For many parents, after the initial joy of a positive pregnancy test begins to wear off, a sense of dread can begin to set in. It’s not the idea of parenthood that scares us so much, but the thought of losing a pregnancy. With the an estimated 26% of all pregnancies end in miscarriagethis anxiety is understandable.
Pregnancy can have many symptoms, and you can assume the worst with every new ache or pain you experience when you’re expecting—especially if you’re not sure how to spot the signs of a miscarriage. Even if you know the symptoms of pregnancy loss, you may feel anxious as you think about the following steps if you should find yourself in this position.
To help provide a clear understanding of what to do in the event of a miscarriage, we reached out to experts Jian Jenny Tang, MDan assistant professor of obstetrics, gynecology, and reproductive science at the Icahn School of Medicine at Mount Sinai in New York, and Steffanie Wright, MD, MPH, MS, an OB-GYN at Weill Cornell Medicine in New York. Together, they share insight into pregnancy loss symptoms, treatment, pain management, and more.
When Can Miscarriage Happen?
According to Dr. Wright, “[Miscarriages] can occur at any time in pregnancy but is most common in the first trimester.” In fact, it is estimated approximately 80% of all pregnancy losses occur in the first 12 weeks.
said Dr. Miscarriages can occur at any time during the first 20 weeks of pregnancy (a loss after 20 weeks is considered a stillbirth). However, they usually occur during the first six to eight weeks of pregnancy.
said Dr. Tang, “The most common cause of pregnancy loss is abnormal chromosomes, also known as fetal aneuploidy,” which can be either presence or absence of one or more chromones.
Common Miscarriage Symptoms and What to Do If You Experience Them
“The most common [pregnancy loss] the symptoms are cramping and bleeding,” said Dr. Wright, “but it can vary from person to person.” In terms of how much blood indicates a miscarriage, the American College of Obstetricians and Gynecologists (ACOG) states that “light bleeding in early pregnancy is normal and does not mean you will miscarry.”
In addition to cramping and bleeding, Dr. However, “loss or reduction of pregnancy symptoms, such as nausea, vomiting, breast tenderness, or fatigue” can also be signs of miscarriage. Finally, said Dr. Wright in some cases, “Patients may not experience any symptoms and then find out they have experienced a miscarriage at their prenatal appointment.”
Stressed by Dr. Tang and Dr. Wright says that if you experience any bleeding or any other possible miscarriage symptoms at any point during pregnancy, it’s important to contact your health care provider to determine next steps. “Medical advice does not change based on gestational age,” said Dr. Tang.
When to Seek Emergency Care
In some cases, severe symptoms may prompt your OB-GYN to direct you to the nearest emergency department, including heavy vaginal bleeding or signs of infection, according to Dr. Tang. “Heavy vaginal bleeding often means you’re passing golf ball-sized blood clots or soaking through the top of a sanitary pad every hour for two to three hours,” she explains. Signs of infection may include “fever, severe lower abdominal pain, foul-smelling vaginal discharge, low blood pressure, feeling faint, or dizziness.”
Dr. added. Wright says that second- or third-trimester miscarriage symptoms usually require emergency care (more on that later) and that you should head to the nearest emergency room if you’re experiencing “severe pain.”
Miscarriage Treatment and Intervention
How a miscarriage is treated or managed depends on factors such as how far along an expecting parent is, the severity of symptoms, and how the body handles the situation on its own. The first step is usually a sonogram to “confirm the diagnosis,” says Dr. Tang. Once your provider has verified that you are experiencing pregnancy loss, Dr. Wright, “The three most common methods of management include expectant management (watchful waiting), medical management with a combination of drugs, or surgical management.”
Basically, explained Dr. Tang, “If the patient prefers less invasive or more natural [treatment] approach, expectant management is safe for patients with miscarriages under six weeks [gestation], with timely follow-up.” However, this method is not recommended for loss after 12 weeks of pregnancy, because it “will increase the risks of bleeding and infection; therefore, the surgical approach is better.” Finally, he says, drug management is “highly effective for miscarriages under eight weeks.”
In the case of medication management, Dr. Your provider will have you take two different medications within 24 to 48 hours to help the body completely release the remaining tissue. This regimen includes medications mifepristone and misoprostol. It is important to note that although, in this case, these drugs will be used to treat miscarriage, because of the Supreme Court. overturned Roe v. Wade in 2022whether you have access to these drugs during a miscarriage depends on abortion laws in say where you are receiving treatment.
Pregnancy loss surgery management helps to ensure that there is no tissue left in the body after a miscarriage. According to Dr. Wright, patients undergoing this treatment are likely to develop a dilation and curettage (D&C) if the loss occurs in the first trimester or dilation and evacuation (D&E) if the loss occurs in the second or third trimester.
Miscarriage Recovery
There are two parts to miscarriage recovery: physical and emotional.
In terms of physical healing, Dr. Wright advises patients to take Ibuprofen or Tylenol. , warm compresses, and rest. said Dr. Only these drugs can help patients manage common side effects, including nausea and vomiting.
The Emotional pain often goes beyond the physical, with parents experiencing a wide range of emotions, including depression, anxiety, and even post-traumatic stress disorder (PTSD), according to Dr. Tang. “We teach patients coping techniques like meditation, breathing, and journaling” to help them process their feelings. Additionally, emphasizes Dr. Tang and Dr. Wright the importance of support and community during this time. “After a miscarriage, I always encourage patients to lean on their friends and family,” says Dr. Wright, adding, “Unfortunately, miscarriage is very common, and you may be surprised to find a friend or family member who has gone through a similar experience.”
There’s no timetable for emotional recovery after a pregnancy loss—you may be ready to try again right away, or it may take several months (or longer). No matter how long, if you decide to try to conceive after a miscarriage, Dr. Tang and Dr. Wright that most patients who experience pregnancy loss go on to have successful subsequent pregnancies.
