Coping with Miscarriage: What You Need to Know

Highlights

• Miscarriage is pregnancy loss before 20 weeks of pregnancy.
• Miscarriage occurs in up to 1 in 4 pregnancies.
• There are different types of miscarriage, including missed miscarriage where you don’t have any symptoms.
• If you don’t miscarry naturally, your doctor will discuss with you the possible next steps.
• Treatment options for miscarriage include watching and waiting (expectant management), medicine, and surgery.

In This Article

• What is a miscarriage?
• What are the symptoms of a miscarriage?
• What will happen if I go to the hospital with a miscarriage?
• What are the types of miscarriage?
• How is a miscarriage treated?
• What happens if I miscarry at home?
• Why do miscarriages happen?
• What are the risk factors for miscarriage?
• Can I prevent a miscarriage?
• Tools and Assistance

What is a Miscarriage?

A miscarriage is pregnancy loss before 20 weeks of pregnancy. If a baby dies after 20 weeks of pregnancy, this is called a stillbirth.

Up to 1 in 4 pregnancies end in miscarriage before 10 weeks of pregnancy.

Common symptoms of miscarriage are:

• Cramping lower abdominal pain, similar to period pain
• Vaginal bleeding

Around 1 in 4 individuals experience vaginal spotting or bleeding in the first trimester. This does not always mean a miscarriage is occurring.

If there are concerns about a miscarriage, seeking medical advice and support is recommended.

If heavy bleeding, strong pain, or feeling unwell occurs, urgent medical attention should be sought.

Symptoms of a Miscarriage

The most common sign of a miscarriage is vaginal bleeding, which can vary from light red or brown spotting to heavy bleeding. If it is very early in the pregnancy, it may not be recognized as a miscarriage and may be mistaken for a period.

Other signs may include:

• Cramping pain in the lower abdomen, which can vary from period-like pain to strong labor-like contractions
• Passing fluid from the vagina
• Passing blood clots or pregnancy tissue from the vagina

What Happens if I Go to the Hospital with a Miscarriage?

In a hospital setting, medical staff will assess the urgency of care. Depending on symptoms, immediate care may be provided or there may be a wait. If symptoms worsen, notifying medical staff promptly is important.

Types of Miscarriage

There are several types of miscarriage, as well as other types of pregnancy loss, including ectopic pregnancy, molar pregnancy, and blighted ovum.

• Threatened miscarriage: Vaginal bleeding or lower abdominal pain, but the cervix remains closed.
• Inevitable miscarriage: Miscarriage has already started, with vaginal bleeding and strong cramping. The cervix will be open.
• Complete miscarriage: All pregnancy tissue has passed from the uterus. Cramping pain and vaginal bleeding may continue but should get lighter.
• Incomplete miscarriage: Some pregnancy tissue remains in the uterus, with ongoing bleeding and cramping. Medical attention is needed to remove remaining tissue.
• Missed miscarriage: No symptoms of miscarriage are noticeable, detected through a routine scan. Symptoms such as nausea and fatigue may reduce or disappear.
• Recurrent miscarriage: Three or more consecutive miscarriages. A medical evaluation is recommended to explore potential causes.

How is a Miscarriage Treated?

A doctor will assess symptoms and may conduct an ultrasound to confirm the miscarriage type. Treatment options vary based on individual circumstances.

• Expectant or natural management: Waiting for pregnancy tissue to pass naturally, which can take a few weeks.
• Medical management: Medication like Misoprostol can speed up the process by causing contractions. It may result in pain, bleeding, and nausea.
• Surgical management: A D&C (dilatation and curettage) may be needed, especially in cases of heavy bleeding or infection risk. It’s a minor procedure performed under general anesthesia.

What Happens if I Miscarry at Home?

If a miscarriage occurs at home:

• Use pads to manage bleeding.
• Save pregnancy tissue for medical testing if desired.
• Take pain-relief medication as needed.
• Rest and seek medical advice.
• A follow-up check-up is recommended to confirm the miscarriage is complete.

Causes of Miscarriage

Most miscarriages occur due to developmental issues, often caused by chromosomal abnormalities that happen randomly and are not inherited. Other causes may include:

• Autoimmune conditions
• Hormonal problems
• Blood clotting issues
• Thyroid disorders
• Uncontrolled diabetes
• Severe infections with high fevers
• Uterine abnormalities such as fibroids

Risk Factors for Miscarriage

Certain factors increase the risk of miscarriage, including:

• Advanced maternal age
• Smoking
• Alcohol consumption in the first trimester
• High caffeine intake (more than 500mg per day)
• If three or more miscarriages occur, further medical evaluation may be recommended.

Can I Prevent a Miscarriage?

Many miscarriages happen for unknown or unpreventable reasons. However, maintaining a healthy lifestyle can support pregnancy health. Recommendations include:

• Reducing exposure to serious infectious illnesses
• Avoiding smoking and alcohol
• Limiting caffeine intake

Tools and Assistance

Medical Support

• Doctors and Midwives: Your healthcare provider will guide you through recovery and treatment options.
• Hospitals: Hospitals offer scans, blood tests, and counseling during miscarriage care.
• Counseling: Many hospitals provide counseling services for emotional support.

Emotional and Peer Support

• Support Groups: Peer support groups provide a space to share experiences and emotions.
• Grief Organizations: Charities offer helplines, forums, and support for grieving parents.
• Family and Friends: Talking to loved ones can help you cope with loss.

Self-Care Tools

• Physical Recovery: Follow your doctor’s advice on rest, pain management, and post-miscarriage care.
• Mental Health: Seek professional help if needed to manage grief and emotional distress.

Financial Assistance

• Insurance: Check for coverage on treatments and hospital stays.
• Support for Families: Some organizations offer financial support for funeral costs.