What You Need to Know About Pregnancy Loss
*Disclaimer: I am not a doctor. This website is not an attempt to practice medicine or provide specific medical advice, and it should not be used to make a diagnosis or to replace a qualified healthcare provider's judgment. Always consult a licensed physician or other medical professional and follow their advice regardless of anything read on this website.
After my first miscarriage, I thought I knew what pregnancy loss was like. I had been through it myself. I took my personal experience and ascribed it to what I thought all miscarriages looked like. But as I began to connect with more women on the subject, I realized I didn’t know as much as I thought.
I learned medical terminology, treatment options, and the different types of loss. I had no clue. By the time I had my second loss, I was officially convinced no two miscarriages are the same. Humbled, my heart filled with grace and deeper compassion for women who walk this treacherous road as I gained an understanding of the uniqueness of each miscarriage experience.
Whether you or someone you care about has experienced pregnancy loss, we are going to dive into what miscarriage looks like in its many forms. We will define terms and explore the different types of loss because I believe being informed helps us love each other better.
If read past this point, thank you for your willingness to learn and to love women who have suffered pregnancy loss.
What Is Miscarriage?
This may seem obvious, but there is a distinction between pregnancy loss before and after 20 weeks gestation. A miscarriage (also known as early pregnancy loss) is when pregnancy loss occurs before 20 weeks, whereas after 20 weeks, it is referred to as a stillbirth.
How Common Is Miscarriage?
There are a lot of statistics thrown around regarding miscarriage, probably the most common being the “1 in 4” statistic. However, there is inconsistency with whether this figure suggests 1 in 4 women experience pregnancy loss or 1 in 4 pregnancies end in miscarriage.
Other statistics suggest that 10-20% of all pregnancies end in loss with 80% of those being before 12 weeks and 1-5% being between 13-20 weeks… And that’s just for known pregnancies. When considering miscarriages that occur before a woman knows she is pregnant, research suggests as many as 30% of all pregnancies end in loss, but there is no way to know this for sure. [1]
Types of Pregnancies & Miscarriages
No two miscarriages are the same. There are several types of miscarriages a woman may experience. As you read through the following categories of pregnancy loss, be mindful of the unique challenges they present to mothers and how knowledge of these differences may help you support women through pregnancy loss and the grief that follows.
Threatened Miscarriage
A threatened miscarriage is when a woman experiences bleeding, little or no pain, an undilated cervix, and the baby may have a heartbeat. Threatened miscarriages are often just that—a threat. Many women go on to have healthy pregnancies after a threatened miscarriage, however, this is not always the case.
Inevitable Miscarriage
Inevitable miscarriages can come after a threatened miscarriage or without warning. There is usually heavy vaginal bleeding and cramping as the cervix opens to pass the baby.
Missed Miscarriage
A missed miscarriage is when the baby has died but remains in the uterus. Some women’s pregnancy symptoms dissipate, but others may not notice anything unusual until a scan reveals the baby has stopped growing and has no heartbeat.
Complete Miscarriage
A complete miscarriage is when all pregnancy tissue has been expelled from the uterus. Cramping is common as the uterus contracts to empty and there may continue to be bleeding for several days.
Incomplete Miscarriage
An incomplete miscarriage is when some pregnancy tissue remains in the uterus. There may still be bleeding and cramping as the mother’s body tries to pass the remaining tissue, but sometimes an incomplete miscarriage may illicit medical intervention to avoid infection or further complications.
Recurrent Miscarriage
This is debated. Some claim recurrent (or repeat) miscarriage is defined as having two or more consecutive miscarriages, whereas others say it is having three or more consecutive miscarriages. It is estimated that only 1% of women experience recurring miscarriages.
Chemical Pregnancy
A chemical pregnancy is a loss that happens before the fifth week. It gets its name from the chemicals, or hormones, that produce a positive pregnancy test. Since it is too early to see signs of a developing fetus on an ultrasound, the human chorionic gonadotrophin (hCG) hormone is the only visible clue that a woman is pregnant at that point. [3] This type of pregnancy is, of course, no less a pregnancy and no less the loss of a human child.
Ectopic Pregnancy
Ectopic pregnancy is one type of early pregnancy loss where the embryo implants outside the uterus, most commonly in the fallopian tube, but it can also occur in the ovary or the scar of a previous C-section. This type of pregnancy can be life-threatening if not recognized and treated promptly. Sadly, there is no possibility for an ectopic pregnancy to survive. [4]
Molar Pregnancy
A molar pregnancy is an uncommon type of pregnancy loss where an egg is fertilized but a baby does not develop. This occurs when the cells that normally form a placenta grow into a clump of abnormal cells instead. [5]
Blighted Ovum
Blighted ovum, also known as anembryonic (no embryo) pregnancy, is when the fertilized egg attaches to the uterine wall, but an embryo does not develop. Though the gestational sac and placenta continue to grow, the sac remains empty, eventually resulting in pregnancy loss. [6]
Causes
Most miscarriages are not a result of anything the mother has or has not done. Up to 70% of miscarriages happen because the baby fails to develop properly, usually due to a chromosomal abnormality that was spontaneous, not inherited [2].
But sometimes, miscarriage can also be caused by:
Hormonal imbalances
Immune system or blood clotting issues
Medical conditions such as thyroid problems or diabetes
Severe infections causing high fevers
Problems with the womb or cervix
Treatment
Unfortunately, nothing can prevent a miscarriage once it has begun, but different treatment options are available to ensure a safe miscarriage. As soon as a miscarriage starts, treatment depends on the mother’s health.
watch & Wait
Also known as natural management, “watch and wait” entails waiting at home for the pregnancy tissue to pass from the womb by itself. This can happen quickly, or it may take a few weeks. It’s important to consider the advice of the midwife or doctor as to whether this is a safe option for the mother based on her condition.
medication
Medication speeds up the passing of pregnancy tissue. This may be offered for a number of reasons such as in an incomplete miscarriage that needs help passing remaining tissue, or in a missed miscarriage when the mother’s body is still waiting for the miscarriage to begin. A woman may be asked to stay in the hospital until she has passed the tissue or she may be advised to go home.
Surgery
A dilatation and curettage (or D&C) is an outpatient surgery often recommended for heavy bleeding, significant pain, signs of infection, or if natural or medical management has failed. A woman may also find a D&C to be preferred. This 10-20 minute procedure involves general anesthesia and either suction or scrapping of the uterus to remove any remaining tissue and—in cases where the baby has not yet passed from the body—to remove the baby from the womb.
Duration & Recovery
Duration and recovery are unique to each woman. Some miscarriages may start and finish within days while others may last several weeks. In most cases, it could take a few weeks to a month before full recovery. A woman’s period may begin again within 4-6 weeks after the miscarriage.
Emotional recovery may also vary. Everyone grieves differently. Miscarriage is the loss of a child, and though grief does change over time in frequency and intensity, it is not uncommon for a mother to grieve the loss of her child in some measure unendingly.
Why Does This Matter?
Why should my knowledge of miscarriage matter? Whether you have experienced a miscarriage or not, pregnancy loss affects many women, many of whom you may know. Understanding their experience on a deeper level helps you to empathize and support bereaved mothers through their unique circumstances. For more practical ways to support women who have suffered pregnancy loss, check out my post coming later this month on How to Support Someone Through Miscarriage.
If you have had or are currently experiencing a miscarriage, my heart is with you and for you. I would love to pray for you. If you feel comfortable, feel free to send me a message with your prayer request.
IN HIS LOVE, DANIELLE
References
[1] “Miscarriage.” March of Dimes, Feb. 2023, www.marchofdimes.org/find-support/topics/miscarriage-loss-grief/miscarriage.
[2] “Miscarriage.” Pregnancy, Birth and Baby, 17 July 2023, www.pregnancybirthbaby.org.au/miscarriage.
[3] “Chemical Pregnancy: Causes, Symptoms & Treatment.” Cleveland Clinic, 11 Dec. 2021, my.clevelandclinic.org/health/diseases/22188-chemical-pregnancy.
[4] “Ectopic Pregnancy.” Pregnancy Birth and Baby, www.pregnancybirthbaby.org.au/ectopic-pregnancy. Accessed 4 Oct. 2023.
[5] “Molar Pregnancy.” Pregnancy Birth and Baby, www.pregnancybirthbaby.org.au/molar-pregnancy. Accessed 4 Oct. 2023.
[6] “Blighted Ovum.” Pregnancy Birth and Baby, www.pregnancybirthbaby.org.au/blighted-ovum. Accessed 4 Oct. 2023.
