Miscarriage

Bloodloss in the first period of your pregnancy raises concerns even though this does not have to equal a miscarriage. About half of women experiencing bloodloss in the first three months of pregnancy do have a miscarriage. This page will provide you with more information on miscarriages.

Sometimes the bleeding is completely innocent and is caused by an increased blood flow in the cervix and increased discharge in the vagina. The influence of pregnancy hormones may cause the walls of some blood vessels to soften and tear.
Acute or persistent pain in addition to vaginal bloodloss may indicate a miscarriage, so in this case contact us immediately.

Miscarriage

A miscarriage is the loss of a non-viable foetus. The first signs are usually vaginal bloodloss. The most occurring cause for a miscarriage is usually a development error. An interrupted cell division or other abnormalities prevents the foetus from developing. A miscarriage is a kind of natural selection system created to allow mainly healthy children to be born. Early miscarriages occur quite regularly: 1 out of 10 pregnancies end in miscarriage.

Missed abortion

Sometimes it occurs that the first ultrasound shows a non-living foetus; a so-called non-vital pregnancy or missed abortion.
If the heart beats during the term ultrasound the chances of a miscarriage are small, yet not excluded. An ultrasound before the seventh week of pregnancy (3 weeks ‘late’) often does not provide clearance so the ultrasound will be repeated a few weeks later.
After the diagnose of a missed abortion you have three possibilities:

  • Waiting for a natural miscarriage: If the ultrasound shows a non-viable foetus, waiting for a spontaneous miscarriage is one possibility. This choice can be preferable for the body as well as for the grief process. The time span of this process is unpredictable. The miscarriage will start with blood loss and painful cramps and the loss of blood before and after the ejection of the foetus can be intense. Afterwards the pain and loss of blood will fade. It is very important to maintain contact with your midwife; we will make appointments for necessary phone calls.
  • Stimulating a miscarriage using medication: If the ultrasound shows a non-viable foetus but you do not want to wait for a natural miscarriage, it is possible to stimulate a miscarriage using medication. It is important to know that this medication can only be prescribed by a gynaecologist so we are not able to provide you with the medication directly. The course of this miscarriage is similar to a natural miscarriage.
  • Curettage: The third option after the identification of a non-viable foetus is curettage, extracting the tissue from the uterus using a suction curette. This usually takes place under local anaesthetic, sometimes under full anaesthetic. This procedure is also used when your body has not ejected all the tissue during a miscarriage and the blood loss continues for too long. If you decide on curettage we will plan the appointment at the gynaecologist for you within one week. During this appointment the pros and cons of your choice will be reviewed and a date for the curettage will be set.

After a miscarriage

  • The body usually recovers quickly after a miscarriage. During the first weeks after the miscarriage you might experience some bloodloss and brown discharge.
  • Mentally a miscarriage can be a huge shock. The loss of the pregnancy starts a grieving process.
  • Feelings of disbelieve, confusion, anger, low spirit and disappointment can be intense after a miscarriage. Feelings of guilt and responsibility may also occur. Of course the experience of a miscarriage is very personal and will depend on your character and situation.
  • It is important to maintain contact with us and make an appointment at the practice or per phone.
  • We also like to invite you to come on a consultation prior to concieving again to discuss the possibility of a next pregnancy.
Next pregnancy

A next pregnancy immediately after a miscarriage is physically possible, although it might be preferable to wait for the first menstruation (usually 4-6 weeks after the miscarriage) to allow yourself the time to recover physically as well as mentally. The chance of a good pregnancy is just as big after a miscarriage as without a miscarriage.