The following day, May 19, my OB/GYN told me that the results confirmed that I would be having miscarriage. She explained that although the gestational sac had grown to 8mm already, the fetus had not developed inside. She says it's not my fault and it's not because I have done something wrong. She says it just happens. I asked her if it's possible that it's still early and that the fetus could still develop. She says the chances are very slim and she didn't want me to get hopeful and disappointed. When I asked her what I should do next, she gave me three options:
- To wait for it to happen and let nature takes its course. Once my body recognizes that I am no longer pregnant, the body flushes out the tissues from the uterus. I should expect cramping and bleeding anytime during the next few weeks. She told me that if I had excessive bleeding (using more than one pad an hour), I should call her or go to the ER.
- She could give me a medicine called Misoprostol to help out flush the contents of the uterus (it sounded like some form of abortion).
- Undergo a procedure called D & C (dilation and curettage) to fully empty the uterus and make sure no tissues are retained to avoid an infection.
I opted to wait and let nature take its course. In the meantime, I started searching the internet to find as much information as I can. Then I realized that there was so much more the doctor didn't tell me on what I was about to go through.
What is a Miscarriage?
A miscarriage is the loss of a pregnancy during the first 20 weeks. It is usually your body's way of ending a pregnancy that has had a bad start. The loss of a pregnancy can be very hard to accept. You may wonder why it happened or blame yourself. But a miscarriage is no one’s fault, and you can't prevent it.
It is shocking to learn that miscarriages are very common especially in the first three months of pregnancy. I read that about 1 in 4 pregnancies end in a miscarriage. It is even also common for a woman to have a miscarriage before she even knows that she is pregnant.
What causes a miscarriage and how is it treated?
Most miscarriages happen because the fertilized egg in the uterus does not develop normally. A miscarriage is not caused by stress, exercise, or sex. In many cases, doctors don't know what caused the miscarriage.
The risk of miscarriage is lower after the first 12 weeks of the pregnancy. No treatment can stop a miscarriage. As long as you do not have heavy blood loss, a fever, weakness, or other signs of infection, you can let a miscarriage follow its own course. This can take several days.
If you have Rh-negative blood, you will need a shot of Rhogam. This prevents problems in future pregnancies. If you have not had your blood type checked, you will need a blood test to find out if you are Rh-negative.
Many miscarriages complete on their own, but sometimes treatment is needed. If you are having a miscarriage, work with your doctor to watch for and prevent problems.
If the uterus does not clear quickly enough, you could lose too much blood or develop an infection. In this case, medicine or a procedure called a dilation and curettage (D&C) can more quickly clear tissue from the uterus.
Other Risk Factors for Miscarriage
Factors that may increase your risk of miscarriage include:
- Your age, especially at age 35 and older.
- A history of recurrent miscarriage (three or more).
- A history of miscarriages on your mother's side of the family.
- Polycystic ovary syndrome, which can cause ovulation problems, obesity, increased male hormone levels, and an increased risk of diabetes.
- A poorly controlled ongoing disease (such as diabetes or an autoimmune disease).
- Certain bacterial or viral infections during pregnancy.
- A blood-clotting disorder such as antiphospholipid antibody syndrome.
- Problems with the structure of the uterus (such as a T-shaped uterus).
- A history of pregnancy with a birth defect.
- A physical injury.
- Exposure to dangerous chemicals, such as benzene, arsenic, or formaldehyde, before or during pregnancy.
- The father's age, especially beyond age 35.
Other factors that may slightly raise miscarriage risk include:
- Nonsteroidal anti-inflammatory drug (NSAID) use (such as ibuprofen or naproxen) at the time of conception or during early pregnancy.
- Alcohol use during pregnancy.
- Cigarette smoking during pregnancy.
- Cocaine use during pregnancy.
- A snakebite.
- Caffeine use during pregnancy.
- A chorionic villus sampling (CVS) or amniocentesis to test for birth defects or genetic problems. When done by a highly trained provider, one study showed that these tests have a risk of miscarriage of about 1 in 400. Some studies have shown higher risks, between 2 and 4 in 400. This greater risk may be more likely in medical centers with less experienced providers, especially for CVS.
There are also known factors that do not increase the risk of miscarriage, such as exposure to computer monitors or electric blankets, sexual intercourse, and exercise.
Tips In Dealing With a Miscarriage
A miscarriage doesn't happen all at once. It usually takes place over several days (sometimes up to two weeks), and symptoms vary. Here are some tips for dealing with a miscarriage:
- Use pads instead of tampons. You will probably have vaginal bleeding for a week or so. It may be like or slightly heavier than a normal period. It is normal to have mild or moderate vaginal bleeding for up to 14 days after a miscarriage. But the bleeding should not be severe. For most women, passing clots of blood from the vagina and soaking through their usual pads or tampons every hour for 2 or more hours is not normal and is considered to be severe bleeding. You may use tampons during your next period, which should start in 3 to 6 weeks.
- Take acetaminophen (Tylenol) for cramps. Read and follow all instructions on the label. You may have cramps for several days after the miscarriage.
- Eat a balanced diet that is high in iron and vitamin C. You may be low in iron because of blood loss. Foods rich in iron include red meat, shellfish, eggs, beans, and leafy green vegetables. Foods high in vitamin C include citrus fruits, tomatoes, and broccoli. Talk to your doctor about whether you need to take iron pills or a multivitamin.
- Talk with family, friends, or a counselor if you are having trouble dealing with the loss of your pregnancy. If you feel very sad or depressed for longer than 2 weeks, talk to a counselor or your doctor.
- Talk with your doctor about any future pregnancy plans. Most doctors suggest that you wait until you have had at least one normal period before you try to get pregnant again. If you don't want to get pregnant, ask your doctor about birth control options.
- It is important to be alert to the symptoms of a miscarriage so that you can seek medical evaluation. If you are having symptoms of a miscarriage, avoid sexual activity (called pelvic rest) and strenuous activity until your symptoms have been evaluated by a health professional.
- Call 911 or other emergency services immediately if you are pregnant and you have severe vaginal bleeding AND signs of shock.
Early signs of shock include:
- Lightheadedness or a feeling that you are about to pass out.
- Restlessness, confusion, or signs of fear.
- Shallow, rapid breathing.
- Moist, cool skin or possibly profuse sweating.
- Weakness.
- Thirst, nausea, or vomiting.
- Abnormal increase in heart rate.
After a miscarriage, are you at risk for miscarrying again?
Miscarriage is usually a chance event, not a sign of an ongoing problem. If you have had one miscarriage, your chances for future successful pregnancies are good.
It is unusual to have three or more miscarriages in a row. But if you do, your doctor may do tests to see if a health problem may be causing the miscarriages.
Coping with a miscarriage
It is normal to go through a grieving process after a miscarriage, regardless of the length of your pregnancy. Guilt, anxiety, and sadness are common and normal reactions after a miscarriage. It is also normal to want to know why a miscarriage has happened. In most cases a miscarriage is a natural event that could not have been prevented.
To help you and your family cope with your loss, consider meeting with a support group, reading about the experiences of other mothers, and talking to friends or a counselor or member of the clergy.
The intensity and duration of the grief varies from woman to woman, but most women find that they can return to the daily demands of life in a fairly short time. It is important to call your health professional if you have symptoms of depression that last for more than 2 weeks. The loss and the hormonal swings that result from a miscarriage can cause symptoms like postpartum depression.
A healthy, full-term pregnancy is possible for most women who have had a miscarriage, and even after having repeated miscarriages. If you want to become pregnant again, check with your doctor or nurse-midwife. Most health professionals recommend waiting until you have had at least one normal menstrual period before attempting to become pregnant after a miscarriage.
My Experience
A few days after being informed of my miscarriage, I started having light brown spottings. At 4 a.m. of May 26, I woke up from light cramping and a bright red discharge which intensified during the day. I started passing out large tissues/clots of blood which required frequent trips to the bathroom. The bleeding and cramping became so unbearable by 5 p.m. that my whole body felt cold and I felt like throwing up. When I went to the bathroom, I passed on a very large tissue which I thought was the gestational sac.
I took two Advils (200 mg each) which helped the pain subside. I noticed that every time I felt unbearable pain (despite the painkillers), I would pass on large tissues. I tried listening to my body, and learned that whenever I get intense pain or discomfort, it usually meant it wants to get rid of something. So I try to sit and wait for a few more minutes in the bathroom every time. The bleeding and cramping gradually subsided as each day passed. I would experience heavy bleeding and cramping for about an hour or more but I would feel better after each pass.
On the fifth day, around 5 p.m., I felt another intense discomfort and pain so I went into the bathroom and stayed there for a while. A few minutes after, I suddenly felt a gush of large tissue. When I looked at it, I was astonished to see a large sausage-like structure, looking more like the gestational sac, with its end looking like it was detached from something, most likely the uterus. At that instant, I felt a massive feeling of relief and lightness and my stomach felt empty. The cramps and the intense pain were gone.
On June 1, I went to see my OB/GYN and gave her an account of what happened. She did a transvaginal ultrasound and told me that my uterus is already empty and that it was good I had flushed out everything naturally. I was relieved to know there was no retained tissue and I didn't need to have a D & C. She said that the bleeding should subside more in a few days and that I should wait for a couple of months if I decide to try getting pregnant again.
Today I am grateful for being free from pain and recovering from the loss. I feel blessed to have the support of family and friends in helping me go through the process. I learned that maintaining a positive attitude helps the body heal faster.
It's amazing how the human body works and how many of us don't realize that it is a wondrous miracle all by itself.
