Know the Signs of Miscarriage

A miscarriage is when a woman loses a pregnancy before the 20th week. It’s impossible to know how many pregnancies end in miscarriage, since many occur before the woman even knows she’s pregnant. But for women who know they are pregnant, the estimates range from 10 to 20 percent. If you think you are having a miscarriage, get medical help immediately.

Steps

Identifying the Symptoms

1. Call your physician or go to the emergency room if tissue, fluid, or what appears to be clumps of blood come out of your vagina. This could mean that you are miscarrying. Depending on how far along you are, and how heavy you are bleeding, your doctor may recommend you go to the emergency room, or that you wait to be seen during office hours.
   • If you do pass tissue that you think might be fetal tissue, put it in a clean, sealed container and take it with you to the doctor.
   • Taking the tissue with you may seem strange, but the doctor will be able to test it to confirm whether it was fetal tissue.
2. Recognize that you may be at risk of miscarrying if you have spotting or vaginal bleeding. Many women have bleeding, but do not miscarry. However, it is safest to call your doctor immediately to see if you need to visit the ER.
   • You may also experience cramping. If you have strong cramping, it is another sign that you should see a doctor quickly.
3. Take note if you experience lower back pain. Back pain, abdominal discomfort, or cramping may be signs that you are miscarrying, even if you have no bleeding.
   • Contact your doctor before taking any pain medication.
4. Recognize the symptoms of a septic miscarriage. This occurs when a woman has an infection in her uterus and miscarries. It is dangerous for the woman’s health and requires immediate medical care. Symptoms include:
   • Fluid coming from your vagina that smells bad.
   • Vaginal bleeding.
   • Fever and chills.
   • Cramping and pain in your abdomen.

Knowing What to Expect at the Doctor’s Office

1. Get a medical check-up. There are several tests and exams that your doctor will probably do to determine whether you have lost the pregnancy.
   • The doctor will likely do an ultrasound to see if the fetus is visible in your womb. If so, the ultrasound will also let the doctor see if it is developing properly. If the fetus is old enough, it may be possible to check the heartbeat.
   • Your doctor may do a pelvic exam to see if your cervix is opening.
   • Blood tests will allow the doctor to measure your hormones.
   • If you have passed tissue and brought it with you, your doctor can test it to confirm whether it is fetal tissue.
2. Understand the diagnoses you may be given. There several possibilities:
   • A threatened miscarriage is when you are showing signs that you may be about to miscarry. Not all threatened miscarriages actually miscarry. If you have cramps, or you are bleeding, but your cervix is not opening, then you may be diagnosed with a threatened miscarriage.
   • If there is nothing the doctor can do to prevent a miscarriage, you will be diagnosed with an inevitable miscarriage. This diagnosis is likely if your cervix has opened, and your uterus is contracting to expel the fetus.
   • A complete miscarriage occurs when all of the fetal and pregnancy tissues are expelled.
   • An incomplete miscarriage is when you miscarry but some of the fetus or placenta is not passed out through your vagina.
   • missed miscarriage occurs when you do not pass the fetus or placenta even though the fetus has died.
3. Follow your doctor’s advice if you have been diagnosed with a threatened miscarriage. Not all threatened miscarriages actually miscarry. However, depending on your situation, it may not be possible to prevent a miscarriage. Your doctor may recommend:
   • Resting until the symptoms stop.
   • Not exercising.
   • Abstaining from sex.
   • Not traveling to areas where you will not be able to get quick, high quality medical care if you need it.
4. Know what to expect if you have miscarried, but not passed all of the tissues. What your doctor recommends may depend on your preferences.
   • You can wait to see if your body passes the remaining tissue on its own. This could take up to a month.
   • You can take medication to induce your body to expel the tissue. This usually works quickly, sometimes within a day. The medication can be taken by mouth or by putting it directly into your vagina.
   • If you are showing signs of infection, the doctor will dilate you and remove the tissue.
5. Give yourself time to recover physically if you have miscarried. Chances are the recovery will be quick and you will be physically healthy within a few days afterwards.
   • Know that your period may resume the following month. This means that you are physically capable of getting pregnant again immediately. If you do not wish to do so, use contraception.
   • Allow your vaginal tissues 2 weeks to recover. During this time, don’t have sex or use tampons.
6. Take the time to heal psychologically. Studies show that women who miscarry can grieve the same as those who lose a baby to stillbirth close to their due date. It is extremely important you give yourself time to grieve and surround yourself with supportive people to talk to.
   • Get support from friends and family members that you trust.
   • Seek out a support group.
   • Most women who miscarry go on to have healthy pregnancies afterwards. A miscarriage probably does not mean that you won’t be able to have a baby.

Thinking about Future Pregnancies

1. Understand the common causes of miscarriage. Many miscarriages occur because the baby wasn’t developing properly. This can occur for several reasons either arising from the genetic makeup of the fetus or from the mother’s health.
   • Genetic disorders in the fetus. These can be either inherited problems or problems occurring in that particular egg and sperm.
   • Diabetes in the mother.
   • An infection.
   • Maternal hormonal imbalance.
   • Thyroid problems.
   • Disorders of the uterus or cervix.
2. Lower your risk for future miscarriages as much as possible. While not all miscarriages can be prevented, there are some things that may make you more at risk.
   • Smoking.
   • Drinking alcohol. Alcohol may cause irreversible harm to your baby even if you do not miscarry.
   • Taking drugs. Avoid all street drugs if you are pregnant or attempting to become pregnant. Do not take any medications, even over-the-counter medications or herbal remedies, without first consulting your doctor.
   • Diabetes.
   • Being overweight or underweight.
   • Problems with your reproductive organs, particularly the uterus or cervix.
   • Environmental toxins.
   • Infections.
   • Immune disorders.
   • Hormonal imbalances.
   • Invasive prenatal tests such as amniocentesis or chorionic villus sampling
   • The risk of miscarriage increases for women over the age of 35.
3. Know what does not cause miscarriage. The following activities should not cause miscarriages under normal conditions. If your doctor advises you differently, follow your doctor’s advice.
   • Moderate exercise.
   • Having safe sex. Avoid infections.
   • Working in jobs that do not raise your risk of being exposed to environmental toxins, infectious agents, chemicals, or radiation.

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• Cope With a Miscarriage
• Prevent Recurrent Miscarriages
• Determine If You Had a Miscarriage

Sources and Citations

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• Prevent Recurrent Miscarriages
• Determine If You Had a Miscarriage
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• Care for Yourself After a Miscarriage
• Recover from a Miscarriage
• Console Someone Who Had a Miscarriage
• Get Through a Miscarriage

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