Last week I made the case for the importance of speaking openly about pregnancy loss. My hope over the next few weeks is to shine a bright light on the many faces and facets of loss.
I’m starting this week talking about miscarriages. As a refresher, miscarriage refers to pregnancy loss before 20 weeks. An estimated 10-25% of pregnancy’s will end in miscarriage, with most miscarriages occurring before the 13th week of pregnancy. As I noted last week, miscarriage is the most common complication of pregnancy.
Given its frequency, it’s remarkable how much misinformation there is about miscarriage. What I see often in my clinical practice is very informed, intelligent women who are utterly unprepared for the possibility of miscarriage. They do not understand their risks and have received little to no information following an early loss about the physical and emotional changes that lay ahead.
This is due in large part to women receiving the message that they should not disclose their pregnancies prior to the start of the second trimester. The thinking behind this is that loss is less likely after the 13th week. While this is true, it fosters a culture of superstition where women are fearful of letting anyone know they are pregnant before they hit what they perceive to be the “safe zone” of the 13th week. This has some pretty serious consequences.
- There is no support network in place when a loss occurs. Women who experience a miscarriage are then tasked with finding and securing support all while dealing with the emotional and physical fall out from their loss.
- Women do not have a full understanding of the statistics and make incurrent assumptions about why they miscarried and what, if anything the loss this means about future pregnancies.
- Women do not hear stories from other women about what it’s like to experience a miscarriage and are unprepared for the experience. From the physical to the emotional, from medical procedures and hormonal changes to the process of grieving, woman do not know what to expect.
So, in an effort to de-mystify miscarriage, below are some statistics and information that every woman should know.
- The most common cause of miscarriage is chromosomal abnormality
- Miscarriage rates increase with age
- Miscarriages are often (but not always) associated with some signs and symptoms including cramping, back pain, bleeding, contractions, and sudden decrease in pregnancy symptoms. HOWEVER having these symptoms does not always signify a miscarriage as many of these symptoms taken alone are also quite common in healthy sustained pregnancies
- Some miscarriages occur without signs or symptoms. These are referred to as missed miscarriages where miscarriage is diagnosed on ultrasound
- Depending on gestational age and type of miscarriage, medical management can look different ranging from pain medication to assuage discomfort, to surgical procedures such as vacuum aspiration or dilation and curettage (D &C), to medication given to control bleeding.
- Physical recovery following a miscarriage depends on how much the pregnancy had progressed and what type of procedure was involved. You will likely experience bleeding and some pain or discomfort.
- Hormone levels may take some time to stabilize following a miscarriage.
Stay tuned next week for information about coping following a miscarriage.