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What happens during a miscarriage? Signs to look out for

Pregnancy loss can feel like a very lonely experience, but many women go through it, as it’s believed that 10 to 20% of pregnancies end in miscarriage. Despite the fact that it’s a common experience, though, there’s no such thing as a ‘normal’ miscarriage. However, there are a few similarities that many women experience.

Possible first signs of a miscarriage

Light bleeding or spotting during their first trimester of pregnancy isn’t abnormal, but you should always report it to your provider to be on the safe side. This helps your provider better monitor the rest of your pregnancy. If the bleeding seems especially heavy or gets heavier, that could be a sign of a miscarriage, and women who notice heavy vaginal bleeding during pregnancy should contact their provider for a medical exam.

Heavy bleeding can also be a sign of an ectopic pregnancy. An ectopic pregnancy occurs when the fertilized egg implants in a location other than the uterus, such as in the fallopian tube. Women who are at risk of ectopic pregnancy should also make sure to call their provider right away if they notice this, as ectopic pregnancies can be life-threatening.

Other indicators

There are a few other common symptoms of miscarriage that a woman might experience.

  • Abdominal pain or cramping to varying degrees of intensity. Cramping may feel like light pressure in the abdomen, or it may be severe and extremely painful
  • Lower backache, often intense
  • Dizziness or lightheadedness
  • Tissue with clots or pink/white mucous passing from vagina

When you’re at the provider’s office

A healthcare provider will likely perform a pelvic exam, an ultrasound, and blood tests to determine if a woman is miscarrying. If this is the case, her provider may let her choose between letting the miscarriage happen naturally and without medication, or undergoing surgical or medical intervention to help complete the process. Medical interventions might be among the following:

  • Rh-immune globulin:

Rh-immune globulin is a simple injection given to all pregnant women who have Rh-negative blood cells, as well as Rh-negative women who have miscarried or had an ectopic pregnancy. An Rh-immune globulin injection is important because if an Rh-negative woman has an Rh-positive fetus, the woman’s immune system will create antibodies against the Rh proteins on the fetal blood cells. This doesn’t impact the current pregnancy, but if a pregnancy occurs in the future and the fetus is Rh-factor positive, the mother’s antibodies will attack the fetus’s blood cells. By administering Rh-immune globulin, or RhoGAM®, the woman’s immune system doesn’t make the antibodies and there is no risk for future pregnancies.

  • Suction aspiration, or dilation and evacuation (D&E):

For early miscarriage, and sometimes second trimester miscarriage, the healthcare provider may perform a suction aspiration or a D&E. During suction aspiration, the provider numbs the cervix, dilates it, and removes the remaining tissue using a small, gentle suction device. During a D&E, those same steps are performed and forceps are then used to remove any remaining tissue. Women are asleep during a D&E. They can have someone in the room with them for the procedure, and they also need a partner, family member, or friend to drive them home and monitor them for the rest of the day.

  • Medicine to help the uterus contract and pass any remaining tissue:

This is the most common type of management for women who experience a second trimester miscarriage.

  • Pain medication:

Late miscarriage is less common, and usually happens in a hospital. It can also be more painful than an early miscarriage. Pain medication might be prescribed for a late miscarriage while the process runs its course.

Any procedures or medication depend on a woman’s individual circumstances, but either way, her healthcare provider will help her understand her options, and make the best choice possible.

After the provider’s office

Bleeding and cramping from a miscarriage may last anywhere from a few hours to a few days. Sometimes the blood looks like heavy menstrual blood, or if a woman is later in her pregnancy, it may appear more clotted. Women usually are advised to avoid intercourse and using tampons for about a week after they receive a miscarriage diagnosis. They may also use over-the-counter pain medication to reduce the pain from cramping, as well as sanitary pads, hot water bottles, or a liner for their beds, depending on how much bleeding they are experiencing. Once the miscarriage is complete, it can be normal to continue to spot or bleed lightly for four weeks or more; symptoms of pregnancy, such as nausea and breast tenderness, tend to resolve quickly. Ovulation and your period usually return within four to six weeks after a miscarriage.

Some women have a follow-up appointment after the miscarriage is complete. This may be especially helpful for women who are looking for closure after a miscarriage. These appointments are called “pregnancy loss follow-ups,” and they can help a mother and her partner process what they experienced with the miscarriage, as well as give them an opportunity to plan for the future.

  • OBOS Pregnancy and Birth Contributors. “Miscarriage in the First Trimester.” OurBodiesOurselves. Our Bodies Ourselves, Apr 9 2014. Web.
  • “Understanding Early Miscarriage.” UC Regents, 2015. Web.
  • “Miscarriage.” MarchofDimes. March of Dimes Foundation, Jul 2012. Web.
  • Mayo Clinic Staff. “Rh factor blood test: Why it’s done.” MayoClinic. Mayo Foundation for Medical Education and Research, Jun 23 2015. Web.

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