Any woman who is pregnant or trying to conceive benefits from learning some facts about this sad but real possibility. Do you know how to recognize a miscarriage, and what you can expect afterwards?
All spontaneous pregnancy loss before the twentieth week is termed miscarriage. In medical terms, it is also referred to as "spontaneous abortion" though that sounds unpleasant. There are three distinct types of miscarriage:
- A complete miscarriage commences on its own, and all the pregnancy-related tissues are expelled from the uterus fully.
- An missed miscarriage refers to a fetal death without the start of a miscarriage. The fetus remains in the uterus, and women may require medication or D&C to complete the miscarriage.
- In a partial miscarriage, some tissues are retained while others are expelled. This requires the same treatment as a missed miscarriage.
It is probably safe to say that every pregnant woman is aware of miscarriage symptoms: bleeding, cramping and pain. Vaginal bleeding during pregnancy can have causes other than miscarriage (including ectopic pregnancy, which can be very dangerous indeed), so all pregnant women who encounter bleeding should seek medical help. If your bleeding is heavy, head to the ER if you don't have other options.
A missed miscarriage is harder to detect, and is usually diagnosed quite coincidentally during a routine ultrasound scan. Some women notice a sudden halt to their pregnancy symptoms, and this can also indicate that the baby has passed away in some cases. Report any worrying symptoms to your doctor.
An active miscarriage will usually involve several hours of heavy, red bleeding with clots, tissues, and eventually the fetus that will still be in its amniotic sac. If your doctor sent you home to complete an early miscarriage, or if you just started bleeding and are waiting to see your doctor, you will want to avoid sitting on the toilet so you don't lose the products of conception.
Taking what you find to your doctor can be useful, especially after multiple miscarriages for testing. Alternatively, you can bury the fetus.
After your miscarriage
After a naturally completed miscarriage or a dilation and curretage (D&C), it is normal and expected for a woman to bleed two to three weeks. So do not fret if your post-miscarriage bleeding lasts a lot longer than a menstrual period. The bleeding cleans out the uterus and prepares your body for menstrual cycles again.
Do watch out for signs of infection while you are bleeding. A fever, nausea and vomiting, a tender feeling in the abdomen, confusion, bad-smelling blood or mucus, and prolonged bleeding are sure signs of a post-miscarriage infection. This can be due to retained tissues within the uterus, but not always. It is always important to have a medical checkup including an ultrasound after a miscarriage, to ensure that there are no tissues left in your uterus.
Your doctor will tell you when to make this appointment, but it will usually be a few weeks after the initial miscarriage or D&C after a missed miscarriage. While you are bleeding, do not have sex or insert objects (including tampons) into your vagina, and stick to showers rather than having a bath. Give yourself some time to rest in bed, with a good book or a cheesy movie, and allow your partner or a friend to look after you. Women who just had a miscarriage will be exhausted, both physically and emotionally.
This is normal. Don't try to be active before you feel up to it.
Trying again after miscarriage
After your bleeding has completely stopped and you have seen a doctor to make sure your uterus is empty, you should wait until you get another menstrual period. After that, you can try to conceive again as soon as you and your partner both feel ready. Research shows that women who get pregnant again within six months of a miscarriage have a bigger chance of a healthy pregnancy than others, so don't think you have to wait too long.