Miscarriage is the loss of a pregnancy in the first 20 weeks. About 10 to 20 percent of known pregnancies end in miscarriage, and more than 80 percent of these losses happen before 12 weeks.
It is not always easy to understand that a miscarriage is taking place. It can last several days, and one woman’s symptoms can be very different from another’s. Below is a list of common miscarriage symptoms:
Often, the first sign of a miscarriage is vaginal bleeding. It may be light or heavy, constant or irregular. Vaginal bleeding may also occur during the first trimester with a normal pregnancy. In most cases, women who experience light bleeding in the first trimester go on to have successful pregnancies. Sometimes even heavier bleeding doesn’t result in miscarriage. However, painful bleeding is a sign that miscarriage is more likely.
Pain may start a few hours to several days after bleeding has begun. It may be pelvic cramps, belly pain, or a persistent, dull ache in your lower back.
It’s very important to be aware that vaginal bleeding, spotting, or pain in early pregnancy can also signal an ectopic or a molar pregnancy. If you have any of these symptoms, call your caregiver or midwife right away so they can determine whether you have a problem that needs to be dealt with immediately.
Tissue or Fluid Passing
Blood clots or grayish tissue (fetal tissue) or fluid passing from the vagina. If you can, save this tissue in a clean container. Your caregiver may want to examine it or send it to a laboratory for testing to try to find out the reasons for the miscarriage. In any case, your caregiver will want to see you again at this point, so call her/him to let her/him know what’s happened.
Reasons for Miscarriage
Since most health care practitioners won’t do a full-scale workup of a healthy woman after a single miscarriage, it’s usually impossible to know the reasons for the miscarriage. And even when a detailed evaluation is performed (in case you’ve had two or three consecutive miscarriages, for instance), the reason may still remain unknown half the time. However, there are several possible causes of miscarriage. These include:
- The mother’s age (35 and older) and/or the father’s age (35.2 and older)
- A history of miscarriages (three or more).
- Polycystic ovary syndrome.
- A blood-clotting disorder (such as antiphospholipid antibody syndrome).
- Uterine or cervical problems: A problematic structure of the uterus (such as a T-shaped uterus), severe uterine adhesions (bands of scar tissue), or cervical insufficiency (a weak or abnormally short cervix).
- Alcohol use, smoking, cocaine use or heavy consumption of caffeine during pregnancy.
- Exposure to certain chemicals (such as lead, arsenic and cetain other chemicals) or medicines.
- A history of birth defects or genetic problems: If you, your partner, your child or family members have a genetic abnormality or have had one identified in a previous pregnancy.
- Certain viral or bacterial infections during pregnancy: Research has shown a somewhat higher risk for miscarriage if you have HIV, gonorrhea, listeria, mumps, measles, rubella, cytomegalovirus, parvovirus and certain other infections.
- Diagnostic procedures: There’s a small increased risk of miscarriage after amniocentesis chorionic villus sampling (both of which are performed for diagnostic genetic testing).
- Your risk of miscarriage rises with each child you bear.
- Your risk of miscarriage is also higher if you get pregnant within three months after giving birth.
When to See a Doctor
What should I do if I suspect I’m having a miscarriage?
Call your caregiver or midwife immediately if you ever notice unusual symptoms such as bleeding or cramping during your pregnancy. Your caregiver will examine you to see if the bleeding is coming from your cervix and check your uterus. She/he may also want to do a blood test to check for the pregnancy hormone HCG and repeat it in two to three days to see if your levels are rising as they should be with a normal pregnancy.
In case you’re having bleeding or cramping and your caregiver has even the slightest suspicion that you have an ectopic pregnancy, you’ll have an ultrasound right away. If there’s no sign of a problem but you continue to spot, you will have another ultrasound at about 7 weeks.
Recurrent Miscarriage Risks
It’s normal to be worried about the possibility of another miscarriage. However, fertility experts don’t consider a single miscarriage in the first 12 weeks of pregnancy to be a sign that there’s anything wrong with the mother or the father.
In certain situations, such as if you had a miscarriage during the second-trimester or premature birth during the early-third-trimester from a weakened cervix, you might be referred to a high-risk specialist even after a single loss so your pregnancy can be carefully managed.
Getting Pregnant after Miscarriage
You may have to wait a bit. In most cases, physical recovery from miscarriage will take only a few hours to a couple of days. Your periods will likely return within four to six weeks, and it’s possible to become pregnant during the menstrual cycle immediately after a miscarriage. However, though you may be physically ready to get pregnant, there’s no need to rush. Give yourself and your partner some tome to grieve over the loss. If you want to wait a bit, you’ll need to use contraceptives to prevent pregnancy during this time Once you feel emotionally ready to conceive again, ask your caregiver for guidance.