A pregnancy that ends on its own spontaneously within the first 20 weeks of pregnancy is considered a miscarriage. Miscarriage, also known as “spontaneous abortion”is one of the most common complications in early pregnancy. It’s not considered an abortion in the common understanding of the word. A woman may have a miscarriage before she is even aware of her pregnancy. 

A chemical pregnancy may account for 50-75% of all miscarriages. This happens when a pregnancy is lost shortly after implantation. This can show up as bleeding that occurs around the time of her expected period. Most women have no idea they conceived when they experience a chemical pregnancy. 

Even though it’s pretty common, miscarriages are an extremely devastating experience. It’s possible that a miscarriage could happen before a woman misses a menstrual period. As many as 50% of all pregnancies end in miscarriage. 15-25% of pregnancies will end in miscarriage of a recognized pregnancy. 80% of miscarriages happen within the first 3 months of pregnancy. Any miscarriage that happen after 20 weeks is less likely but when they do, doctors consider them late miscarriages. 

So what happens during a miscarriage? A miscarriage or spontaneous abortion is when your embryo or fetus is expelled, at random, from your uterus before 20 weeks of pregnancy. 

The factors that cause miscarriages are many. Contrary to popular belief, miscarriages are not caused by falls, stress, exercise, fights with your spouse, or morning sickness. Most miscarriages happen through complications like genetic defects, immune reactions, or mostly abnormal chromosomes. There are times where miscarriages can not be explained. It has nothing to do with the mother or if she did anything “wrong” to cause the miscarriage. Preventing miscarriages are difficult is nearly every case. 

It’s likely someone you know has had a miscarriage. They’re extremely common. If you have ever experienced a miscarriage, you’re certainly not alone. 

There are a few signs and symptoms that indicate you could possibly be experiencing a miscarriage. 

Just like everything else, symptoms vary from woman to woman. However, there are a few common sign that can generally be associated with a miscarriage. 

The most common sign of miscarriage is spotting or bleeding. This blood can be slightly brown in color similar to a discharge to extremely heavy bleeding.

Other symptoms of a miscarriage could include:

• Mild to severe back pain
• Weight loss
• White-pink fluid discharge
• Feeling faint or light-headed
• Contractions
• Tissue or clotted discharge from the vagina
• Cramping and pain in the abdomen
• Decrease in signs of pregnancy
• Bleeding that goes from light to heavy
• Weakness
• Fever in addition to other symptoms

Additional causes of signs and symptoms of miscarriage could be (but not limited to)

• Severe Malnutrition
• Radiation
• Thyroid Disease
• Maternal Age
• Severe Kidney Disease
• Certain medicines, drugs like Accutane
• Uterine abnormalities
• Hormonal Irregularities
• Heart Disease
• Uncontrolled Diabetes
• Environmental hazards, exposure, radiation, or toxic agents
• Incompetent cervix
• Smoking, drinking, or illegal drugs
• Group B beta strep
• Autoimmune disorders
• Kidney disease

Underlying health conditions that can be associated with miscarriage and contribute to signs and symptoms of miscarriage:

• Hypertension
• HIV
• Malaria
• Lupus
• Coeliac disease
• Gonorrhea
• Syphilis
• Chlamydia
• Rubella
• Diabetes
• Lupus
• Thyroid gland problems

Chances of having a miscarriage can vary depending on age and health history. Women under 35 years old have about a 15% chance of miscarriage. Women who are 35-45 years old have a 20-30% chance of miscarriage. Women over the age of 45 have a 50% chance of miscarriage. However, no matter the age, women who have had a previous miscarriage have a 25% increased chance of having another miscarriage. 

Although miscarriages can have many factors that contribute to the cause or risk of it happening, there are different types of miscarriages you may hear your doctor mention. 

Recurrent Miscarriage – considered as 3 or more consecutive first trimester miscarriages. This affects 1% of couples trying to conceive 

Complete Miscarriage – When the products of conception or the embryo empty of out the uterus. Bleeding that comes with the miscarriage should subside quickly along with any pain or cramping. These miscarriages can be confirmed with an ultrasound. 

Inevitable or Incomplete Miscarriage – accompanied bleeding with an open cervix. A miscarriage is inevitable when thre is a dilation in the cervix or a rupture in the membranes. If the miscarriage incomplete, bleeding and cramps may be persistent.

Missed Miscarriage – experiencing a miscarriage unknowingly. When a miscarriage occurs and there is no expulsion of the embryo. Signs would be symptoms of pregnancy loss. And the absence of fetal characteristics.

Threatened Miscarriage -early pregnancy bleeding normally accompanied with cramping or lower backaches. The cervix remains closed with bleeding resulting from implantation.

Treatment When It Comes To Miscarriage

The treatment for a miscarriage aims to prevent continued hemorrhaging and infection. Normally the body knows to expel fetal tissue by itself. However, if it’s a late pregnancy and the body does not, your doctor may perform a dilation and curettage or a D and C. This is where the doctor will open the cervix and use a thin instrument to remove the rest of the fetal tissue.

Although the signs and symptoms can be commonly placed and be caused from a multitude of issues that boost your risk. And although miscarriages cannot be prevenet unless you have been diagnosed with a specific risk factor and have a healthcare plan from your provider. There are ways to be proactive to have the healthiest pregnancy possible.

By simply leading a healthy lifestyle, common practices could include:

• Supporting chronic conditions prior to pregnancy
• Keeping a healthy weight range
• Eating healthy
• Managing stress
• Regular exercise
• Taking vitamins like folic acid and B vitamins. Combating vitamin deficiencies that can affect conceiving. 
• Avoid and treat STI infections
• Avoiding cigarettes and alcohol
• Only take medications recommended from your provider 

Once you find out you’re pregnant, creating a healthy environment for your pregnancy for your baby to grow in is optimal.

• Keep your abdomen safe
• Avoid second hand smoke
• Limit or eliminate caffeine
• Avoid environmental hazards
• Avoid high impact activities for risk of injury

Diagnosing a Miscarriage

There are several tests to determine if you have suffered a miscarriage especially if you’re not sure. Tests used to diagnose a miscarriage can be:

Pelvic Exams – A pelvic exam can determine if the cervix has thinned out or opened.

Ultrasounds – Placing a small probe into the vagina can help look for sound waves to check for the heartbeat of a fetus. Also, some women choose to undergo an external abdominal ultrasound to avoid the discomfort of an internal exam. 

Blood Tests – blood tests are extremely useful to find beta-human chorionic gonadotropin (HCG) and progesterone are normal. Both hormones are associated with a healthy pregnancy.

Pregnancy After Miscarriage

After a miscarriage is completely possible to go on and have a normal pregnancy. About 85% of women have normal pregnancies and births after a miscarriage. Miscarriages are not an indication of a fertility problem and finding the determining factor with your provider is entirely feasible. You and your provider can develop a health care plan that is custom to your needs. More than one miscarriage only happen to 1%-2% of women and repeated miscarriages which are considered three or more. 

If you’ve had two or more miscarriages in a row, it’s recommended to stop trying to conceive, and use a form of birth control. This way you can ask your doctor and do tests to figure out the underlying issues of the constant miscarriages. 

When dealing with the effects of miscarriages, it’s not only the physical effects but the emotional toll it plays on a person. A range of emotions from sadness to guilt and worry. Although not a physical symptom of a miscarriage, it is a symptom.

Talk to your family, friends, and partner to create a support system that may be necessary to get through this hard time. Also talking to a professional health counselor may be necessary and a valuable resource to you and your partner. 

Asking your doctor for more information about the resources you may need is what they’re there for in addition to the physical support. Don’t forget, everyone heals differently, in different ways, and at a different pace. Whether it’s your first or fifth, it’s important to take care of both your body and mind after a miscarriage. Allow yourself time to grieve. Sharing your feelings openly can help too, we are all in this together.

If you have or had a miscarriage, or symptoms of a miscarriage, you should know that the doctors at Rosh Maternal & Fetal Medicine understand the emotional toll of pregnancy loss.

They’re dedicated to supporting you through the challenges, finding the cause, and helping you have a healthy baby. If you’ve had two or more miscarriages, please call their office in the Midtown East area of New York City, or schedule a consultation online and let their expertise help you overcome recurrent miscarriage.

Dealing With Signs or Symptoms of a Miscarriage? Call Rosh MFM

Talk to our team by phone or book an appointment online to get started. Call one of our six convenient NYC locations or schedule a video consultation online today. Come visit your NYC OBGYN!