A miscarriage is the loss of a pregnancy within the first 20 weeks of gestation. It’s also commonly called early pregnancy loss or spontaneous abortion.
Miscarriages are surprisingly common. In fact, 10 to 15 percent of known pregnancies end in miscarriage, and 80 percent of those happen in the first trimester.
These stats may sound alarming, but learning about miscarriages can help you prepare for pregnancy. A little preparation and knowledge can go a long way.
Our bodies are intricate machines. Pregnancy adds another layer of complexity. While it’s not always clear why miscarriages happen, there are some definite risk factors to be aware of.
Age is generally the biggest risk factor. The older you are during pregnancy, the greater the risk for fetal chromosomal problems and pregnancy loss.
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A history of miscarriages, reproductive organ issues, or underlying health conditions like high blood pressure or PCOS are other common factors.
While those risk factors are largely out of your control, you may be able to reduce your risk through changes in lifestyle factors like smoking, alcohol consumption, and body weight.
The causes of miscarriage are varied and sometimes unknown. But here’s what we do know:
About half of miscarriages result from the sperm, egg, or fetus not having the right number of chromosomes. These irregularities prevent the fetus from developing properly.
Problems with the uterus or cervix, infections, physical trauma, and chronic health conditions can also lead to a miscarriage.
There’s no scientific evidence to suggest sexual activity, exercise, or common working conditions can bring on miscarriages. Shock or fright or the use of birth control prior to pregnancy also doesn’t cause a miscarriage.
Most miscarriages happen before a woman has even realized she’s pregnant. A miscarriage at this early stage looks like normal menstrual bleeding and often appears at the same time as a regular period.
Telltale signs of a miscarriage during the first and second trimesters are:
- abdominal, back, or pelvic pain or cramps
- an abrupt drop in pregnancy indicators
- vaginal discharge (pinkish mucus, blood, tissue, or clots)
- weight loss
But don’t worry too much — many women spot or bleed at the beginning of their pregnancy and go on to have healthy pregnancies.
Miscarriages are complex and present in several forms.
Just as its name implies, a threatened miscarriage is when there’s a chance and indications of miscarrying. The symptoms are light bleeding and cramping. With medical care, you may be able to prevent the miscarriage.
Bleeding, spotting, and cramping indicate that a miscarriage is inevitable.
This is when an embryo dies but no tissue leaves the body. You may not even realize you’ve had a miscarriage until you go in for a medical appointment. This occurs in about 15 percent of known pregnancies.
An embryo dies and some fetal tissue is passed, but some remains in the womb. This may cause a lot of bleeding and cramping.
This is when the body has released all tissues related to the pregnancy. There may still be bleeding and cramping as the uterus empties.
Though it’s rare, an untreated miscarriage could develop into a serious infection of the uterus.
Some women experience multiple miscarriages (this is also rare). It’s best to discuss repeated pregnancy loss with your healthcare provider. Together you can identify possible causes and determine a treatment plan.
You know your body best. If anything feels “off” or you notice signs of a miscarriage, call your healthcare provider ASAP.
During an exam, your provider will assess your symptoms. They may recommend an ultrasound and check your levels of pregnancy hormones to confirm an embryo is still growing.
Depending on the outcome of your physical exam, your healthcare provider may recommend a variety of treatment options.
For threatened miscarriages, they may recommend bed rest or hormone injections or address other medical conditions in an effort to save the pregnancy.
Incomplete miscarriages usually require medical intervention to remove remaining pregnancy tissue. Medication or a surgical procedure can remove the lingering material if it doesn’t leave your body naturally.
Some miscarriages don’t require any treatment or medical intervention, since all tissue passes on its own. This is especially common with losses very early in pregnancy. If bleeding and cramping persist, it’s best to see your healthcare provider to confirm all tissue has passed.
To reduce the risk of infection following a miscarriage, you may be instructed not to insert anything into your vagina for a short time. Call your healthcare provider or head to the ER if you have a fever, chills, or other symptoms of an infection.
Every miscarriage is different, and the experience will vary from person to person.
As mentioned before, an early-stage miscarriage might happen without you realizing it and before you know you’re pregnant at all. Symptoms may seem like a regular monthly cycle and end quickly.
For some women, miscarrying takes a more noticeable course.
Several factors affect the duration of a miscarriage and how it feels, including:
- how many weeks into the pregnancy you were
- how quickly your body passes the fetal tissue and afterbirth
- the number of fetuses you were carrying
All things considered, a miscarriage can last anywhere from hours to weeks. While one woman may have only light bleeding and cramping, another may bleed for several days. Usually, the physical process of a miscarriage happens gradually and resolves within 2 weeks.
After a miscarriage, it can take up to a month or more for your body to physically recover. Your period should return in 4 to 6 weeks. Pregnancy hormones might linger in your body for a couple of months.
The psychological effects of a miscarriage have a timetable of their own.
Women have a much higher risk of developing depression than men do. Add pregnancy hormones and the experience of miscarrying to the mix, and the chances are even greater.
Postpartum depression (PPD) is a period of severe depression after delivering a baby or having a miscarriage.
This is due in part to fluctuations in estrogen and progesterone levels. Changes in thyroid levels, emotional and physical fatigue, and grief are among other possible causes. Up to 15 percent of women experience PPD.
PPD has many markers that may show up anywhere from a few weeks to several months after a miscarriage. Talk to your healthcare provider if you experience these symptoms for 2 weeks or longer:
- crying a lot (an unusual and extreme amount)
- body aches or digestive troubles that don’t go away
- changes in diet or sleep
- feeling hollow, hopeless, irritable, overwhelmed, restless, sad, or withdrawn
- lack of connection to loved ones
- lack of emotion, energy, motivation, or interest in pleasurable activities
- thoughts of suicide or self-harm
- trouble concentrating, focusing, or remembering things
Thankfully, PPD is well known and very manageable. Common treatments include therapy and medication. Your doctor will know the best options for your specific situation.
The duration of PPD varies from woman to woman. According to a 2014 review of studies, about half of women who get treatment for PPD are symptom-free within a year. Without treatment, PPD may take longer to resolve.
Some women may experience ongoing symptoms of depression, which could be related to a personal history of depression.
If you think you may have postpartum depression, contact your healthcare provider right away. Depression is a serious and treatable condition, and you don’t have to go through it alone.
Help is available:
The National Suicide Prevention Lifeline is available 24 hours a day, so don’t hesitate to call: 1-800-273-8255. You can also always call or visit your nearest emergency room to talk with a mental health professional on hand.
If you prefer to text, reach the Crisis Text Line by texting “HOME” to 741-741.
Miscarriages are usually outside your control and can’t be prevented. But here’s how you can minimize your risk:
- Address any health issues that may impact your pregnancy.
- Avoid drugs, alcohol, and too much caffeine.
- Get regular checkups throughout your pregnancy. (This is key for early detection and preventing threatened miscarriages from advancing.)
- Make healthy lifestyle choices: Eat nutritious foods, get plenty of sleep, move your body regularly, try to manage your stress levels, and follow your healthcare provider’s recommendations on maintaining a healthy pregnancy weight.
- Make sure any over-the-counter meds and supplements you take are pregnancy-safe.
- Protect your belly and be extra careful to avoid physical accidents.
- Take prenatal vitamins.
Understandably, losing a pregnancy can take a heavy physical and mental toll. Make self-care a priority and give yourself time to grieve and heal.
Between your doctor and available counseling services, there are many resources to help you move forward and feel like yourself again. And remember, having a miscarriage doesn’t mean you won’t be able to have a healthy pregnancy in the future.