Signs of a Miscarriage and What to Do After

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A miscarriage is one of the most devastating events that can occur in the life of an expectant mother. If you’ve endured one, you may wonder why it happened to you. Emotions from sadness to anger and everything in between are completely understandable. As heart-wrenching as a miscarriage is, it’s actually fairly common. The Mayo Clinic estimates that between 10 and 20% of known pregnancies end in miscarriage. And up to 60% of all conceptions, in which the woman may not even be aware she is pregnant in the early weeks, end in miscarriage. So, you are not alone if you have gone through this trauma, and there is hope for the future.

In this post, we’ll talk about the reasons miscarriages happen, how to recognize one, and how to recover and move forward if you’d like to become pregnant again. If you’ve gone through a miscarriage and have any coping tips, we’d love to hear them in the comments section.

What causes a miscarriage?

Many early pregnancy failures are beyond a woman’s control. Sometimes, women who don’t know they’re pregnant don’t notice a very early miscarriage because it can appear as spotting. Miscarriage, which is clinically defined as the spontaneous loss of a fetus before the 20th week of pregnancy, may have no identifiable cause. Working, sexual activity, and exercise do not affect an early miscarriage. However, recent studies have suggested a link between antibiotic use and miscarriage.

More than 80% of miscarriages occur within the first three months of pregnancy; those that occur after 20 weeks are called late miscarriages or stillbirths. Most miscarriages occur when the fetus is not developing normally. This abnormal development may be due to a chromosomal defect (such as those that cause Down syndrome and other developmental disorders). In fact, half of all miscarriages are thought to occur for this reason.

But moms should not feel responsible for a possible chromosomal defect, as the Mayo Clinic states:

Most of these chromosome problems occur by chance as the embryo divides and grows — not because of problems inherited from the parents.

In some cases, though, health conditions in the mother, like diabetes and uterine disorders, may cause a miscarriage. Women who are over age 35 or who have had three miscarriages have a higher risk of miscarriage, in addition to women with thyroid problems. Women who have suffered more than one miscarriage may wish to have an ultrasound, hysteroscopy, or other test to determine whether uterine issues were a causative factor.

See also: Dad Matters: How a Father’s Genes Affect Baby

Miscarriage Symptoms

Intuition plays a big role in motherhood, even before a baby is born. Many women who have endured miscarriages say that they “just knew something was wrong.” But there are telltale signs to look for.

Bleeding

May be light (i.e., spotting) or profuse. But bleeding doesn’t always mean a miscarriage. Dr. Ingrid Rodi of The Fertility Center in Santa Monica, California, points out that about 30% of pregnant women may bleed. To be safe, women who experience bleeding during pregnancy should seek medical attention.

Pain

Mild discomfort or severe pain may occur in the pelvic area, abdomen, or even the lower back. Some women who have miscarried describe the pain as similar to menstrual symptoms. If you’re experiencing any level of pain, it’s important to see your doctor.

Movement

As a mom-to-be, you’re naturally attuned to the movement and activity of the life inside you. If this movement changes, or suddenly ceases, it could be a sign that you’re miscarrying. Again, if you experience this or any other symptom (or if something “just doesn’t feel right”), then see a doctor.

Types of Miscarriages: Early Miscarriage vs. Pregnancy Loss

An early miscarriage can refer to many events that might not even result in pregnancy loss. Per UC Davis Health’s Department of Obstetrics and Gynecology, the types of miscarriages include the following:

• Threatened miscarriage: This refers to spotting or bleeding in the first trimester. About one-third of all women bleed in the first trimester, and only half of those women miscarry.
• Complete miscarriage: The entire pregnancy is passed from the uterus.
• Incomplete miscarriage: Only some pregnancy tissue has passed, with the rest eventually passing on its own.
• Anembryonic gestation: The embryonic tissue never developed into a fetus or started to develop and stopped.
• Embryonic or fetal demise: The early fetus (at 10 weeks or more) stops developing.
• Missed abortion: The pregnancy stops developing but tissue does not pass out of the uterus for at least four weeks.
• Septic miscarriage: An infection in the uterus that requires urgent medical treatment, which includes antibiotics and suction evacuation of the uterus. The mother will develop a fever and may have bleeding, pain, and a foul discharge odor.

Most miscarriages can go without medical treatment. Our bodies are strong and can bounce back after loss, as difficult as it may be to handle for the time being.

Things to expect if you go through a miscarriage: Vaginal bleeding will occur for 5-7 days after a miscarriage and be similar to a period. Cramping and blood clots about the size of a quarter are normal. However, vaginal bleeding that is heavier than a normal period for 1-2 days, lasts more than 7 days, or soaks a maxipad every hour for 2-3 hours should be seen by a doctor (women also should not wear tampons directly after a miscarriage, or have sex). Similarly, seek medical attention if you have a high fever of above 100.4 degrees Fahrenheit, foul discharge, or severe abdominal pain.

How to Recover After a Miscarriage

Recovering emotionally from a miscarriage is as important as recovering physically. First, acknowledge and honor your loss. Don’t let anyone undermine what you are going through. The loss is very real for you and possibly your partner.

Grief is a process that you need to allow yourself in order to heal. Let go of any feelings of guilt (because it wasn’t your fault!) and immerse yourself in self-care rituals. That might mean a warm bath, a good cry, a support group, some comfort food, or whatever feels best for you. As the doctors at USC Fertility tell us, “one of the treatments that has been proven to improve outcome is good, old-fashioned TLC.”

Physically, you may be feeling less energetic for a while, and your menstrual cycles may not return to regularity for up to 8 weeks. Talk with your doctor and see if it’s a good time to strengthen your body with restorative yoga or other soothing, movement-based therapy. On the other hand, you may prefer to be less active physically as you recover, and that’s fine, too. Honoring your loss also means honoring yourself.

See also: Should I Exercise While Pregnant?

Becoming Pregnant After a Miscarriage

The good news is that miscarriage tends to be an isolated incident that does not recur in most future pregnancies. According to USC Fertility, the chances of women experiencing a second miscarriage range from 14% to 21% (and only about 1% to 4% of women will have two miscarriages in a row). Most women (close to 70%) who have endured even up to three consecutive miscarriages will go on to have subsequent healthy pregnancies and live births.

So, how soon after a miscarriage can you get pregnant? The answer varies according to each woman (by age, medical history, circumstances of the miscarriage, etc.) but in general, most women may start trying after their first menstrual period following the miscarriage. Trying to conceive soon after a miscarriage may actually improve the odds of becoming pregnant. A research study published in the Obstetrics & Gynecology journal found that 70% of women who tried to get pregnant within 3 months after the miscarriage did get pregnant, compared to 51% of women who became pregnant after waiting longer than 3 months.

That said, there are several steps you can take to improve your chances of getting pregnant after a miscarriage:

• Make it a priority to quit smoking if you’re a smoker. Alcohol should also be eliminated.
• Take measures to lower your blood pressure if it’s high. A low-sodium diet and daily walking routine can help.
• Work toward a healthy weight if you’re currently overweight or underweight.

However, the most important measure you can take is to find your peace. This may seem like the most difficult thing after what you’ve been through, so do it in your own way and time, whether it means taking 10 minutes out of your day for a meditative breathing practice or sleeping in on a rainy Saturday morning.

It’s your body, your heart, and your process.