About one out of every five pregnancies ends in miscarriage (also called a spontaneous abortion). Usually this happens because the pregnancy is not growing or developing properly. There is nothing you can do to prevent this kind of miscarriage. There are a few rare kinds of miscarriage, such as subchorionic haematoma (a blood clot under the placenta) or insufficient cervix (where the cervix gradually opens too early) which sometimes can be treated successfully with bed rest, and for an insufficient cervix, with a special stitch put in by an obstetrician. Most of the time, it doesn’t matter what you do: a healthy pregnancy will stay inside you and grow.
The first sign of a miscarriage is usually bleeding with cramps. Bleeding and cramps can also occur in normal pregnancies, so don’t panic if this happens to you. You don’t need to go to bed or to Emergency, but take it easy until you talk to your midwife. Usually we suggest that you do no heavy work and do not have sex until you can be examined and have an ultrasound to find out what is going on. After the examination and ultrasound, you will find out from your midwife one of three things. You may have a perfectly normal pregnancy and may go back to your usual activities. You may have a rare condition which needs bed rest and special treatments, or you may be miscarrying.
If you are miscarrying because the pregnancy is not growing properly, there is nothing you can do to stop it. Miscarriage is a natural process and is rarely dangerous. Most women will start with a little bleeding and a few cramps. This bleeding will get heavier than a period and the cramps may get severe. A hot water bottle will help. You may take acetaminophen (Tylenol) or ibuprofen (Advil) for the pain or your doctor may prescribe a stronger painkiller. The bleeding may include big dark red blood clots and then you may see the pregnancy tissue, which is usually pink or greyish. Once the pregnancy tissue has passed, the cramps will go away and you will feel better. After that, you will bleed like a normal period. Your next period may be a bit late.
Some women may need to go to the hospital for a D&C (dilation and curettage). This involves having an anaesthetic and having the uterus emptied with a suction machine. This is necessary if the bleeding is too heavy for too long, if the pain cannot be controlled, or if you have signs of infection.
- You are soaking more than 2 pads per hour for more than 3
- Hot water bottles and painkillers are not working and the pain is more than you can
- Your temperature is more than 38 degrees Celsius or 101 degrees Fahrenheit for 2 readings half an hour
Having a miscarriage is a sad, upsetting experience. Share your feelings with your partner, family, or friends. Discuss any concerns and plans for future pregnancies with your midwives.
Dr. Ellen Wiebe