Early Miscarriage {Miscarriage and Pregnancy Loss Awareness}

Spontaneous abortion, or miscarriage, is the term used for a pregnancy that ends on it's own within the first 20 weeks of gestation. The medical name spontaneous abortion gives many women a negative feeling, so throughout this series of posts I will refer to any type of spontaneous abortion or pregnancy loss under 20 weeks as miscarriage.

What causes an early miscarriage?
According to the American Pregnancy Association, during the first trimester, the most common cause of miscarriage is chromosomal abnormality - meaning that something is not correct with the baby's chromosomes. Most chromosomal abnormalities are the cause of a faulty egg or sperm cell, or are due to a problem at the time that the zygote went through the division process. Other causes for miscarriage include (but are not limited to):

• Hormonal problems, infections or maternal health problems
• Lifestyle (i.e. smoking, drug use, malnutrition, excessive caffeine and exposure to radiation or toxic substances)
• Implantation of the egg into the uterine lining does not occur properly
• Maternal age
• Maternal trauma

Factors that are not proven to cause miscarriage are sex, working outside the home (unless in a harmful environment) or moderate exercise.

What to expect through the process
In most first trimester miscarriages, the baby stops developing at some point early in the pregnancy. The woman's body then recognizes that the pregnancy is not viable and begins to shed the uterine lining, leading to mild cramping alongside vaginal bleeding -- the most common signs of miscarriage.

The woman's body does not always recognize immediately that the pregnancy is not viable, however, and weeks can pass before miscarriage symptoms appear. If an ultrasound takes place during this time period, the doctor will usually diagnose a missed miscarriage or a blighted ovum (depending on the exact circumstances and assuming the doctor is confident in the dating of the pregnancy).

Your doctor should give you some guidance on what to expect from the testing process and ultimately the treatment, but here is some general information about diagnosis and physical recovery from first-trimester miscarriage.

After diagnosing a pregnancy loss, doctors sometimes offer women a choice of miscarriage treatment. The options are usually to wait for a natural miscarriage, have a D&C, or use medication to bring on the miscarriage bleeding.

If your pregnancy loss involved a medical emergency such as a ruptured ectopic pregnancy or a hemorrhage, you may have had no choice but surgery. But if you do have a choice in your treatment, each of your options has possible pros and cons depending on your situation and personal outlook. Your doctor will go over these with you. 

What to expect afterward
The time right after a pregnancy loss can be filled with a lot of emotions. Just like with the loss of a loved one or family member, the loss of your child can find you tumbling through the different stages of grief. I remember coming home from my D&C and just feeling numb. Not wanting to talk, not wanting to deal with anything. I turned inside and didn't let anyone in. Everyone recovers from the emotional pain differently, no one way is correct or right.

After your miscarriage, you will also be going through physical recovery as well. It takes a few weeks to a month or more to recover physically from a miscarriage. Your recovery will depend on how far along you were into the pregnancy. Some women experience the following physical effects:

• Vaginal bleeding, similar to a menstrual period, may last up to a week after a miscarriage.
• Light bleeding, or spotting.
• Depending on your menstrual cycle, normal periods should resume in 3-6 weeks.
• Lower abdominal pain similar to menstrual cramps may last up to 2 days after the miscarriage.
• Breast discomfort, engorgement or leaking milk; ice packs and a supportive bra may relieve discomfort. This discomfort usually stops within a week.
• Some pregnancy hormones remain in the blood for one to two months after a miscarriage.

You may resume normal activities as soon as you feel able. However, it is wise to ask your doctor for more specific instructions regarding any vigorous or strenuous exercise.

Please remember - you are NOT alone. There are many different support groups out there to help you through this. Please don't hesitate to reach out. Whether it be online, in person or over the phone. There are people out there who want to help you through this. 

Sources: About.com Miscarriage/Pregnancy Loss, American Pregnancy