4th weeks after conception, is also called a “chemical pregnancy“.  You may have an initial positive pregnancy test but the miscarriage occurs before any evidence of a pregnancy can be seen on ultrasound. It is usually associated with chromosomal abnormalities.

Another cause of a miscarriage in the early stages of pregnancy is a blighted ovum. This is when the fertilized egg develops a placenta but not an embryo. On ultrasound, there would be no heartbeat.

Recurrent miscarriages do need to be investigated for a possible cause that can be treated.

When Do Most Miscarriages Occur?

Most miscarriages occur during the first 12 weeks of pregnancy (in the first trimester) but can occur until the 20th week of pregnancy.

Miscarriage Statistics

MiscarriageIn healthy young women, the chances of having a miscarriage are about 10 to 20%.

Unfortunately the older you are, the higher the risk of a miscarriage occurring (over 35 years of age it increases to 20 to 35% and over 45 it increases to almost 50%). If you have had a previous miscarriage, the risk of another miscarriage increases to about 25%.

However, in the majority of women, miscarriage is usually a one-time occurrence and most go on to have a healthy pregnancy after a miscarriage.

What Are The Early Signs Of A Miscarriage?

The sudden disappearance of morning sickness and breast tenderness can be early signs of a possible miscarriage.

However, the most common signs are heavy bleeding with blood clots and pain or cramps in lower abdomen when the miscarriage is actually happening.

I woke up in the early hours of the day with lower abdominal cramps. These lasted for about an hour or so before I started bleeding and passed blood clots. The cramps subsided after passing the blood clots. I had no warning signs or symptoms. It does catch you off guard when it happens so suddenly.

Working, normal routine exercise and intercourse does NOT cause a miscarriage in an uncomplicated pregnancy.

Are There Different Types Of Miscarriages?

Miscarriages are described as threatened, complete and incomplete.

A Threatened Miscarriage is when you have some vaginal bleeding but a fetal heartbeat can still be heard, that is, your baby is still alive. An ultrasound examination will confirm the presence of the fetus in the womb and that everything is still OK for now. You will have to take it easy for a few days and avoid intercourse for a few weeks. Your health care provider will most likely do more frequent follow up visits until everything has stabilized.

A Complete Miscarriage is when you have passed all the fetal tissue and the uterus is empty on ultrasound examination. Mine was a complete miscarriage and I did not need any treatment.

An Incomplete Miscarriage is when you have passed some of the fetal tissue but there is still some tissue in the uterus on ultrasound examination. This will need to be treated medically, usually with a D&E (dilatation and evacuation).

An Inevitable Miscarriage is when no fetal heartbeat is detected and your cervix has started dilating or your waters have broken. A miscarriage is either about to occur or has started happening, that is, it is inevitable.

Are There Any Symptoms After A Miscarriage?

Physically, some spotting or mild discomfort may occur after a miscarriage. I had slight spotting for a few days.

Symptoms to watch out for are fever, heavy bleeding or ongoing pain. These may indicate infection so it is advisable to contact your health care provider if any of these symptoms occur after a miscarriage.

Emotionally it may take a little longer to recover and if you feel you need support, discuss this with your doctor.

What Are The Chances of Getting Pregnant After A Miscarriage?

The good news is that after one or even two miscarriages the chances of a normal full term pregnancy is still excellent (80% to 90%).

Therefore it is only after three consecutive miscarriages that investigations will normally be done.

Although the physical recovery only takes a few days, the intense feeling of loss can evoke emotions such as sadness, guilt and anger. You need time to work through these emotions, so don’t rush your grieving process.

Talk about your feelings and allow yourself to experience them fully – it is the best medicine!

But if you are having trouble coping, please talk to your doctor or a counselor – you may need that extra support.

What Happens After A Miscarriage?

Your menstrual cycle should resume its normal pattern within 4 to 6 weeks.

Most health care providers recommend you wait for between one to three menstrual cycles before trying to conceive again. However, if you are healthy and emotionally ready, then go for it.

Once you become pregnant again, you may be scared, anxious and reluctant to tell anyone to start with – that is perfectly normal. I did not announce my subsequent pregnancy until after the first ultrasound – even then it was only to family. But you will eventually get to the point where you start getting excited – this time it is happening!

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