Miscarriage is never a simple experience. It can be sudden and shocking, difficult and painful, or stealthy and silent. But it always leaves the sufferers with the most intense of feelings — anger, frustration, doubt, hopelessness, and sadness are some — and a loss that is profound and lasting, not to mention countless questions about miscarriage that seemingly have no answers.
Know that you are not to blame for your pregnancy loss. It can happen even if you have the best doctors and excellent prenatal care. According to the National Health Service (NHS), about one in every eight known pregnancies will end in miscarriage, and most miscarriages cannot be prevented.
One of the best ways to prevent a miscarriage, know that it is happening to you, or recover from one, is to educate yourself about this rather common pregnancy risk.
Dr. Patricia Evelyn P. Palaypayon is a seasoned obstetrician-gynecologist and an occupational health and safety physician at the Ospital ng Palawan in Palawan, Philippines. In this article, she provides the answers to some common questions about miscarriage, including symptoms, and the recovery stage.
12 Frequently asked questions about miscarriage
What is miscarriage and what are its main symptoms?
Miscarriage or as we call it, spontaneous abortion, refers to loss of pregnancy from whatever cause before the foetus is capable of extra-uterine life. The main symptoms are delayed menses, vaginal bleeding, and cramps or lower abdominal pain.
How will I know if it’s just bleeding/spotting or if I’m already miscarrying?
If there is bleeding or spotting only, the probable diagnosis would be a threatened miscarriage. Miscarriage is classified based upon the location of the foetus and the placenta, and the degree of cervical dilation, which is determined by a pelvic examination. A pelvic ultrasound often helps, too, to define the position of the foetus and the placenta.
Can I lose the baby even if I don’t feel pain or show signs of miscarrying?
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Yes. Many women don’t even know that they’ve had a miscarriage (since they hadn’t known they were pregnant to begin with), thinking that it’s just heavy menstruation. Lower abdominal pain can likewise be mistaken for dysmenorrhea, when the miscarriage is already happening.
What causes a missed or silent miscarriage?
The causes of miscarriage are not fully known. About 50% happen because of the wrong number of chromosomes. Sometimes, miscarriage is caused by a uterine problem such as scarring. Physical trauma can be a cause as well.
What is an incomplete miscarriage?
A miscarriage is labelled incomplete if bleeding has begun and the cervix is dilated, but tissue from the pregnancy still remains in the uterus. This happens when the fertilised egg in the uterus does not develop normally.
Can I still miscarry in the second trimester of pregnancy?
Yes. Remember that the first trimester is the first three months of pregnancy, and the second trimester is the fourth to sixth month of pregnancy. It is called a late miscarriage when a baby dies between 14 and 24 weeks of pregnancy.
When should I go to the doctor and have a scan?
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You will need several scans as your pregnancy progresses: an early pregnancy ultrasound at six to eight weeks to confirm the viability of the foetus, a dating ultrasound at 10 to 13 weeks to calculate the estimated due date, a nuchal translucency ultrasound at 14 to 20 weeks to measure the thickness of the fluid build-up at the back of the developing baby’s head and to screen for abnormalities, and an anatomical survey ultrasound at 18 to 20 weeks to find out the sex of your baby (if you want to know) and to take measurements of the baby’s different body parts. Make sure to show up to your appointment and follow your doctor’s schedule for check-ups and scans, and to ask him/her about any pregnancy-related problems or concerns you have.
Can ultrasound scans harm the baby?
No, having an ultrasound won’t affect your baby. An ultrasound sends sound waves through the womb (uterus) which bounce off the baby’s body, so the sonographer or the ultrasonologist can see the baby’s position and movements.
How soon after a miscarriage can I have sex and try to get pregnant again?
It is safe to resume intercourse once the bleeding has stopped. The most common recommendation for the next pregnancy is three to six months after miscarriage.
When will my period return?
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After a miscarriage, women will have their period within four to six weeks. But it may take as long as two to three months before menstruation returns to normal.
What is a recurrent miscarriage?
Recurrent miscarriage, also called habitual abortion or recurrent pregnancy loss, is two or more failed clinical pregnancies confirmed by ultrasound/sonographic or histopathological examination before the 20th week from the time of the last menstruation period. It is different from infertility as infertility is the inability to conceive.
What is the best way to recover after a miscarriage?
- Give yourself a chance to heal both physically and emotionally.
- Refrain from having sex until the bleeding has stopped.
- Use sanitary pads for the first 24 hours.
- Discuss your recovery and birth control options with your doctor.
- Take all prescribed medications.
- Seek support from others (like family, friends, and fellow mums).
- See a therapist if necessary.
Were these answers to commonly asked questions about miscarriage helpful? Share with someone you know who might need to hear this.
