For many parents, after the initial elation of a positive pregnancy test begins to wear off, a sense of dread can begin to set in. It’s not the idea of parenthood that scares us so much, but the thought of pregnancy loss. With one an estimated 26% of all pregnancies end in miscarriagethis discomfort is understandable.
Pregnancy can come with many symptoms, and you might assume the worst with every new ache or pain you feel when you’re expecting—especially if you’re not sure how to recognize the signs of a miscarriage. Even if you know the symptoms of pregnancy loss, you may feel anxious as you wonder about the next steps if you should find yourself in this position.
To help you get a clear understanding of what to do in the event of a miscarriage, we turned to experts Jian Jenny Tang, MDassistant professor of obstetrics, gynecology and reproductive science at the Icahn School of Medicine at Mount Sinai in New York, and Steffanie Wright, MD, MPH, MS, OB-GYN at Weill Cornell Medicine in New York. Together, they share information about pregnancy loss symptoms, treatment, pain management, and more.
When can miscarriages occur?
According to Dr. Wright, “[Miscarriages] It can occur at any time during pregnancy, but is more common in the first trimester.” In fact, it is estimated that about 80% of all pregnancy losses occur in the first 12 weeks.
Dr. Tang notes that miscarriages can occur at any point during the first 20 weeks of pregnancy (a A loss after 20 weeks is considered a stillbirth). However, they usually appear during the first six to eight weeks of pregnancy.
Dr. Tang says, “The most common cause of pregnancy loss is chromosomal abnormality, also known as fetal aneuploidy,” which can be either presence or absence of one or more chromones.
Common symptoms of miscarriage and what to do if you experience them
“The most common [pregnancy loss] Symptoms are cramping and bleeding,” says Dr. Wright, “but this can vary from person to person.” As for how much blood signals a miscarriage, the American College of Obstetricians and Gynecologists (ACOG) notes that “a small amount of bleeding in early pregnancy is common and does not necessarily mean you will have a miscarriage.”
In addition to cramping and bleeding, Dr. Tang says that “the loss or reduction of pregnancy symptoms such as nausea, vomiting, breast tenderness, or fatigue” can also be signs of a miscarriage. Finally, Dr. Wright says in some cases, “Patients may have no symptoms and then find out they miscarried at their prenatal appointment.”
Dr. Tang and Dr. Wright stress that if you experience any bleeding or any other possible miscarriage symptom at any point in your pregnancy, it’s vital to see your healthcare provider to determine next steps. “Medical advice does not change based on gestational age,” notes Dr. Tang.
When to seek emergency care
In some cases, severe symptoms may prompt your OB-GYN to refer you to the nearest emergency department, including heavy vaginal bleeding or signs of infection, according to Dr. Tang. “Heavy vaginal bleeding usually means you’re either passing golf-ball-sized blood clots or soaking through maxi pads every hour for two to three hours,” she explains. Signs of infection can include “fever, severe lower abdominal pain, foul-smelling vaginal discharge, low blood pressure, feeling faint or dizzy.”
Dr. Wright adds that second- or third-trimester miscarriage symptoms usually require emergency care (more on that later), and that you should proceed to the nearest emergency room if you’re experiencing “severe pain.”
Abortion treatment and interventions
How a miscarriage is treated or treated depends on factors such as how far along an expectant parent is, the severity of symptoms, and how the body handles the situation on its own. The first step is usually an ultrasound to “confirm the diagnosis,” says Dr. Tang. Once your provider verifies that you are experiencing pregnancy loss, Dr. Wright says, “The three most common management pathways include expectant management (watchful waiting), medical management with a combination of medications, or surgical management.”
Typically, Dr. Tang explains, “If the patient prefers a less invasive or more natural [treatment] approach, future management is safe for patients with a miscarriage of less than six weeks [gestation], with timely monitoring”. However, this approach is not recommended for loss after 12 weeks of pregnancy, as it “will increase the risks of bleeding and infection. Therefore, the surgical approach is better.” Finally, she says, medication management is “very effective for miscarriages under eight weeks.”
In the case of medication management, Dr. Tang says your provider will ask you to take two different medications 24 to 48 hours apart help the body completely eliminate the remaining tissue. This regimen includes medications mifepristone and misoprostol. It is important to note that, however, in this case, these drugs will be used to treat a miscarriage, due to the Supreme Court overturning Roe v. Wade in 2022;whether you have access to these drugs during a miscarriage depends on abortion laws state where you are seeking treatment.
Surgical management of pregnancy loss helps ensure that no tissue remains in the body after the miscarriage. According to Dr. Wright, patients undergoing this treatment will likely have a expansion and scraping (D&C) if the loss occurs in the first trimester or a expansion and evacuation (D&E) if the loss occurs in the second or third trimester.
Miscarriage Recovery
There are two parts to recovery from a miscarriage: physical and emotional.
When it comes to physical recovery, Dr. Wright generally recommends that patients take ibuprofen or Tylenol. , warm compresses and rest. Dr. Tang notes that these drugs can help patients manage common side effects, including nausea and vomiting.
The Emotional pain often lasts longer than physical pain, with parents experiencing a wide range of emotions, including depression, anxiety, and even post-traumatic stress disorder (PTSD), according to Dr. Tang. “We teach patients coping methods like meditation, breathing and journaling” to help them process their emotions. In addition, Dr. Tang and Dr. The Wrights stress the importance of support and community during this time. “After a miscarriage, I always encourage patients to lean on their friends and family,” says Dr. Wright, adding, “Miscarriage is unfortunately very common, and you may be surprised to find out that a friend or family member has gone through something similar experience. .”
There’s no timeline for emotional recovery after pregnancy loss — you may be ready to try to get pregnant again right away, or it may take a few months (or more). However long it takes, if you decide to try to conceive after a miscarriage, Dr. Tang and Dr. Wright stress that most patients who experience pregnancy loss continue to have successful subsequent pregnancies.
