Miscarriages
are far more common than many people realize. In fact, up to 20 percent of
pregnancies end in miscarriage, defined as the loss of a fetus before the 20th
week of pregnancy (after 20 weeks, it is
called a stillbirth). Just because they are common, however, does not make them
easy.
Most miscarriages occur before the seventh
week of pregnancy. This means that you may miscarry before you even realize you
are pregnant and think you are just having a heavier than normal period. But if
you know you are pregnant or are further along in the pregnancy, a miscarriage
may feel like a devastating loss.
Physical experience
Typically, most miscarriages, especially
those early in a pregnancy, do feel like a heavy period, including cramping and
discomfort. The duration is typically longer, as it can take a few days to a
few weeks for the body to clear the uterus.
Physically, this is a very important part of
the process. In order to resume your normal menstrual cycle and for your
overall health, we need to make sure the miscarriage is complete. Sometimes
this means allowing nature to take its course; other times, we may prescribe
medication to move things along, or recommend dilation and curettage, commonly
called a D&C, a procedure in which we gently remove the contents of the
uterus. There are several factors we consider with you before recommending how
to proceed.
If you’ve miscarried, we’ll typically advise
you to avoid strenuous activity, intercourse, and insertion of anything into the
vagina, such as a tampon, for a couple weeks afterward. We’ll want to see you
for a follow-up appointment a few weeks after the miscarriage, or sooner if you
experience signs of an infection including excessive bleeding or abdominal
pain, fever and chills, or a foul-smelling discharge.
If you have a D&C, it may be possible to
tell the miscarriage happened. Even if this is not the case, a miscarriage or
two is not a sign in and of itself that you can’t successfully carry a
pregnancy. If you experience multiple miscarriages without a clear cause, we
can run tests to determine if there is an underlying issue.
Emotional experience
Beyond the physical outcome of a miscarriage,
you can expect a range of emotions, including denial, anger, guilt and
depression. It’s normal to undergo all the stages of the grieving process, even
if the pregnancy wasn’t planned. Every woman experiences this loss differently.
There is no one way or right way to feel. The passing of time often helps, but if
you find yourself struggling with depression, let us know as we may be able to
help or provide a referral for counseling.
The good news is that most of the time,
having a miscarriage does not indicate a problem with your ability to carry a
pregnancy to term. Often, women experience a loss between other perfectly
healthy and successful pregnancies.
