Understanding Miscarriages

The medical term for miscarriage is spontaneous abortion. It refers to early pregnancy loss in the first trimester, or during the first 13 weeks of pregnancy. Unfortunately, early pregnancy loss is common and is thought to affect 10% of known pregnancies. In reality, this number is even more common as some losses go unrecognized. You get into a situation where a woman just thinks that she had a weird period and doesn’t even recognize that she experienced a loss. Most early pregnancy losses are the result of a genetic issue. When mom and dad’s chromosomes link up, the body can detect that there may be an abnormality that is not compatible with growth and development, and the pregnancy may result in a loss.

Now, a lot of women wrestle with whether or not something they did or did not do caused or contributed to their loss. Put this out of your mind, don’t even entertain it. In most cases, neither you nor your partner had any responsibility in this. It is not something you could control or change.

Smoking, alcohol and caffeine have been studied as potential causes. The jury is still out in regards to smoking and alcohol. In other words, results are conflicting. At any rate, don’t do it. Moderate amounts of caffeine consumption, which is less than 200 milligrams per day, the equivalent of two cups of coffee per day, does not appear to increase risk.

The risk of early pregnancy loss does increase as we get older, particularly over the age of 40.

What do you typically experience with a pregnancy loss?

Bleeding and cramping are the most common symptoms. The cramping is similar to that experienced with a menstrual cycle, and the bleeding can be anywhere from spotting, to bleeding like a period, to even heavier bleeding. If you experience any of these symptoms, contact your healthcare provider.

Also keep in mind, you might experience spotting at various times throughout your pregnancy. The tissue is very sensitive in pregnancy. There’s a massive increase in blood flow to the area. Anytime something rubs up against the tissue of the cervix or the vaginal walls, such as intercourse, pelvic exams, or ultrasounds with the use of the vaginal probe, it can cause spotting.

How is early pregnancy loss typically diagnosed?

Typically by taking a history and performing a physical exam. An ultrasound may also be necessary. A blood test, measuring the pregnancy hormone or human chorionic gonadotropin, HCG, may also be necessary. The ultrasound and blood tests may need to be repeated for confirmation.

What are the options for early pregnancy loss?

Your physician will work with you to tailor your treatment plan specific to your situation. Options may include allowing the tissue to pass naturally. Medications may also be used to help expel the tissue. In some cases, surgery may be recommended. Your physician will review the specifics of each management plan with you in detail.

Another thing to keep in mind is if your blood type is RH negative, RH is rhesus factor, a protein found on your red blood cells, you may receive a shot of RH immunoglobulin. This is to help prevent future serious problems if the mother is RH negative and the fetus is RH positive.

What happens next?

We typically recommend pelvic rest, which means nothing in the vagina for a period of two weeks after a loss to help prevent infection. When should you be concerned? If you have a temperature with a fever of 100.4 or more, you have severe nausea, vomiting where nothing is staying down, everything you eat and drink is coming back up. If you experience severe pain that typical over the counter pain medications are not helping. If you have heavy bleeding where you are soaking, flooding your pad, having to change it every hour because it is soaked, saturated, and this goes on for more than an hour, seek medical care.

If you find that you are having trouble coping with your loss, talk to your provider, be open and honest about your feelings. Seeking counseling services, grief support groups, and spiritual support may also be helpful. Please know that most women can and will go on to have healthy, successful pregnancies. Recurrent pregnancy loss is rare. If you wish to try again, we recommend waiting until after your next normal cycle. If you do not desire pregnancy, we recommend starting a reliable form of contraception.

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