One of the more difficult topics to cover and discuss is the topic of miscarriage. In the unfortunate event that someone endures a miscarriage, everything feels like it stops; your plans and excitement may turn to fear, worry, and sadness, and you may have questions about your health and what comes next. It is very important to know how to manage and navigate this unexpected detour in your journey to parenthood; it is often not easy at first. This article is intended to help you understand more about this type of loss, what comes next in terms of recovery and preparation to try again, and the emotional impact it can have on a person.
This is a very sensitive, serious, and emotional topic to cover, and everyone’s experience may vary. It’s crucial to remember that you are not alone and that this is something that you can overcome and possibly try again if you desire to do so.
Miscarriage is defined as a loss within the first 20 weeks of pregnancy. About 10 to 20 percent of known pregnancies end in miscarriage. Some miscarriages may occur very early in pregnancy, and sometimes they occur even before you might even know about pregnancy. Miscarriage is a relatively common experience; however, many people may not fully understand the physical and emotional challenges of a miscarriage. Recovery from a miscarriage takes time, patience, and support. This article will help you with healing by understanding what can cause a miscarriage, how to cope with it, and what medical care might be needed in order to recover fully and conceive again.
A chemical pregnancy is a very early miscarriage that can occur before you even know that you are pregnant. A chemical pregnancy is most likely the result of chromosomal abnormalities in the fertilized egg. There may be no signs of a chemical pregnancy. Most women simply begin to bleed around the time of their next period, though their period may arrive a few days late or be slightly heavier. If you are going through a frozen embryo transfer cycle, the HCG level is usually tested 10-14 days after the frozen embryo transfer procedure, a positive low HCG level might indicate that a chemical pregnancy is happening. The level will usually decrease in a few days and a period will start after the HCG level goes down to zero.
A blighted ovum also occurs very early in pregnancy. It happens when a fertilized egg attaches to the uterine wall, but an embryo does not develop. You may feel signs of pregnancy, but when your doctor performs an ultrasound, an empty gestational sac is found, or a heartbeat of the fetus cannot be detected. In this case, you may miscarry the pregnancy naturally or need to schedule a dilation and curettage (D&C) procedure, in which the cervix is opened, and the pregnancy is gently curetted, or removed, from the uterus.
Symptoms of a miscarriage include:
Your doctor will confirm the miscarriage using ultrasound and draw blood to check the HCG levels. Once the miscarriage has been diagnosed, your uterus will need to be empty so your normal menstrual cycle can resume, and then you can try to conceive again. Even if your miscarriage progresses naturally, your doctor will likely want to check in with you for a few weeks or months to make sure that you do not develop any complications.
The emotional impacts of a miscarriage can be devastating and hard to get through. Everyone processes it differently. You might feel a mix of overwhelming emotions such as shock, denial, grief, sadness, anger, guilt, numbness, vulnerability, and/or depression.
It is important to remember that a miscarriage is not your fault. Most miscarriages are caused by a genetic abnormality that keeps the fetus from developing normally. It is also important to remember that your hormones will change dramatically after a miscarriage, especially after discontinuing hormonal injections. You need to take your time and space to process the emotions from shock or anger to acceptance. It is also important to communicate with your partner as how you process the miscarriage might be different and communication is the key to getting through it together. A strong and personal support system will help recover emotionally from your loss.
The time of physical recovery after a miscarriage depends on how far along you were before pregnancy loss. Since miscarriage occurs before 20 weeks of gestation, this can vary greatly. It may take several weeks to a month or more for your body to recover after a miscarriage. You can expect to have some cramping pain and bleeding during this time, the symptoms should gradually get lighter. If a miscarriage happens after 6-week gestational age, depending on each individual case, your doctor is likely to prescribe medications either orally or vaginally to help your body pass any remaining tissues. In some cases, you may need to schedule a dilation and curettage (D&C) procedure to help complete the miscarriage if you wish to try to get pregnant again in the future.
It is important to realize that your experience is normal and that it is not your fault. The human body endures a miscarriage for a large number of reasons; many of which are in your best interest, medically speaking. Each person will have their own way of working through their own emotional recovery; there is no rush to recover.
If you do not feel ready to face the world, you should take your time until you are ready. When you are ready, even if it may seem painful to talk about what you went through, sharing your story with others will allow you to feel less alone and help you heal. If you are in a relationship, open up to your partner for support. This will help your partner to heal as well.
There are many in-person and online support groups available for miscarriage and baby loss. While your friends and family will always be there for you, it can also help to connect with others who have gone through the same loss as well.
Some support groups for grievances can be found below:
http://www.emptyarmsbereavement.org/miscarriage-support-group
https://www.uclahealth.org/sites/default/files/documents/Regional-Support-Groups.pdf?f=33014d4e
Medically speaking, if a miscarriage happens early in gestational age (<6 weeks), it is safe to start trying to conceive after one normal menstrual cycle post-miscarriage or after your HCG level becomes negative. Check with your doctor about your specific situation. Sometimes if a miscarriage happens after 6 weeks of gestational age, a doctor may recommend waiting for two normal menstrual cycles post-miscarriage in order to try again. If there is scarring in your uterus or pieces of placenta left behind, your doctor might recommend a longer wait.
It is equally important to make sure that you feel emotionally ready to try again. Talking to your doctor about what you are feeling physically and emotionally can help you in deciding when a good time is to start trying to conceive again.
If you have questions about your fertility, recurrent miscarriages, or trying to conceive after loss, you may contact our fertility specialists who will support you with compassionate care throughout the process.