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Miscarriage – Part 1:
What Is It? And What Do I Do?

Woman grieving the loss of baby after a miscarriage.

What is miscarriage?

Miscarriage is when you lose your pregnancy within the first five months or twenty weeks.

Miscarriage is actually very common. About fifteen percent of positive pregnancies end in miscarriage, and another fifteen percent of pregnancies end in a heavy or late period – before they’ve even been discovered. The medical term for miscarriage is “spontaneous abortion” – as opposed to an “elective abortion” or a medically necessary “therapeutic abortion.”

I’m pregnant and having bleeding. How do I know if it’s a miscarriage?

Bleeding in the first trimester is so common it affects half of all pregnancies.

But not all bleeding is the sign of an impending miscarriage.

Light spotting in the first trimester is pretty common. What’s known as “implantation bleeding” happens when the fertilized egg implants itself into the uterus lining, stimulating the placenta to form. Other bleeding can happen randomly, such as spotting after intercourse, or blood on the bathroom tissue after wiping yourself. This kind of spotting light cramps and is normal in the first stages of pregnancy.

But if you’re having bright red bleeding that doesn’t stop and soaks a pad in an hour, you may be having a miscarriage. In this case, you should call your doctor. Miscarriage generally has intense cramping, similar to severe menstrual cramps or even a “mini-labor.”

Give yourself lots of extra time after a miscarriage before trying to get pregnant again.

With a spontaneous miscarriage, the cramping and bleeding tend to build over several hours, at which point you may pass pregnancy tissue: a large blood clot mixed with white, grey, or yellow material. You may even see what looks like an embryo. Once you pass the pregnancy tissue, the bleeding usually goes back down to a normal menstrual level. A spontaneous miscarriage is usually over within 12 hours, but the post-miscarriage bleeding can last up to a week.

Sometimes a miscarriage starts but doesn’t finish. This is called a “missed abortion or miscarriage” or an “incomplete miscarriage or abortion.”

Medical Intervention for Miscarriage: When is it necessary?

If an embryo dies but doesn’t pass out of your body, you may need medical help. There are three options:

OPTION 1: Wait

Give yourself some extra time. It can take two weeks or more for a failed pregnancy to pass spontaneously.

OPTION 2: Medication

A prescription drug can bring on the “mini-labor” stage of miscarriage. “Cytotec” or “Misoprostol” are medications that soften the cervix and cause the uterus to contract, which pushes out the pregnancy tissue. Your medically-assisted miscarriage will start within twenty-four hours of taking the medication, and it lasts the typical six to twelve hours of a spontaneous miscarriage. If the medicine doesn’t work, you will need a suction D&C.

OPTION 3: D&C

A third option is a suction D&C: an out-patient procedure done under anesthetic. Suction, similar to a medical vacuum, removes all the pregnancy tissue from the uterus. The main advantage of a suction D&C is it gets the process completed quickly and efficiently.

Choose the option that works best for your situation and circumstances.

Regardless of how the miscarriage is completed, it’s best for you to wait 3-4 cycles before attempting conception again. If you get pregnant too soon after a miscarriage, the risk of recurrent miscarriage is slightly higher.

To summarize, we saw that miscarriage is common, light spotting is normal during early pregnancy, but heavy bleeding with cramps is probably a miscarriage. If your spontaneous miscarriage didn’t complete, you can wait, use medication, or get a D&C.

If you had a miscarriage and want to know more about getting over your feelings and trying to get pregnant again, check out Miscarriage – Part 2: Causes and Coping.

Learn more about your pregnancy with my book, DIY Baby! Your Essential Pregnancy Handbook

Call for an appointment 248-964-6061.

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