Miscarriage is the spontaneous loss of a pregnancy, a common and often difficult experience. It is not the fault of the individual, as it occurs for various reasons beyond anyone’s control.
Understanding Miscarriage Timing
Miscarriage refers to the loss of a pregnancy before 20 weeks of gestation. Most miscarriages, approximately 80%, occur early in pregnancy, specifically within the first trimester, which is before 13 weeks. These are often termed “early miscarriages.” The risk of pregnancy loss decreases significantly after the first trimester.
A “late miscarriage” occurs between 13 and 20 weeks of gestation, during the second trimester. While impactful, late miscarriages are much less common than early ones, affecting between 1% and 5% of pregnancies. Pregnancy loss that occurs after 20 weeks of gestation is medically classified as a stillbirth, not a miscarriage.
Factors Contributing to Miscarriage
The causes of miscarriage can vary depending on the gestational stage. In the first trimester, the most frequent cause is related to chromosomal abnormalities in the developing fetus. These issues, such as having an incorrect number of chromosomes, prevent the fetus from developing properly. Over 50% of first-trimester miscarriages are attributed to such genetic irregularities.
For miscarriages occurring later in pregnancy, between 13 and 20 weeks, chromosomal problems can still be a factor, but other causes become more prevalent. These may include structural abnormalities of the uterus, such as an unusually shaped womb or a weakened cervix, also known as cervical insufficiency. Severe infections affecting the mother or the amniotic fluid can also lead to later losses. Certain chronic health conditions in the pregnant individual, like uncontrolled diabetes, high blood pressure, or thyroid disorders, can increase the risk of miscarriage, especially if not well-managed.
Recognizing Symptoms and Seeking Medical Attention
Recognizing the signs of a miscarriage is important for seeking timely medical care. The most common symptoms include vaginal bleeding, which can range from light spotting to heavy flow with blood clots or tissue. Abdominal cramping and pain, often more intense than menstrual cramps, are also frequent indicators. Some individuals may also notice a decrease in common pregnancy symptoms, such as nausea or breast tenderness.
If these symptoms occur, contact a healthcare provider promptly. Medical professionals conduct an ultrasound to check for a fetal heartbeat and assess the pregnancy’s development. Blood tests to measure human chorionic gonadotropin (hCG) levels, a pregnancy hormone, may be performed, with repeat tests to observe changes. A pelvic exam might be done to check if the cervix has begun to open.
If a miscarriage is confirmed, several management options are available. Expectant management involves waiting for the pregnancy tissue to pass naturally. Medical management uses medication to help the uterus expel the tissue. Surgical management, such as a dilation and curettage (D&C), removes tissue from the uterus.
Coping and Healing After Miscarriage
Recovering from a miscarriage involves both physical and emotional healing. Physically, individuals can expect vaginal bleeding, similar to a menstrual period, which may last for several days to a few weeks. Cramping and abdominal pain are common as the uterus contracts to return to its normal size. Most individuals find their menstrual cycle returns to a regular pattern within four to six weeks.
Emotionally, a miscarriage can bring a wide range of feelings, including grief, sadness, anger, and guilt. These feelings are a normal part of the grieving process. Allowing oneself to grieve and acknowledging these emotions is an important step in healing. Seeking support from partners, friends, family, or support groups can provide comfort during this time. Professional counseling is an option for those who find the emotional impact particularly challenging to navigate.