Pregnancy Info

It is important to know the signs of miscarriage as it is fairly common in early pregnancy. Understanding the signs of miscarriage will help you know when to seek medical care and what is normal to experience during early pregnancy.

A miscarriage is a pregnancy that ends on its own during the first 20 weeks of pregnancy, and usually during the first trimester, or first 13 weeks of pregnancy. A quarter or more of all pregnancies may end in miscarriage, but many of these miscarriages occur before a woman knows she is pregnant and may seem to her like a normal period. Most women will experience a miscarriage in their lives, though they may not be aware of it.

The fact that miscarriage is common does not make it less devastating for the woman who knows she is pregnant when a miscarriage occurs. Women who know or suspect that they have experienced a miscarriage should allow themselves to mourn for the lost fetus, and should seek counseling if their feelings of sadness do not ease with time.

In the first 20 weeks of pregnancy, women should watch for some of the common possible signs of miscarriage, such as:

• Vaginal bleeding
• Back pain that feels like cramps
• Cramping similar to menstrual cramps
• Pinkish mucus discharge
• A gush of fluid from the vagina
• Passing clots of blood and tissue
• Sudden loss of pregnancy symptoms

A woman who is experiencing any of these symptoms should not panic, but should call her doctor as soon as possible. A pregnant woman should not be embarrassed to call after hours if she may be experiencing a miscarriage. If a pregnant woman is experiencing a lot of bleeding or discharge and/or having severe cramps, and cannot get in touch with her doctor, she should go to the emergency room.

The signs of miscarriage listed above may mean one of several things, and a doctor can help determine which is the case:

• The woman may be experiencing normal symptoms of pregnancy that will not result in a miscarriage. Some spotting or bleeding can occur in a healthy pregnancy, and some woman will have back pain and cramping as the body adjusts to being pregnant. Also, some early symptoms of pregnancy like morning sickness and tender breasts usually ease after the first trimester.
• The woman may be having a threatened miscarriage, where there are some signs of miscarriage that might indicate a problem with the pregnancy, but the fetus is still alive and the cervix is closed. In this case there may be something doctors can do to reduce the chances of a miscarriage, and the woman’s pregnancy might continue normally.
• The woman may be having a miscarriage, where the fetus is dead and/or the cervix has dilated, meaning the pregnancy cannot be saved. In this case a doctor will determine if a D&C (dilation and curettage) is necessary to remove any material from the uterus and prevent infection in the mother.

In most cases, women who experience a miscarriage can go on to have a healthy pregnancy when they are ready to try again. Miscarriages usually occur due to a problem with the developing fetus that will not repeat in future pregnancies. A smaller number of miscarriages are due to hormonal problems, infection, injury to the mother, exposure to harmful substances, or underlying medical conditions that may need to be treated before the woman can have a healthy pregnancy.

When a woman is carrying multiples it is possible to miscarry one of the fetuses but carry the other(s) to a healthy delivery.

To reduce the risk of miscarriage, women should practice good care before and during their pregnancy, including:

• Don’t drink alcohol, smoke, or use drugs
• Eat a healthy, well-balanced diet and try to keep weight gain reasonable
• Take recommended prenatal vitamins
• Drink plenty of water
• Do light or moderate exercise as recommended by your doctor
• Avoid dangerous activities like contact sports during pregnancy
• To the extent possible, avoid harmful chemicals
• Learn to reduce or manage stress
• Treat any existing medical conditions and get recommended vaccinations before becoming pregnant

In most normal pregnancies, moderate activity, including safe sex, should not cause a miscarriage. A woman with a history of miscarriage or signs of miscarriage may be advised to be more cautious.

Sources:

American Congress of Obstetricians and Gynecologists, “Early Pregnancy Loss” [online]
American Pregnancy Association, “Miscarriage” [online]
MedlinePlus Medical Encyclopedia, “Miscarriage” [online]