Miscarriage is defined as a pregnancy loss at less than 20 weeks. Once pregnancy is diagnosed, the risk of miscarriage is about 10 – 12%. This risk starts to rise after age 35 and, over the age of 40 years, the miscarriage rate is over 33%. A large number of pregnancies are lost before they are diagnosed.
Most miscarriages occur at less than 10 weeks gestation and, in general, the pregnancy tissues will pass naturally with what looks like an extra heavy period. The bleeding is often accompanied by strong pelvic cramps. Usually the bleeding and cramping settles after 2 – 3 hours. Occasionally, there may be incomplete passage of pregnancy tissues which results in ongoing bleeding and cramping. In other cases, there is no bleeding and the pregnancy tissues are retained. These 2 scenarios require a visit to the GP or hospital.
Usually there is no known cause for a miscarriage. Approximately half of miscarriages are due to abnormal chromosomes. If a pregnancy is not progressing normally, there is nothing that can be done to prevent a miscarriage.
Miscarriages are more common in older women than younger women. They are also more common in women who drink more than 3 alcoholic drinks per week in early pregnancy or women who smoke. Research also states that miscarriage may occur if a woman drinks more than 3 to 5 cups of coffee per day.
Uncontrolled diabetes, fibroids or thyroid problems influence the possibility of miscarriage. Women who experience 3 or more miscarriages need medical checks to rule out any medical conditions.
No matter how healthy a woman may be, a miscarriage can happen. When pain and bleeding are experienced, contact your obstetrician immediately. Blood tests and an ultrasound may be organised and then, after an examination, you will know a miscarriage has occurred.
A complete miscarriage is when all pregnancy tissue has passed. A miscarriage where some pregnancy tissues remain in the uterus is known as an incomplete miscarriage. When no tissue has been passed, then this is known as a missed miscarriage.
- If bleeding and pain are not too severe, wait to see if there is a natural expulsion of pregnancy tissues
- If bleeding becomes heavier often with blood clots, tissue may be passed.
- Bleeding may last for up to 4 weeks
- Some women may require surgery, known as a D&C.
- Waiting can be emotionally draining for some.
After a miscarriage, bleeding may occur for approximately 2 to 4 weeks with a period starting within 4 to 6 weeks. Use sanitary pads and not tampons until bleeding stops. Avoid sex until bleeding ceases. Wait until after the next period before attempting another pregnancy.
You may feel grief which is normal however speak with your GP or obstetrician if these feelings continue.