The loss of pregnancy before 20 weeks is called a miscarriage. This occurs in 15-20% of all pregnancies.
It is difficult to say what causes all miscarriages, but most pregnancies are thought to be lost because of errors in growth and development such as a chromosomal defect or arrest of growth only days after conception. The use of birth control pills, over-the-counter remedies, exercise, sex or stress cannot cause a miscarriage.
The loss of the viability of the pregnancy usually occurs between 6 and 10 weeks of pregnancy. Recognition of the loss of pregnancy may not occur until many weeks later. The course that you take now will depend upon your current condition, desires, the size of the pregnancy and your doctor’s recommendations.
A MISCARRIAGE AT HOME
You will first note some spotting and mild cramping that signals the fact that your body has begun to expel the tissue of the pregnancy. The cramping and bleeding will increase until the cervix has sufficiently dilated to push the tissue out. During the miscarriage, you may bleed heavily, soaking a pad every 10 minutes. The cramping can be quite uncomfortable. Tylenol is okay to use. Avoid aspirin or ibuprofen until the miscarriage is complete.
While you are bleeding heavily you may want to sit on the toilet. A pillow at your back for support, a heating pad on your abdomen and something to drink. Soon you will pass a couple of clots that may be quite large. After this the cramping will ease up considerably and the bleeding slow down, signaling that you have passed the tissue of the pregnancy. It is not necessary to collect anything that is passed.
You can call the office anytime for direction and advice. If you are soaking pads every 10 minutes for more than two hours, then please do call the office for direction or go to the emergency room at Good Samaritan Regional Medical Center at 12th street and McDowell.
Office number: 602-241-1671.
A D & C AT THE HOSPITAL
A D&C is a surgical procedure performed under general anesthesia to remove the tissue of the pregnancy from the uterus.
Although the procedure is quite brief, you will wake up sleepy from the anesthesia. About an hour after you wake up, you may go home. You may want to return to bed to sleep the remainder of the day. Most women are able to return to light activity the following day. Cramping and bleeding is common after a D&C. You may bleed for up to three weeks.
During your recovery, you will continue to bleed, on and off, for up to 3 weeks. Some minor cramping will continue in the next few days also. We recommend that you not put anything into the vagina during your recovery, to reduce the risk of infection. No tampons, tub baths, douching or intercourse until the bleeding has resolved for a week.
Exercise will increase the blood loss, so light activity in the first few days will minimize bleeding.
Although cramping, bleeding and occasional clotting is normal after both a miscarriage and a D&C, you should not be soaking more than 2 pads an hour nor experience worsening, exquisite pain after the uterus has been emptied. These are important symptoms to report to you doctor.
Other things to call about:
- Fever greater than 100
- Nausea and vomiting for more than 12 hours
- Steadily increasing amount of bleeding or pain.
- Foul smelling vaginal discharge.
COPING WITH THE LOSS
Emotional healing can take longer than physical healing. Grief can involve a wide range of feelings which is a normal response to pregnancy loss. During this recovery you may experience a loss of appetite, emotional changes and irritability, sleep disturbances and inability to focus on daily tasks. Although these symptoms are normal, they should gradually resolve in the weeks and months to come.
Since you have been more intimately involved in the pregnancy than your partner, his feelings may be quite different from yours. Since he didn’t experience the pregnancy first hand as you have, these feelings are understandable.
Others in your life can be less than supportive with comments such as "you can always get pregnant again." Although statements such as these may not be very helpful, these people do care about you and are trying to voice their support, but just don’t have the right words.
If feelings of grief and loss are disturbing your life, you can talk to your doctor, a counselor or attend a support group.
THE NEXT PREGNANCY
You next period should arrive in 4 to 6 weeks after a pregnancy loss. We recommend that you not try to conceive for two months following the loss of pregnancy. Allow the uterus to heal and return to normal size and prepare for the next pregnancy. Continue your prenatal vitamins. Let us know if you need help with birth control during this time.