There are few things as heartbreaking as experiencing a miscarriage—whether or not a pregnancy was planned.
While miscarriage, medically termed a “spontaneous abortion”, is a natural pregnancy loss, it is often marked by feelings of shame, sadness, fear, and even anger—feelings which are further amplified by natural hormonal shifts. Your feelings are valid, and we grieve with you.
We hope to bring clarity to your questions and fears following the loss of a pregnancy within the first 20 weeks, including:
- Why miscarriage happens
- What a miscarriage is like
- What to do after a miscarriage
If you are ready, take a breath and read on.
Why miscarriages happen
Ten to twenty percent of known pregnancies end in miscarriage. However, the true percentage is likely higher because many occur before pregnancies are confirmed. Women who actively chart their menstrual cycles (such as through a natural family planning or fertility-awareness-based method) may be more likely to notice early pregnancy losses.
Although a miscarriage doesn’t feel like a natural occurrence, it’s often your body’s way to release a pregnancy that is not viable, usually due to chromosomal abnormalities.
Miscarriage can happen to any mother. However, certain risk factors can increase the risks to your pregnancy. These factors include (but are not limited to):
- Age (35 years of age or older)
- Weight (underweight or overweight)
- Habits (smoking, alcohol, or drug use during pregnancy)
- Medical conditions (such as high blood pressure, diabetes, some STDs, and obesity)
- Pregnancy involving multiples
- Previous pregnancy losses
Warning signs of a miscarriage
Knowing the signs of an oncoming miscarriage may help you to know what to expect and when to seek medical care.
Most miscarriages occur before the 12th week of pregnancy. Indications of a miscarriage include:
- Vaginal spotting or bleeding
- Sharp abdominal pain
- Lower back pain
- Fluid or tissue passing from your vagina
It’s worth noting that most women who see spotting during the first trimester end up having healthy pregnancies. However, if you are having bleeding or a combination of symptoms, it’s important to get in touch with your medical provider.
What to do if you think you may be having a miscarriage
If you believe you may be experiencing a miscarriage, it’s important to take care of your body as well as your mental health.
Contact your medical provider. You may need to go in for an appointment if you have not passed all of the tissue or if the miscarriage is unconfirmed.
If you have passed tissue, put it in a clean container and bring it to your appointment with a healthcare provider.
Write down any questions you have.
If you can, ask a supportive friend or family member to accompany you to your appointment.
At your appointment, your practitioner may perform an ultrasound, pelvic exam, and/or blood test to confirm that you have experienced a miscarriage and see if the miscarriage is complete.
What to expect when having a miscarriage
Pregnancy loss will look different in each trimester. Once a miscarriage has begun, it cannot be stopped because the fetus has already passed away. The body knows that it must expel all pregnancy tissue and has begun this process.
Chemical Pregnancy
For a very early pregnancy loss, you may not have known that you were pregnant and may assume that you are having a heavy period.
1st Trimester Miscarriage
For a first trimester loss, you can expect painful vaginal bleeding and cramping to last from a few hours to two weeks, and in some cases longer. Depending on how far along your pregnancy was, you may notice the fetus when you pass tissue. You are likely to be able to pass all tissue without medical help, but it’s still a good idea to contact your medical provider.
2nd Trimester Miscarriage
For a second trimester loss, you will experience painful vaginal bleeding and cramping. The fetus and placenta will probably be apparent when the miscarriage is complete. Contact your provider to discuss to confirm the miscarriage systems and choose how you will manage the pregnancy loss.
After 20 weeks a pregnancy loss is considered a stillbirth which you can read more about here.
Miscarriage Procedure Choices
If you have had an incomplete miscarriage, it’s essential to take medical action to prevent further complications, such as infection. You may have up to three options, depending on your situation:
Watchful waiting: you give your body time to pass the tissue in its entirety (7-14 days)
Dilation and Curettage (D&C) surgery: a surgery in which the doctor removes any remaining tissue from the uterus
Misoprostol: a drug that induces the uterus to contract and expel tissue
What happens after a miscarriage
After a pregnancy loss, there are many details one has probably not thought about because you never expected to deal with a pregnancy loss.
You may be wondering, “Can I bury my baby? Will I get a death certificate after a miscarriage?”
Death certificates after miscarriage are part of state record systems, and some parents also find that they bring a sense of closure to the experience. Whether or not you receive one can depend on the length of gestation (usually 20 weeks) or the weight of the fetus, but this varies by state.
A few states require a death certificate regardless of length or weight. You can visit the CDC’s website to see what your state requires.
Burial policies vary from state to state. You are allowed to give your baby a burial, although you may not be informed of this and may have to request the remains within a certain time frame. You might have to navigate regulations to request remains after a miscarriage in the hospital, so don’t hesitate to discuss this process with your doctor. Some states allow hospitals to remove the remains of an early miscarriage without the burial/cremation process, while others do not.
Depending on the length of your pregnancy, you may be required by the state to go through a funeral home for the burial or cremation process. Some states allow the remains of a miscarriage to be buried on private property, while others require all burials to be in a cemetery. Appropriately-sized caskets are available for burials, and if you are a person of faith you may be able to hold a memorial service or funeral with your faith community.
You deserve support
Your pregnancy losses do not make you less of a mother or less of a woman. This is a difficult time both physically and emotionally. For mental health support, seek out counseling and supportive loved ones. Allow yourself to feel whatever emotions well up inside without guilt or self-condemnation.
Remember that even when you walk through unimaginable darkness, your future is bright.
The content on She Might is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on the She Might Website.