What is a Miscarriage?

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Miscarriage - What Is a Miscarriage?

A miscarriage is when you lose a pregnancy before 20 weeks. Most happen in the first 12 weeks. It can feel emotionally devastating, or come as a surprise because you didn't realize that you were pregnant. Either way, know that it’s not your fault, and it’s likely that you’ll be able to have a baby in the future.

Signs of a miscarriage can include:

• Bleeding from your vagina that may be heavy
• Pain in your lower belly that feels like really bad menstrual cramps
• Pregnancy signs that were there (such as tender breasts or nausea), are gone

These symptoms can happen for other reasons. But see your doctor to get checked out.

Causes

Most miscarriages are due to things that are out of your control. More than half happen because of problems with chromosomes, which hold the genes that set the baby's hair color, eye color, health, and other features.

Having too many or too few chromosomes can prevent a baby from developing normally. These problems often happen by chance. They're not caused by anything you or your partner did.

Less often, one of these health problems in the mother may make a miscarriage more likely:

• Hormone problems
• Infections
• Uncontrolled diabetes
• Thyroid disease
• Lupus
• Exposure to radiation or toxic chemicals
• Smoking, drinking alcohol, or using illegal drugs

The age at which you get pregnant can also affect your risk. Women in their late 30s or 40s are more likely to miscarry than are younger women. But many women have healthy pregnancies well into their 30s and 40s.

Many things affect your chances of having a miscarriage. It’s often hard for your doctor to know exactly what caused your pregnancy to end.

Diagnosis

If you think you may be having a miscarriage, tell your doctor about your symptoms, including when the bleeding started, how heavy it’s been, and whether you’ve had pain or cramping.

Your doctor will give you a physical exam and use an ultrasound to check on the baby’s growth and heartbeat. You may also get a blood test to check your level of a hormone called hCG (human chorionic gonadotropin). If your hCG level is low or is falling, it may mean that you had a miscarriage. You might need to get more than one ultrasound or hCG test to know for sure.

Will I Need Medications or Surgery?

After a miscarriage, any remaining tissue from the pregnancy should pass from your body. This may happen naturally within about 2 weeks.

If the bleeding hasn't stopped after 2 weeks or if you have an infection, your doctor can give you medicine to make your uterus expel the rest of the tissue. You will have heavy bleeding during this time, and you might have cramps, diarrhea, and nausea.

You might need a procedure called dilation and curettage, or D&C. If so, the doctor will widen your cervix (the opening to your uterus) and then use gentle suction or scraping to remove the remaining tissue.

Recovering From a Miscarriage

The physical recovery can take 1 or 2 months. Your period should start within 4 to 6 weeks. Don’t put anything in your body, including a tampon, and don’t have sex for about 1-2 weeks.

It can take longer for you to heal emotionally, especially if you knew you were pregnant when you miscarried. You might have many different feelings, such as anger and sadness, that can last for some time. Your partner may also have grief that takes a while to recover from.

To help you manage those emotions and feel better, you may want to ask your doctor to recommend a therapist or grief counselor. You might also want to look into a support group. And lean on friends and family whom you feel comfortable telling.

When It's OK to Try Again

Most women who miscarry go on to have successful pregnancies. Ask your doctor how long you should wait before you try to get pregnant again. Some recommend waiting until you've had one to three normal periods. Make sure you also feel emotionally prepared to get pregnant again.

If you've had more than two miscarriages, you and your doctor can talk about what might be going on and the best ways to help you have a baby.

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