Early miscarriage is especially difficult. You’re likely settling into the notion that you’re pregnant and then it’s over. You’re sad and confused and, of course, apprehensive about trying again.
An unfortunate statistic is that 50% of pregnancies end in miscarriage, depending on age, and it’s much higher in advanced reproductive age. The majority occur before the 12th week of pregnancy. For some women, a miscarriage happens even before they know they’re pregnant. They attribute the cramping and blood to just a heavy period. But for women who are dealing with infertility and have sought treatment, confirmation of the pregnancy happens very early.
The Causes of Early Miscarriage
When a miscarriage happens in the first 12 weeks of pregnancy, it’s referred to as an early miscarriage. Research attributes more than half of early miscarriages to a chromosomal issue with the fetus. Chromosomes provide the genetic material that determines things like hair, eye color, gender and so on.
The normal fertilized egg contains 23 pairs of chromosomes, an equal number form the mother and father. Chromosomal abnormalities occur when there is an extra, missing or duplicated chromosome. Chromosomal abnormalities cause a host of birth defects, many of them deadly and dire. Other defects inhibit fetal growth, development of the placenta or even prevent an embryo from developing at all.
Sometimes an accident causes a miscarriage, such as abdominal trauma or exposure to toxins. Mothers with certain health conditions are at greater risk for miscarriage. These conditions include thyroid disease, lupus and other autoimmune issues, uncontrolled hypertension, certain viruses, cervical issues, STIs and certain clotting disorders.
What Happens in an Early Miscarriage?
If you begin cramping or spotting, you will need to alert your physician. If they believe you are at risk, you may need to cut back on activity until the doctor confirms the pregnancy is intact. Unfortunately, once your body begins the process of miscarriage, your doctor won’t be able to halt it.
The main goal of treatment during a miscarriage is preventing a hemorrhage, or excessive bleeding, and infection. Your physician will alert you to what indicates a hemorrhage, including soaking one sanitary napkin within an hour, for more than two hours.
Treatment for Early Miscarriage
Very often, especially in early miscarriage, your body passes all of the pregnancy-related tissue on its own. You and your physician may choose the “watch and wait” approach. In this case cramping and bleeding may begin at any time. The cramping is typically much more painful than a period and the bleeding is much heavier. The worst of the miscarriage lasts about eight hours with light bleeding continuing for up to two weeks, possibly starting and stopping a few times. Once heavy bleeding and pain subside you may resume normal activities, but confirm this with your physician.
If the miscarriage is incomplete, meaning there is tissue left behind, you will need treatment to control excessive bleeding and prevent infection. These treatments include:
Dilation and curettage, also known as a D&C, which involves opening your cervix and removing any tissue left behind. Your doctor performs your D&C as surgery, in a clinical setting or hospital, under general anesthesia. This normally takes 15-20 minutes, and in most cases you return to your home to recover. Recovery requires a few days of limited activity but after the bleeding and cramps subside you may resume normal activities.
Misoprostol is a medication used in cases where your body doesn’t expel all the pregnancy tissue, or in cases of fetal demise when the “watch and wait” approach proves ineffective. About 75% of the time the body completes the miscarriage on its own.
At a time you determine with your doctor, you place Misoprostol pills directly into your vagina and you begin passing pregnancy tissue within a few hours. Expect cramping and bleeding. Monitor for signs of hemorrhage. Your doctor will advise you on ways to ease the pain, including ibuprofen and a heating pad.
After your miscarriage and treatment, your doctor sees you for a follow-up visit. At this time, they use ultrasound and/or a blood test to confirm your miscarriage, and treatment is complete. You and your doctor are able to discuss any emotional issues you are experiencing or expect to experience.
When Should We Try Again?
Although in most cases you are physically able to try to conceive again within a few weeks of your pregnancy, it’s common to put another pregnancy off for awhile. You’re probably feeling drained both physically and emotionally and you need some time to grieve and adjust, even if you’re in treatment for infertility.
Your physician understands the trauma a miscarriage causes so discuss anything you’re feeling with them. There is no need to go it alone. Early miscarriages are common for women who conceive on their own as well as those undergoing fertility treatment.
If you have a history of early miscarriage and want to discuss your options for future pregnancy contact LA IVF. Our caring and compassionate team are here to help you realize your dream to grow your family.