Miscarriage is the sudden loss of a pregnancy before the 20th week. It is more common than many women realize, with up to 50% of fertilized eggs failing to implant in the uterus and develop. These very early pregnancy losses usually occur before a woman realizes that she is pregnant. The miscarriage rate among women who do know that they are pregnant is around 15%.
Most women make full physical recoveries one to two months after miscarriage and experience successful pregnancies in the future. Emotional recovery may take longer; depression and anxiety are common after pregnancy loss. Women can benefit from support from a mental wellness practitioner in addition to care from their women’s health provider.
What Services Are Offered Under Miscarriage Care?
When a miscarriage occurs, it is important to seek medical help to make sure that no tissue remains in the uterus, because it can cause a serious infection. Your Advantia provider can offer you several treatment options. In many cases, there is no “right” choice, only the one that suits you best.
Some women choose expectant management, where the body is allowed to move at its own pace to expel the pregnancy. While this is the most natural option, it is also less predictable and may not be sufficient for removing all the tissue from the body.
Other women may choose to have a procedure called dilation and curettage (D&C) to remove the tissue from the womb. This option offers more certainty, but is a surgical procedure that requires sedation or anesthesia. D&C and medication options are available if expectant management is unsuccessful. Following the miscarriage care instructions of your provider can lower your risk of infection.
If you have a Rh-negative blood type, you may also need a dose of the prescription medication RHOGAM after a miscarriage to help prevent complications during future pregnancies.
Advantia women’s health providers can collaborate with mental wellness specialists to support your recovery, both physically and emotionally.
Causes, Symptoms, Risks & Treatment
There are several causes of pregnancy loss, and most are out of your control. Chromosomal abnormalities are the most common factor. There are some situations in which children can survive – and even flourish – with chromosomal abnormalities, such as in Down Syndrome. For the most part, chromosomal abnormalities are not compatible with life and the body must end the pregnancy when this occurs.
Abnormal development of the placenta, poorly managed or undiagnosed chronic illness, a recent infection or an uncommon shape to the uterus can also cause miscarriage. The risk of miscarriage increases with age, a history of previous miscarriages or chronic health conditions like diabetes and autoimmune disorders, substance use or exposure to environmental contaminants. A miscarriage is not caused by stress, exercise or sex. A difficult aspect of miscarriage is that most women will never learn the exact cause of their own pregnancy loss.
Many miscarriages occur before women even learn of their pregnancy; the embryo and pregnancy tissue passes with some bleeding at the time of the expected period. For the others, development usually ceases at 5-6 weeks after the last menstrual period but it may take several more weeks before the mother’s body is able to slow down the surge of pregnancy hormones.
In these cases, women have typically gotten a positive pregnancy test, perhaps experienced some symptoms of pregnancy and are looking forward to hearing a heartbeat by the time the miscarriage is detected. If a heartbeat is detected, the likelihood of miscarriage drops significantly with only a very small percentage of pregnancy losses occurring after the first trimester. A loss after 20 weeks is, officially, considered a stillbirth or preterm delivery.
Back or abdominal pain, vaginal bleeding, passing cramps or contractions are all signs of a miscarriage. Once a miscarriage starts, there is nothing you or your healthcare provider can do to stop it from happening.
After you have received medical support for a miscarriage, if you experience heavy bleeding, a fever or other signs of being unwell, you should follow up with a provider right away. Those symptoms may indicate an infection or other complications.
Dealing with Pregnancy Loss
A miscarriage is one of the most devastating experiences that anyone can go through. The loss of a child is unimaginable and the emotional toll that it takes on the parents can be a heavy one. Even for women or couples struggling with an unintended or unwanted pregnancy, miscarriage can still hurt.
If you’ve suffered a pregnancy loss, please know that emotions like sorrow, fear and guilt are common, and everyone deals with grief differently. Some people find that time alone heals the pain and others find that discussing their pain with a therapist, loved ones, a clergy member or in a support group with others is most helpful.
Outlook & Prognosis
Miscarriage is usually a chance event, not a sign of an ongoing problem. If you have had one miscarriage, your chances for future successful pregnancies are still good. In general, a single miscarriage does not warrant extensive testing.
We hope, and typically see, that the next pregnancy is healthy and normal. If you have suffered more than two miscarriages, if you are over the age of 35 or if you have a known family history of certain disorders that can increase the risk for miscarriage, we will discuss with you some testing and recommendations for helping you to experience pregnancy and childbirth.
You should seek urgent care from your provider for a miscarriage, and schedule a follow up appointment as recommended by your provider. Call your provider’s office to schedule an appointment.
