You Are Not Alone
Miscarriage is a lonely experience, yet it is an experience shared by many many women. As many as one in four pregnancies end in miscarriage. Yet, it is very rarely spoken of aloud. Many women who have experienced a miscarriage often find out that a colleague or two have also had the same experience, through discussion after the fact. Unfortunately, it is during the miscarriage and the immediate aftermath, that the support would be more beneficial.
What is a miscarriage? Why do they happen? What happens during the miscarriage? Are there different types? What should you do? What about afterward? Next pregnancy? Is it weird to be grieving for a life you hadn't had the chance to meet? You are in the right place for answers and will be answered below.
I write this as a woman who has had a miscarriage, April 2013. Information in this Hub is not designed or recommended to replace the medical care of a professional.
What is a Miscarriage?
A miscarriage is a pregnancy that has ended before 20 weeks spontaneously as the baby has died. Many of these occur in the first 13 weeks of pregnancy and are known as Early Miscarriages.
An interesting piece of information to note is this: In your first pregnancy, the chance of miscarrying is greater than later pregnancies. Whilst it isn't a comforting thought, it can also let you know you aren't alone.
An early miscarriage can happen by chance, but age does have a small role in increasing the risk:
In women under 30 - 1 in 10 pregnancies may end in miscarriage
In women aged 35-39 - it is up to 2 in 10
In women over 45 the risk is more than half
Why Do They Happen?
There are many reasons for miscarriage, from chromosomal problems to medication effects. Many women, unfortunately, never find out why they miscarried.
It is hypothesized that from half to two-thirds of miscarriages are due to chromosomal problems - too many or not enough. This usually means that the fetus cannot develop normally, and is lost.
Other reasons include the embryo implanting in the wrong place, placental problems, exposure to environmental pollution, alcohol and caffeine as well as drugs and cigarettes increase the risk, and the mother's immune system may play a role.
Risk factors for miscarriage include obesity, smoking during pregnancy, drug use during pregnancy, more than 200mg of caffeine a day, more than two units of alcohol a week - however alcohol is not recommended during pregnancy at all.
The biggest thing to understand, as hard as it may seem, is that when you have a pregnancy that is non-viable (not surviving), there is nothing that you can do to save it. It hurts, and it's heartbreaking, but it's not your fault, nor can you do anything to save them.
During a miscarriage, the fetus, placenta, and blood from the uterus leave the body through the vagina.
This may happen over a longer period of time, or it may happen quickly. The stage you were at of your pregnancy when the miscarriage occurred, and the cause of your miscarriage will affect the types of symptoms you will experience. .
By the time you begin to bleed, your baby may have already died. Sometimes, you may find out that the baby has passed at an ultrasound scan - where the baby is of a size that is weeks smaller than where you thought you were - a 'missed miscarriage'.
Types of Miscarriage?
There are approximately 5 types of miscarriage
Missed Miscarriage - This miscarriage is often discovered at a scan, where there is found to be no heartbeat, and often a smaller than weeks gestation fetus. You may have had no symptoms and be expecting to see a little flutter of a heartbeat in the scan.
Threatening Miscarriage - This is light bleeding, pain similar to period pain, nausea and tender breasts of pregnancy have disappeared, and you may have a sense of 'no longer being pregnant". You may experience these symptoms for days or weeks prior to losing the baby.
HOWEVER - if there is no pain, and only light bleeding - it may be normal spotting around the time your period is due. Your pregnancy may continue as normal.
Inevitable Miscarriage - This is when the cervix opens and the placenta comes away from the uterine wall. Symptoms include heavy bleeding, pain like contractions or bad period pain, faintness and nausea, passing pieces of the placenta that look like clots, feeling shivery or unwell. This type of miscarriage may occur after 16wks and may happen very quickly
Incomplete Miscarriage - This occurs when some of the pregnancy tissue remains in the uterus - commonly between 6-12 weeks. There are several ways this can be dealt with - a dilatation and curettage (also known as a "D+C"), tablets to induce normal delivery, or a 'wait and see'.
Complete Miscarriage - If you have passed the fetus, you will only need monitoring until the cervix closes, which is when the bleeding will slow and stop, the physical pain will disappear.
I'm Miscarrying, What should I do?
You need to look after yourself. Whilst nothing can, unfortunately, be done to save the pregnancy, you may still need medical help.
It is recommended that:
- You take your usual pain relief when needed, and place a hot water bottle on your stomach whilst lying down to ease the discomfort
- If you have no bleeding or only a small amount, see a Medical professional within 24hrs
- If bleeding becomes heavy - eg soaking a pad every 30mins - save everything you pass in a clean container as testing may help find a cause for your miscarriage. If you wish to bury your baby or products of conception, they will be returned to you if you request it.
- Don't use tampons -use a towel or sanitary pads. This helps prevent infection, and you should keep a count of how many you use as the doctor may need to know
- If you are likely to need a D+C, do not eat prior to going to the hospital. Not all women need a D+C and may complete the miscarriage naturally.
- Pack a hospital bag, in case it is needed.
- Have someone drive you to Emergency.
- If you are alone - call for an ambulance - DO NOT drive if you are having a miscarriage
What happens After?
Bleeding normally lasts for about 10 days, and slows as your uterus heals. Again, during this time, do not use tampons - these increase the risk of infection. It is also important to avoid sex and bathing (shower instead).
If your pregnancy was more than 13 weeks along, your breasts may produce milk temporarily. Whilst this feels like a cruel twist of fate - it is normal.
It pays to use contraception when you resume sex after a miscarriage, as conception can occur from 14 days after a miscarriage - your body might be ready to do it again, but you most likely won't be emotionally ready for that yet.
When the bleeding stops - see a medical professional for a check-up.
If at ANY TIME during your miscarriage you have the following symptoms - see your Midwife or Emergency clinic:
- Bleeding for longer than two weeks
- Pain increases
- Temperature increases
This may mean you have an infection or an incomplete miscarriage. This is particularly if you have a natural miscarriage - no D+C, or medication. If you have had a D+C or medication, there will be instructions on the signs you should look for.
How Long Will I Feel Like This?
It is perfectly normal to feel grief after a miscarriage. It is often referred to as both the birth and the death of a baby. As it is with any death, not everyone will react the same way. Not everyone HAS to react the same way.
If your experience differs from that of a friend or colleague - you are still both completely normal. You react in a way that is personal to you. It is the bond with the baby, not the length of the pregnancy, that will determine how intense your grief may be.
Accept the feelings you have regardless of what they are. It is normal to feel a mixture of anger, denial, sadness, acceptance. It is also normal to feel guilty - even though it is NOT YOUR FAULT.
Moods may be all over the place for a while - you may feel fine and suddenly be in tears. You may find yourself crying at the weirdest things - I used to cry all the way to work, and most of the way home the first week or so afterward. Why? We think about things subconsciously when we are pregnant, about what will need to happen in the future, what we need for our child, etcetc....suddenly the 'need' for this thought is not there, and it's a sad reminder. I used to think about the future with the baby in it, on my way to work! Once I was told that was normal, I let myself do it, until...I no longer needed to.
Hormones are also dropping which doesn't help but is temporary.
Using drugs or alcohol is not a recommended way to deal with your feelings. It slows the process down. Better ways are to talk with others, cry, writing down your thoughts.
Anniversaries - particularly of due dates - can stir up old feelings of grief as well. Even if you have conceived again. I was 24wks pregnant with my now 4yr old daughter when the due date of the first pregnancy rolled around - I had a healthy baby growing inside me, and I was upset over the one I had lost? It seemed weird, but its about those things you had planned. I still think of "Peanut" on the 12 Dec. Its also normal not to think of it again - it's all about how you deal with grief.
Make sure you keep your lines of communication open. They may not experience the grief in the same way, but it does not mean they aren't feeling it.
Do not keep your emotions bottled up, it will cause friction, and more stress for you both. Talk with your partner about what you are feeling, and encourage them to do the same.
What about the Next Pregnancy?
The information I have been consulting to write this hub states that:
"Chances that your next pregnancy will be successful drop by only 5%"
However it is recommended to wait for at least one, if not 3 periods, for accurate dating and recovery.
The risk of miscarriage I read somewhere was - 1 in 5 miscarry ONCE, 1 in 25 miscarry TWICE, 1 in 250 miscarry three or more times. If you have RECURRENT miscarriages - please see a medical professional.
Hugs and Good Luck
You are NOT alone. And it WILL get better and easier to deal with. Remember it's okay to cry, and to talk about your feelings.
I'm sorry you've found this hub, because it means you or someone you love has suffered a loss. But I wish to leave you with HUGS, and a sprinkling of sticky baby dust for the next time!
Information gained from: "Understanding Miscarriage" - Miscarriage Support Auckland Inc.
This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2013 Jacqui