It is hard to know exactly how many pregnancies end in miscarriage. A rough estimate is 15-20%, but this may be a gross underestimate considering that many women who have a failed pregnancy may not ever know they were pregnant. The only symptom that exists for some women is a period that starts just a few days late.
Most miscarriages occur in the first 12-13 weeks of pregnancy. While we very rarely know exactly what happens, this typically occurs because of a failure in development of the fetus. More than half of all pregnancies lost at this time are caused by problems with the fetal chromosomes. Most factors that cause a miscarriage are genetic and are not affected by anything the mother or father has done. Most of the time this is a sporadic occurrence, cannot be caused or prevented by anything you have done, and is not likely to occur with a future pregnancy.
Things that can increase a risk of miscarriage:
Poorly controlled diabetes
Abnormalities of the uterus or cervix
Alcohol or illegal drug use
Advanced maternal age
Things that do not affect risk of miscarriage:
Signs concerning for possible miscarriage:
Having any of these symptoms does NOT mean you are having a miscarriage. However, these are symptoms that can be early signs of loss and are reasons to call your doctor:
1. Vaginal spotting or bleeding—this occurs in a large majority of normal pregnancies around the time of implantation. About 50% of women who have bleeding do not miscarry. However, bright red bleeding, heavy bleeding, or passage of clots can also be a sign of an abnormality and are reasons to call the office
2. Strong uterine cramping
3. Passage of purple, red, or white-colored tissue
Because bleeding and pain can also be a sign of an ectopic pregnancy, or pregnancy that has implanted in the wrong place, call for any of these symptoms. If you call and are told to come into the office for evaluation, we will often check an ultrasound and possibly labwork. Your doctor may also need to perform an exam to check the cervix.
Even if your doctor does not think that a miscarriage has occurred, you may be asked to rest and to avoid having sex. This has not been proved to prevent miscarriage. However, it may help reduce bleeding and discomfort.
What happens if ultrasound confirms a pregnancy loss, but I haven’t had any bleeding?
Your doctor will discuss treatment options for you based on what is found on exam and ultrasound. These options typically involve expectant management or dilation and curettage. You and your doctor can decide what is best for you.
D&C (Dilation and curettage)
An appointment is made at Flowers Hospital for a procedure to remove tissue from the uterus. This is performed in the operating room, often under general anesthesia. The cervix is dilated and the tissue is then gently removed from the uterus. This is performed as an outpatient and overnight stay is very rarely necessary. Most women will have some cramping, but few require pain medication stronger than ibuprofen. Recovery time is minimal following this procedure.
Can I get pregnant again? Will I have another miscarriage?
Most women can become pregnant as soon as two weeks after a miscarriage. However, we do not typically recommend that. Most women require more time for the body to heal and to complete the grieving process. We recommend that you do not become sexually active until we have given you clearance to do so (typically 4-6 weeks after the miscarriage). If you wish, we can discuss contraceptive options with you to help prevent becoming pregnant right away.
As above, most miscarriages are sporadic and are not an indication that a woman cannot achieve a healthy pregnancy. If you have had several miscarriages in a row, please discuss this with your doctor. You may need further evaluation for this.
Regardless of whether this kind of loss happens at just a few weeks or later in the pregnancy, a pregnancy loss can be very devastating. Our office is here to offer you support. If you need any assistance through the grieving process, please call us.