I was 27 when I miscarried my very first pregnancy. To this day, I can feel the dread melting over me as I felt my bleeding pick up. Across from me, my new coworker stabbed his penne entree with vigor, talking excitedly about clients and commissions. He was oblivious. It was my third day on the job. Once the shock wore off, I realized I should probably do something...but, what? I had no idea what I could or should do to handle the situation, short of panic-texting my husband and begging him to leave work early. According to the March Of Dimes, 10-15% of women who know they’re pregnant will experience a miscarriage. If I was so woefully unprepared, I’d venture most miscarrying women feel similarly.
Before we dive into this: I am not a doctor, this article cannot replace actual medical advice, and is in no way intended to be used as medical advice or diagnostics.
Symptoms Of A Miscarriage
The most obvious symptom of miscarriage is bleeding; but is it really that obvious? Bleeding, or more specifically, spotting is fairly common in pregnancy. Some mothers even bleed throughout their pregnancy and deliver a healthy, full-term baby! So how can you tell the difference between acceptable spotting and a miscarriage? Typically, brownish blood is “old” - it’s not a sign of an active bleed. When bleeding increases or the blood is bright red, it may be a signal that a miscarriage is impending or actively happening. NOTE: If you are soaking a pad in less than two hours, seek immediate medical attention for a possible hemorrhage.
Physically, early miscarriages feel like a particularly awful period. Cramps (which are really mini-contractions) are common, in addition to bleeding, nausea, and passing fetal tissue. If you prefer, you may collect any fetal tissue you pass in a clean container to take to your hospital or care provider for testing. Psychologically, miscarriage can lead to a range of feelings and emotions. The hormonal shifts can worsen mood swings and create a sense of mental instability. Of course, seeking care for a miscarriage is not purely a physical endeavor. Therapy, support groups, and sharing with loved ones can help ease the burden of miscarriage.
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Seeking Medical Care During Miscarriage
If you are under the care of a primary care physician or an OB-GYN, contact them to describe your symptoms. They may suggest you wait at home for an early appointment the following day. Others may recommend you go to an emergency room. Ultimately, the choice is yours.
Understand that if you do visit an emergency room or urgent care other patients may be seen before you. In the context of medical emergencies, doctors treat miscarriage as...well, non-emergent. That’s because nothing can be done to stop a miscarriage once it starts; the focus shifts to managing symptoms and preventing complications. Typically, emergency rooms can perform an ultrasound and a blood draw. Ultrasounds are not usually a reliable way to determine if a miscarriage has occurred, so the blood draw is the most definitive tool. However, the blood draw must be repeated 24-72 hours later to compare HCG levels. Emergency care providers will typically refer you to a lab or your own physician for the second test, and that provider will deliver your results.
Treatment Options For Miscarriage
There are essentially three options for responding to a miscarriage. None of these treatments are focused on preventing or stopping the miscarriage; they all deal with the aftermath. If the miscarriage is incomplete, remaining fetal tissue can cause infection and even maternal death. In order to prevent these complications, some doctors prefer to use more intervention in miscarriage management.
Watch & Wait
You can wait for the miscarriage to progress naturally. Bleeding can last for weeks but is generally light after the first day. The key here is to make sure you show no signs of illness and to eventually confirm the miscarriage with an HCG level of zero.
Often doctors will prescribe hormone pills that will help complete a miscarriage more quickly. Misoprostol pessaries can be administered vaginally to induce more powerful contractions and cervical dilation. These changes help the body more effectively expel fetal tissue.
Some doctors use a D&C, or dilation and curettage, to confirm a completed miscarriage. However, the procedure can also be used to remove remaining fetal tissue from a partial miscarriage. It’s typically an outpatient procedure.
Healing From A Miscarriage
Physical healing from a miscarriage can take several weeks. Generally, heating pads and ibuprofen can help alleviate the cramping sensations. Recovery looks a lot like home treatments for menstrual cramps or pelvic pain. Emotional healing can take much longer. Studies have shown that hiding or not disclosing a personal trauma creates a sense of social isolation. That isolation worsens depression and anxiety. While sharing might seem painful, it’s the best way to begin emotional healing.