Pregnancy Complication: Miscarriage

There’s no heartbeat. You’ve had a miscarriage. I’m sorry, but she didn’t make it. These are the words that expectant parents never want to hear. Some women may go through pregnancy with no complications, while others struggle with fertility and miscarriages.  Pregnancy can be an incredible experience but may also cause a lot of worry and stress on the expectant parents. 

What is a Miscarriage?

Miscarriage is defined as the spontaneous loss of a fetus before the 20th week of pregnancy. About 10-20% of known pregnancies end in miscarriage. This means that 10-20 women out of 100 who know they are pregnant will experience a miscarriage. Many women may unknowingly have a miscarriage, as many miscarriages happen very early in pregnancy before the woman even knows she is pregnant. 

If the baby is lost after the 20th week of pregnancy, it is termed a stillbirth. An early stillbirth is when fetal death occurs between 20-27 completed weeks of pregnancy. A late stillbirth is when fetal death occurs between 20-36 completed weeks of pregnancy.  And a term stillbirth occurs between 37 or more completed pregnancy weeks. About 1 in 175 births result in a stillborn baby in the United States each year. 

What Causes a Miscarriage?

Most miscarriages result because the fetus isn’t developing as expected. It is rarely due to something that the expectant parents did. It most often occurs for things beyond your control. About 50% of miscarriages are due to chromosomal abnormalities in the first trimester of pregnancy. When the egg and sperm join, there are two sets of chromosomes that join. If there is an abnormal number of chromosomes in either the egg or sperm, the fetus will have an abnormal number of chromosomes. As the fertilized egg grows into a fetus, its cells will divide and multiply several times, which can lead to a miscarriage if abnormalities occur during this process. It is not well understood why chromosomal abnormalities occur but thought that most happen by chance. Other factors that may contribute to a miscarriage include:

• Infection
• Hormonal imbalances
• Uterine abnormalities
• Incompetent cervix
• Smoking, drinking alcohol or using recreational rugs
• Immune system disorders
• Severe kidney disease
• Congenital heart disease
• Unmanaged diabetes
• Thyroid disease
• Radiation
• Certain medications
• Severe malnutrition

What are the Symptoms of a Miscarriage?

Symptoms of miscarriage include the following:

• Bleeding that progresses from light to heavy
• Passing grayish tissue or blood clots
• Cramps and abdominal pain similar to menstrual cramps
• Low back ache that ranges from mild to severe
• A decrease in pregnancy symptoms

What Should I Do if I Think I’m Having a Miscarriage?

If you think you are having a miscarriage, you should notify your doctor right away. They will want to determine if you did have a miscarriage and may recommend further testing like blood work and an ultrasound. Completing the ultrasound will also confirm that no parts of the fetal tissue remain in your body, as this could cause infection, bleeding, or other complications.

If it is determined that the miscarriage is complete and your uterus fully expelled the fetal tissue, no further treatment is usually needed. If it is not complete, your provider may recommend removing the fetal tissue with medication or surgery.

How Soon Can I Get Pregnant After a Miscarriage?

Most women who experience a miscarriage have subsequent normal pregnancies and births. The decision to when you should try to get pregnant again is between your provider, you, and your partner. Providers normally recommend one normal menstrual period before trying to get pregnant again.

While experiencing a miscarriage at any point in your pregnancy is incredibly difficult, remember that it does not mean that you cannot get pregnant. Many women experience successful pregnancies and deliveries after having a miscarriage.  If you are concerned about your ability to get pregnant or carry a baby to term in the future, make sure you speak with your provider about this. 

References/Resources

CDC: What is Stillbirth?

Mayo Clinic: Miscarriage

Cleveland Clinic: Miscarriage