We Know: The Facts About Miscarriage

Am I Having A Miscarriage?

It's early in the pregnancy, and you're having cramping in your abdomen that's growing worse. Or halfway through your second trimester, you stop feeling movement in your uterus. Could you be having a miscarriage?

The main signs are cramping and bleeding, and sometimes even passing small or large blood clots or pieces of tissue. If you've had a baby in the past, you can compare the cramping with the early symptoms of labor. Minor cramping without other symptoms and with no regularity may just mean you need to slow it down a little, while cramps with a rhythm (like labor pains) and cramps while spotting or passing clots probably mean you should seek medical attention.

What Should I Do About A Miscarriage?

Once a miscarriage early in the pregnancy has started, there is rarely anything you can do to save the baby; in most cases, the fetus has already died and your body is just expelling it. Once the cramping has started, rest and make an appointment with your doctor right away. You absolutely should not have sexual intercourse, and heavy exercise can not only ensure you lose the baby, but cause your body damage as well.

When you go to the doctor (which should happen within 24 hours), he/she will probably perform an ultrasound to determine whether the fetus is still viable. He may also test your beta-HCG levels, a hormone that very accurately reveals whether you're pregnant or not. If the fetus is already dead, the doctor will probably recommend a D&C (dissection and curettage) to remove the tissue in your body to make certain the miscarriage is complete and nothing remains inside to sicken you.

At this point, you may want to decide whether to seek counseling. A miscarriage, make no mistake, is the loss of a child, and though it may not seem real to others, it is very real indeed to you and your partner.

What Should I Expect After the Miscarriage?

Both physically and emotionally, miscarriage will impact your life.

• You can expect to have a menstrual-like flow for at least a week afterward. If you had a D&C (a good idea in most cases), the flow will be shorter and lighter.
• You will probably be physically weak for several days, and you will experience soreness just as if you went through childbirth.
• You will almost certainly experience depression, grief, and other emotions.
• You should NOT experience severe pain, though there will certainly be some physical pain. If you have severe pain or abnormal vaginal discharge (mucusy, green, with an offensive odor, or filled with clots), call your doctor immediately.

You may have other questions as well: how long before you can have sex again? When should you try to have another baby? Write these questions down and ask your doctor. In most cases, the answers are that you can have sex about two weeks after most miscarriages or D&Cs, and you can physically try for another baby after your next menstrual period (you may be fertile before then, so watch out). But every person is different, and only a doctor familiar with your specific circumstances can give you the correct answer for you.

Dealing with Emotions

You can expect to have some very strong emotions during and after the miscarriage: anger, grief, disappointment, even clinical depression. In the mother experiencing a loss, this is due at least partly to hormones, but it is also due to the loss of someone you loved.

If you are overwhelmed by your emotions, don't hesitate to seek help. Short-term therapy and perhaps even hormone or drug therapy may help you stabilize your feelings relatively quickly, while ignoring those emotions may cause you to spiral into a real clinical depression, jeopardizing your relationships and perhaps even your life.

When Can We Try Again?

In general, the best time to try again is when the doctor says it's okay. Generally, this is right away, particularly with an early miscarriage, one that occurs within the first trimester. But if you feel emotionally fragile, if you had trouble getting over the miscarriage you just had, or if you and your partner have emotions you need to work through, it's better to wait until you feel stable.

You can improve your chances for a successful pregnancy next time by:

• Quitting smoking if you smoke
• Controlling diabetes
• Avoiding fever over 100 degrees F
• Avoiding exposure to solvents, especially the fumes
• Exercising regularly and taking prenatal vitamins
• Reducing stress and keeping your weight at least near a normal range.

Approximately ninety percent or more of pregnancies following a miscarriage are successful.

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