What is a Miscarriage?
Miscarriage is a heartbreaking loss that many couples endure. Many women are left wondering if it was something they did wrong or if they will still be able to have a child. The doctors and staff at Cherokee Women’s Health Specialists are here for you to answer any of your questions and guide you along the way.
A miscarriage is the loss of a baby before the 20th week of pregnancy. About 15-25% of recognized pregnancies will end in a miscarriage. More than 80% of miscarriages occur within the first three months of pregnancy. Miscarriages are less likely to occur after 20 weeks’ gestation, which are termed late miscarriages.
Listed below are some common questions about miscarriage to help you understand the signs, causes, and treatment options.
What Are the Symptoms of a Miscarriage?
Symptoms of a miscarriage include:
- Bleeding which progresses from light to heavy
- Severe cramps
- Abdominal pain
- Back pain
If you experience the symptoms listed above, contact your physician right away. He or she will tell you to come in to the office or go to the emergency room.
What Causes Miscarriage?
Most miscarriages happen when the unborn baby has fatal genetic problems. Usually, these problems are unrelated to the mother.
Other causes of miscarriage include:
- Medical conditions in the mother, such as diabetes or thyroid disease
- Hormone problems
- Immune system responses
- Physical problems in the mother
- Uterine abnormalities
- Drug or alcohol abuse
A woman has a higher risk of miscarriage if she:
- Is over age 35
- Has certain diseases, such as diabetes or thyroid problems
- Has had three or more miscarriages
A miscarriage sometimes happens because there is a weakness of the cervix, called an incompetent cervix, which cannot hold the pregnancy. A miscarriage from an incompetent cervix usually occurs in the second trimester.
There are usually few symptoms before a miscarriage caused by cervical insufficiency. A woman may feel sudden pressure, her “water” may break, and tissue from the fetus and placenta may be expelled without much pain. An incompetent cervix can usually be treated with a “circling” stitch in the cervix in the next pregnancy, usually around 12 weeks. The stitch holds the cervix closed until it is pulled out around the time of delivery. The stitch may also be placed even if there has not been a previous miscarriage if cervical insufficiency is discovered early enough, before a miscarriage does occur.
How Is a Miscarriage Diagnosed and Treated?
Your doctor will perform a pelvic exam, an ultrasound test and blood work to confirm a miscarriage. If the miscarriage is complete and the uterus is empty, then no further treatment is usually required. Occasionally, the uterus is not completely emptied, so a dilation and curettage (D&C) procedure is performed. During this procedure, the cervix is dilated and any remaining fetal or placental tissue is gently removed from the uterus. As an alternative to a D&C, certain medications can be given to cause your body to expel the contents in the uterus. This option may be more ideal for someone who wants to avoid surgery and whose condition is otherwise stable.
Blood work to determine the amount of a pregnancy hormone (hCG) is checked to monitor the progress of the miscarriage.
When the bleeding stops, usually you will be able to continue with your normal activities. If the cervix is dilated, you may be diagnosed with an incompetent cervix and a procedure to close the cervix (called cerclage) may be performed if the pregnancy is still viable. If your blood type is Rh negative, your doctor may give you a blood product called Rh immune globulin (Rhogam). This prevents you from developing antibodies that could harm your baby as well as any of your future pregnancies.
Can a Miscarriage Be Prevented?
Usually a miscarriage cannot be prevented and often occurs because the pregnancy is not normal. If a specific problem is identified with testing, then treatment options may be available. Your doctor will discuss any treatment options with you.
How Long Will I Have to Wait Before I Can Try Again?
Each patient is different, so discuss the timing of your next pregnancy with your doctor. Your doctor may recommend waiting a certain amount of time (from one menstrual cycle to 3 months) before trying to conceive again. To prevent another miscarriage, your health care provider may recommend treatment with progesterone, a hormone needed for implantation and early support of a pregnancy in the uterus.
Taking time to heal both physically and emotionally after a miscarriage is important. Above all, don’t blame yourself for the miscarriage. Counseling is available to help you cope with your loss. Pregnancy loss support groups may also be a valuable resource to you and your partner. The staff at Cherokee Women’s Health Specialists can provide you with more information about these resources.
Read Our Patients’ Stories of Miscarriage and Hope
Sheila suffered multiple multiple miscarriages, then gives birth to her healthy baby boy Samuel, her miracle rainbow baby.
Jamie shares her story of loss and healing and how seeking — and giving support — helped not only other women, but herself as well.
You may find the following resources helpful in your recovery process:
H.E.A.R.T. Strings Support Group – Hope, Empathy, Alliance, Resources and Teamwork