Miscarriage is sadly incredibly common, occurring in approximately 10% of all pregnancies in the first trimester. It most often occurs due to an abnormal number of chromosomes in the developing embryo. In healthy women, there is little that can be done to prevent miscarriage from happening.
Symptoms of pregnancy loss
At the start of a miscarriage, many women will have bleeding and cramping, however, some women have no symptoms at all, and the miscarriage will be diagnosed on an ultrasound exam.
Miscarriages can be treated in three ways.
One is to wait for the pregnancy tissue to pass on its own. While this has the benefit of not having any medical intervention, it can take up to four to eight weeks to occur, so many women prefer not to have the uncertainty of waiting that long.
The second option is to take a medication called misoprostol that causes the uterus to contract and expel the pregnancy tissue. This usually happens within 24 hours of taking the medication, but can take up to several days. The medication can be repeated if it does not work after the first dose. This is effective 70-90% of the time. Management with medication has the advantage of being able to control the timing of miscarrying while still being able to be in the comfort of your own home, however, there is typically a several hour window of time that is very uncomfortable with heavy bleeding and cramping.
The third option is to have the pregnancy tissue removed surgically through a procedure called a dilation and curettage (D&C). This allows for the most control of timing and least amount of pain, however, does mean receiving anesthesia and undergoing a surgical procedure.
After a miscarriage, you will be seen in the office to confirm that all the pregnancy tissue has been passed and to discuss any questions you might have about the process. Your bleeding will typically taper down and eventually stop after one to two weeks. Your periods will typically resume four to six weeks later.
Planning for another pregnancy
Many women who are trying to get pregnant wonder when they can begin trying again after a miscarriage. While women used to be advised to wait a couple cycles before trying, newer data shows that there is no advantage to waiting and that there may be some advantage to attempting in the first three months after a miscarriage. The bottom line: when you feel physically and emotionally ready to try again, it is safe to do so