Miscarriage is the spontaneous loss of a pregnancy before 20 weeks. At approximately eight weeks gestation, individuals often seek understanding about the physical signs and progression. This article details the physical aspects of a miscarriage at this stage, including its presentation and management.
Recognizing the Signs
Vaginal bleeding is a common indicator, varying in color from pink to bright red, dark red, or brown, and can also appear black. The bleeding may start as light spotting before progressing to a heavier flow, sometimes described as a gush, often exceeding the typical heaviness of a menstrual period. Along with bleeding, individuals may pass blood clots, which can range in size from as small as a dime to as large as a lemon.
The expulsion of pregnancy tissue is another characteristic sign. At eight weeks, this tissue might appear dark red and shiny, sometimes resembling liver, or present as pink, white, or gray material. The embryo itself is very small at this stage, about the size of a small bean; some individuals might discern a fluid-filled sac among the expelled material.
Cramping and abdominal pain frequently accompany the bleeding and tissue passage. This pain can range from mild discomfort, similar to typical menstrual cramps, to more severe or labor-like contractions. The pain is typically felt in the lower abdomen and may extend to the back. A sudden reduction or complete cessation of pregnancy symptoms, such as nausea or breast tenderness, can also signal a miscarriage.
Understanding the Process
A miscarriage typically unfolds through a sequence of physical events. It often begins with initial spotting and mild cramping, progressing to heavier bleeding and more intense contractions as the body expels pregnancy tissue. The process varies among individuals, but understanding common classifications can provide clarity.
A “threatened miscarriage” is characterized by vaginal bleeding and mild cramping, yet the cervix remains closed. In such cases, the pregnancy may continue without further complications, though close monitoring is often recommended. If the bleeding and cramping intensify and the cervix begins to open, it is termed an “inevitable miscarriage,” indicating that the pregnancy loss is likely to occur.
When all pregnancy tissue has been expelled from the uterus, it is a “complete miscarriage.” After a complete miscarriage, bleeding and cramping generally subside relatively quickly. Conversely, an “incomplete miscarriage” occurs when some pregnancy tissue has passed, but a portion remains within the uterus, leading to continued bleeding and cramping. In some instances, a “missed miscarriage” may occur, where the embryo has ceased developing, but the body has not yet expelled the tissue, often resulting in no noticeable symptoms and discovered during an ultrasound examination.
Medical Care and What to Expect
Seek medical attention if a miscarriage is suspected. Contact a healthcare provider for excessive bleeding, such as soaking two or more sanitary pads per hour for at least two consecutive hours, or if there are signs of infection like fever. Severe pain or the passage of tissue also warrants immediate medical evaluation.
Healthcare providers typically use several methods to confirm a miscarriage and assess the situation. An ultrasound examination can determine if there is a fetal heartbeat, evaluate the gestational sac, and identify any remaining tissue in the uterus. Blood tests, particularly those measuring human chorionic gonadotropin (hCG) levels, help assess the status of the pregnancy, with a low or falling level potentially confirming a miscarriage. A pelvic exam may also be performed to check if the cervix has begun to open.
Based on the diagnosis, several management options are available. “Expectant management” involves waiting for the body to naturally expel all pregnancy tissue, a process that can take days to several weeks. “Medical management” utilizes medication, such as misoprostol, to facilitate the expulsion of tissue, which can speed up the process. For cases where tissue is not fully passed or for other medical reasons, “surgical management” like a Dilation and Curettage (D&C) may be recommended to remove remaining tissue from the uterus.
Caring for Yourself After
Physical recovery following a miscarriage involves managing continued bleeding and discomfort. Lighter bleeding, similar to a period, can persist for one to three weeks after the main event. Mild cramping is also common and can be managed with over-the-counter pain relief medications such as paracetamol or ibuprofen. To minimize the risk of infection, it is generally recommended to use sanitary pads instead of tampons and to avoid sexual intercourse until bleeding has completely stopped.
Emotional well-being is also an important aspect of recovery. Grief is a natural and varied response to pregnancy loss, and acknowledging these feelings and allowing time for healing is important. Seeking support from trusted individuals, such as a partner, friends, or family, can provide comfort. Professional counseling and support groups can offer valuable resources for coping with the emotional impact of a miscarriage.