Miscarriage

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  What Is Miscarriage?

  Miscarriage is the loss of pregnancy before 20 weeks of pregnancy. The embryo or fetus cannot live on its own outside the uterus that early in pregnancy. The medical term for miscarriage is spontaneous abortion.

  Many of us who experience miscarriage are not aware that it is fairly common. For every 10 pregnancies, 1 to 2 end in miscarriage. Miscarriage is most likely to happen early in pregnancy — in fact, 8 out of 10 miscarriages happen in the first three months of pregnancy.

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  What Causes Miscarriage?

  If you've had a miscarriage, you've probably wondered why it happened. Some women even blame themselves for miscarriage. But miscarriage is rarely caused by something the pregnant woman did. Having sex, exercise, a mild fall, and most medications do not cause miscarriage.

  It may be difficult for health care providers to know what caused a particular miscarriage. But we do know some things that make miscarriage more likely in general:

  • The embryo or fetus has a chromosome that causes it to develop abnormally. This is not usually a sign of a condition that could cause problems in future pregnancies. It usually happens by chance when the fertilized egg divides and grows. This problem causes at least half of miscarriages.
  • A woman's risk of miscarriage increases as she ages.
  • Severe chronic illness — such as poorly controlled diabetes, rheumatoid arthritis, or lupus — can cause miscarriage.
  • Severe trauma and very serious infections also can cause miscarriage.
  • Abnormalities in the uterus, like scar tissue or uterine fibroids, can cause late miscarriages — after three months.
  • Smoking, the use of alcohol or cocaine, and heavy caffeine use have all been tied to miscarriage.
  • Women who are underweight or overweight have a greater risk of miscarriage than other women.
  • Women who have had two or more miscarriages in a row are at a greater risk of having future miscarriages.

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  What Are the Signs of Miscarriage?

  Signs of a possible miscarriage include

  • vaginal bleeding or spotting
  • severe abdominal pain
  • severe cramping
  • dull, lower-back ache, pressure, or pain
  • a change in vaginal discharge

  These signs may be caused by a condition that is less serious than miscarriage. But you should have a health care provider check you to be safe.

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  What Should I Do if I Think I Am Having a Miscarriage?

  If you think you are having or may have had a miscarriage, contact your health care provider as soon as possible. Your health care provider may do a pelvic exam or other tests.

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  What Are the Different Kinds of Miscarriage?

  There are five kinds:

  Threatened miscarriage — You bleed, with or without mild cramps, but your cervix is closed. Half of threatened miscarriages end in pregnancy loss. In the other half, the bleeding stops, and the pregnancy goes on normally.

  Inevitable miscarriage — You have increasing bleeding, and the cervix begins to open. In this case, there is no chance the pregnancy can continue.

  Incomplete abortion — Some pregnancy tissue comes out of the uterus. But some stays inside. Sometimes treatment is needed to remove the remaining tissue.

  Complete Miscarriage — All the pregnancy tissue comes out of the uterus. Usually, you will not need any treatment.

  Missed Abortion — The pregnancy has ended, but the tissue remains in the uterus. Usually the tissue eventually comes out of the uterus on its own, but treatment is sometimes needed.

  When treatment is needed to complete a miscarriage, the treatment may be medication or an aspiration procedure. During aspiration, a health care provider inserts a thin plastic tube in the uterus to remove the pregnancy tissue with gentle suction.

  Ectopic Pregnancy Ectopic pregnancy is another kind of pregnancy loss. An ectopic or tubal pregnancy occurs when a fertilized egg implants outside the uterus, usually in a fallopian tube. Rarely, it can occur in an ovary or in the abdominal cavity.

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  What Can I Expect During Miscarriage?

  Not all miscarriages cause physical pain. But most women have some cramping. For some women, the cramping can be quite strong. For others, it is gentler.

  Women also have bleeding and may pass large blood clots. Many women are surprised and scared by the heavy bleeding that can occur during a miscarriage.

  The bleeding and cramping can last for a short time, or may last for several hours. Your health care provider can give you medicine and advice about how to manage the pain and cramps during your miscarriage as well as guidance about what is and is not normal to expect. It is important to keep your health care provider aware of what is going on and how you are doing.

  Whether it's painful or not or happens quickly or not, miscarriage is a very upsetting experience.

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  How Can I Expect to Feel After Having a Miscarriage?

  There is no such thing as a "correct" way to feel after having a miscarriage. Miscarriage may cause you to experience a wide range of feelings.

  You may feel a mix of emotions that may include disappointment, despair, shock, guilt, grief, and relief. All are normal. Whatever your state of mind, remember

  • Give yourself permission to grieve this loss. Grief is a normal response to miscarriage, and it should not be made light of or denied.
  • If you have a partner, understand that he or she may need to grieve the loss, too. Your partner may not express his or her emotions the same way you do. But trying to communicate your feelings and support to each other may help each of you cope.

  Give yourself time to heal from the loss of your pregnancy. The amount of time it will take is different for everyone. It is up to you to decide if you want to ask a health care provider for advice about getting pregnant in the future. You may want to know when it would be best to try again. Or you may want to know how to prevent a pregnancy until you are ready for one.

  Staff at your local Planned Parenthood health center, many other clinics, and private health care providers can give you advice and help you plan the timing of your next pregnancy.

  You should feel better as time passes. If you find it difficult to get back to your normal activities after a miscarriage, talk with your health care provider. Your provider may know of additional ways to support you and help you feel better.

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  What if I Have Had More than One Miscarriage?

  If you have had two or more miscarriages in a row, your health care provider may suggest you have some tests done. These tests will see if you have any hormonal imbalances, genetic disorders, or other problems. The tests may reveal a problem that can be treated in order to help you have a healthy pregnancy in the future.