What is Miscarriage and Coping with the Loss

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ConceiveAbilities - Surviving A Miscarriage
Miscarriages are tragic events, and they are more common than most people realize. There are often misconceptions regarding what miscarriages are, how they are caused, and what to do if it happens.

What is a miscarriage?

According to the American Congress of Obstetricians and Gynecologists (ACOG), miscarriages (sometimes also called early pregnancy loss) are the “loss of a pregnancy during the first 13 weeks of pregnancy,” or the first trimester.

Miscarriages are surprisingly common. ACOG believes that roughly 10% of known pregnancies end in a miscarriage. Some doctors believe that figure is much higher. “I tell women they’re very common, and potentially up to a third of women will experience a miscarriage at some point in their lives,” says Siobhan Dolan, MD, MPH, professor of Obstetrics and Gynecology and Women's Health at the Albert Einstein College of Medicine and Montefiore Medical Center.

What causes a miscarriage?

Chromosome Count
The most common cause for miscarriage is due to a fetus not developing properly. About 50% of miscarriages are due to extra or missing chromosomes. This usually happens when the embryo divides and grows, independent of the parents’ genetics. It may be caused by damage to the egg or sperm cell.

Maternal Health Condition
Sometimes a miscarriage can occur because of the mother’s health. If she has any infections or diseases (such as Thyroid Disease), the mother’s body may not be able to adequately nurture the fetus. Problems with a woman’s uterus or cervix can also affect the pregnancy.

Lifestyle or Environmental Factors
External factors may also contribute to the risk of a miscarriage. Women with a history of abusing alcohol, caffeine, marijuana, tobacco, or other drugs are at a higher risk of a developmental problem with the fetus. Doctors suggest limiting or avoiding usage of these substances altogether prior to the pregnancy.

Other Risk Factors
There are other potential causes for a miscarriage, such as:

  • Age
  • Chronic conditions
  • History of miscarriages
  • Invasive prenatal tests
  • Structural problems (uterine or cervical)
  • Weight

For a more complete list, check out these pages from Mayo Clinic or RESOLVE: The National Infertility Association.

What are the symptoms of a miscarriage?

Bleeding and cramping are the most common signs of an impending miscarriage. Some other signs include back or abdominal pain. These are also frequent symptoms of early pregnancy, so it’s important to contact your doctor to conduct some tests to be sure. Usually these involve an ultrasound to check the baby’s health or a test for low hormone levels.

What happens after the diagnosis?

Once the doctor confirms the miscarriage, the priority is to empty the uterus. If there was heavy bleeding leading up to the miscarriage, then this usually means that all fetal tissue was cleared. More often, the miscarriage is “incomplete,” meaning that the tissue still needs to be expelled. There are three methods to do this:

Expectant Management
Some women may opt to wait for the pregnancy to expel itself naturally. Expectant management refers to a clinician monitoring a woman’s condition, instead of immediately taking action. This can take anywhere from a few days to a few weeks. After this time, the body should return to its regular menstrual cycle.

Surgery (D&C)
Doctors may also suggest a minor surgical operation where the fetus and placenta are scraped from the uterus. Dilation and curettage, or D&C, allows the woman to know exactly when the process takes place, unlike with medication, which is somewhat unclear.

In more complicated situations, the doctor may need to prescribe medication to assist with the expulsion of the pregnancy. Mifepristone and Misoprostol are just a few examples, but there are various types that can be used. Medication is less intrusive, but also gives you less control compared to D&C.

The best approach depends on a number of factors, such as the relative risk involved and the state of the miscarriage.

Coping with the Loss

While miscarriages may happen frequently, it’s never easy when they do happen. You may experience a range of emotions, from shock and anger, to sadness and confusion. Understand that this is normal, and grieving will not be in any set time frame or particular order. People may react to your miscarriage differently. Some may reveal their ignorance with lines like “you can always have another.” Ignore them. Focus on improving your mental and physical health.

A few suggestions on ways to cope:

Allow yourself some time to heal. Whatever you’re feeling, allow yourself to feel it. Give yourself time. It may take days, it may take months. Only you will know when and how to find peace with it.

Reach out to your friends and family. You’re not alone. Reach out to your parents, to a best friend, to your partner. Though it may be difficult to fully comprehend what you are going through, they will still provide you with the comfort and love that you need.

Find a support group. There are countless support groups available online- women ready to share words of comfort or stories of solidarity. Explore various support groups for more information and guidance.

Additional Support and Resources

If you need more places for information or support, we’ve compiled a few links that may help you or a loved one recover from the trauma of a miscarriage.

  • MISS Foundation - This foundation is a volunteer-based community aimed at counseling, advocacy, research, and education to parents affected by the loss of a child.
  • Faces of Loss - A blog that aims to humanize and support parents affected by miscarriage and stillbirth.
  • Grieve Out Loud - A support group that features various initiatives to help uplift women.
  • Pregnancy After Loss Support - A website full of useful resources, communities, and advice for attempting pregnancy after pregnancy loss.
  • Hope After Loss - An extensive list of websites, blogs, gifts, and books for friends and families looking for upliftment after their loss.
  • If you are considering alternative routes for carrying a child, visit ConceiveAbilities today to learn more about how surrogacy can help bring new hope to your family.