What to Do When You’re Having a Miscarriage

On the 10th week of my pregnancy, I had my first prenatal check up on May 13, 2009. My OB/GYN did a transvaginal ultrasound to check the growth of the fetus and determine potential problems. She said the gestational sac was there but she could not see the fetus, which probably means a miscarriage. She ordered for another ultrasound at another hospital the following week. The radiologist there did 2 ultrasounds, one abdominal and another transvaginal. As I was looking at the screen, I had a feeling that the doctor was right. And when I asked the radiologist, she politely said my doctor would discuss the results with me. 

The following day, May 19, my OB/GYN told me that the results confirmed that it is a miscarriage because although the gestational sac was already 8mm, the fetus has not developed. She says it’s not my fault and it’s not because I have done something wrong. She says it just happens. I asked her if it’s possible that it’s still early and that the fetus could still develop. She says the chances are very slim and she didn’t want me to get hopeful and disappointed. So I asked her what I should do next. She gave me three options:

1. To wait for it to happen and let nature takes its course. Once my body recognizes that I am no longer pregnant, the body flushes out the tissues from the uterus. I should expect cramping and bleeding anytime during the next few weeks. If I use more than one pad in an hour, it means I’m having excessive bleeding and I should call her or go to the ER.
2. She could give me a medicine called Misoprostol to help out flush the contents of the uterus. It sounded more like some form of abortion.
3.  Undergo a procedure called D & C (dilation and curettage) to fully empty the uterus and make sure no tissues are retained.

I opted to wait for a few weeks to see what happens. In the meantime, I started searching the internet for more information and I learned that there is so much more the doctor hasn’t told me on what I’m about to go through.

What is a Miscarriage?

A miscarriage is the loss of a pregnancy during the first 20 weeks. It is usually your body’s way of ending a pregnancy that has had a bad start. The loss of a pregnancy can be very hard to accept. You may wonder why it happened or blame yourself. But a miscarriage is no one’s fault, and you can’t prevent it.

I was shocked to learn that miscarriages are very common especially in the first three months of pregnancy. I read that about 1 in 5 pregnancies end in a miscarriage. It is even also common for a woman to have a miscarriage before she even knows that she is pregnant.

What are the Common Symptoms?

Common signs of a miscarriage include:

• Bleeding from the vagina. The bleeding may be light or heavy, constant or off and on. It can sometimes be hard to know whether light bleeding is a sign of miscarriage. But if you have bleeding with pain, the chance of a miscarriage is higher.
• Pain in the belly, lower back, or pelvis.

• Tissue that passes from the vagina.

What causes a miscarriage and how is it treated?

Most miscarriages happen because the fertilized egg in the uterus does not develop normally. A miscarriage is not caused by stress, exercise, or sex. In many cases, doctors don’t know what caused the miscarriage.

The risk of miscarriage is lower after the first 12 weeks of the pregnancy.

No treatment can stop a miscarriage. As long as you do not have heavy blood loss, a fever, weakness, or other signs of infection, you can let a miscarriage follow its own course. This can take several days.

If you have Rh-negative blood, you will need a shot of Rhogam. This prevents problems in future pregnancies. If you have not had your blood type checked, you will need a blood test to find out if you are Rh-negative.

Many miscarriages complete on their own, but sometimes treatment is needed. If you are having a miscarriage, work with your doctor to watch for and prevent problems. If the uterus does not clear quickly enough, you could lose too much blood or develop an infection. In this case, medicine or a procedure called a dilation and curettage (D&C) can more quickly clear tissue from the uterus.

Other Risk factors for Miscarriage

Factors that may increase your risk of miscarriage include:

• Your age, especially at age 35 and older.
• A history of recurrent miscarriage (three or more).
• A history of miscarriages on your mother’s side of the family.
• Polycystic ovary syndrome, which can cause ovulation problems, obesity, increased male hormone levels, and an increased risk of diabetes.
• A poorly controlled ongoing disease (such as diabetes or an autoimmune disease).
• Certain bacterial or viral infections during pregnancy.
• A blood-clotting disorder such as antiphospholipid antibody syndrome.
• Problems with the structure of the uterus (such as a T-shaped uterus).
• A history of pregnancy with a birth defect.
• A physical injury.
• Exposure to dangerous chemicals, such as benzene, arsenic, or formaldehyde, before or during pregnancy.
• The father’s age, especially beyond age 35.

Other factors that may slightly raise miscarriage risk include:

• Nonsteroidal anti-inflammatory drug (NSAID) use (such as ibuprofen or naproxen) at the time of conception or during early pregnancy.
• Alcohol use during pregnancy.
• Cigarette smoking during pregnancy.
• Cocaine use during pregnancy.
• A snakebite.
• Caffeine use during pregnancy.
• A chorionic villus sampling (CVS) or amniocentesis to test for birth defects or genetic problems. When done by a highly trained provider, one study showed that these tests have a risk of miscarriage of about 1 in 400. Some studies have shown higher risks, between 2 and 4 in 400. This greater risk may be more likely in medical centers with less experienced providers, especially for CVS.

There are also known factors that do not increase the risk of miscarriage, such as exposure to computer monitors or electric blankets, sexual intercourse, and exercise.

Tips In Dealing With a Miscarriage

A miscarriage doesn’t happen all at once. It usually takes place over several days (sometimes up to two weeks), and symptoms vary. Here are some tips for dealing with a miscarriage:

• Use pads instead of tampons. You will probably have vaginal bleeding for a week or so. It may be like or slightly heavier than a normal period. It is normal to have mild or moderate vaginal bleeding for up to 14 days after a miscarriage. But the bleeding should not be severe.  For most women, passing clots of blood from the vagina and soaking through their usual pads or tampons every hour for 2 or more hours is not normal and is considered to be severe bleeding. You may use tampons during your next period, which should start in 3 to 6 weeks.
• Take acetaminophen (Tylenol) for cramps. Read and follow all instructions on the label. You may have cramps for several days after the miscarriage.
• Eat a balanced diet that is high in iron and vitamin C. You may be low in iron because of blood loss. Foods rich in iron include red meat, shellfish, eggs, beans, and leafy green vegetables. Foods high in vitamin C include citrus fruits, tomatoes, and broccoli. Talk to your doctor about whether you need to take iron pills or a multivitamin.
• Talk with family, friends, or a counselor if you are having trouble dealing with the loss of your pregnancy. If you feel very sad or depressed for longer than 2 weeks, talk to a counselor or your doctor.
• Talk with your doctor about any future pregnancy plans. Most doctors suggest that you wait until you have had at least one normal period before you try to get pregnant again. If you don’t want to get pregnant, ask your doctor about birth control options.

It is important to be alert to the symptoms of a miscarriage so that you can seek medical evaluation. If you are having symptoms of a miscarriage, avoid sexual activity (called pelvic rest) and strenuous activity until your symptoms have been evaluated by a health professional.

Call 911 or other emergency services immediately if you are pregnant and you have severe vaginal bleeding AND signs of shock. Early signs of shock include:

• Lightheadedness or a feeling that you are about to pass out.
• Restlessness, confusion, or signs of fear.
• Shallow, rapid breathing.
• Moist, cool skin or possibly profuse sweating.
• Weakness.
• Thirst, nausea, or vomiting.
• Abnormal increase in heart rate.

After a miscarriage, are you at risk for miscarrying again?

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 good. It is unusual to have three or more miscarriages in a row. But if you do, your doctor may do tests to see if a health problem may be causing the miscarriages.

Coping with a Miscarriage

It is normal to go through a grieving process after a miscarriage, regardless of the length of your pregnancy. Guilt, anxiety, and sadness are common and normal reactions after a miscarriage. It is also normal to want to know why a miscarriage has happened. In most cases a miscarriage is a natural event that could not have been prevented. To help you and your family cope with your loss, consider meeting with a support group, reading about the experiences of other mothers, and talking to friends or a counselor or member of the clergy.

The intensity and duration of the grief varies from woman to woman, but most women find that they can return to the daily demands of life in a fairly short time. It is important to call your health professional if you have symptoms of depression that last for more than 2 weeks. The loss and the hormonal swings that result from a miscarriage can cause symptoms like postpartum depression.

A healthy, full-term pregnancy is possible for most women who have had a miscarriage, and even after having repeated miscarriages. If you want to become pregnant again, check with your doctor or nurse-midwife. Most health professionals recommend waiting until you have had at least one normal menstrual period before attempting to become pregnant after a miscarriage.

Going Through the Experience

During the next few days after being informed of my miscarriage, I had light brown spottings. Early morning after Memorial Day, May 26, I had a bright red discharge and started to have cramps during the day. I started passing out large tissues/clots of blood which required frequent trips to the bathroom. The bleeding and cramping built up until 5pm when the pain became so unbearable that my whole body felt cold and I felt like throwing up. That was when I passed on the largest tissue which looked like the sac. I took 2 Advils (200 mg each) which helped a lot with the pain. I noticed that everytime I felt unbearable pain (despite the painkillers), it’s a sign that I’m about to pass on large clots of blood. This experience, I learned, is definitely not for the faint of heart. 

The bleeding and cramping still continue but gradually subside as the days go by. There are one or two instances during the day where I experience sudden heavy bleeding but it gets better after that. 

Recovering

Today, May 29, I feel better and strong enough to do some light chores around the house and even write this article. I am blessed to have family and friends, a loving husband, and faith in God to help me get through all this. I am seeing my doctor again on June 1 with the hope that everything goes well and I won’t need to have a D & C.

I hope this article helps women who are going through a similar experience or those who know someone who does. Everything happens for a reason. Things always get better. And it’s amazing how God makes us stronger every time we rise from a fall.