Navigating early pregnancy loss can sometimes feel confusing and even overwhelming. Know that you are not alone. The following information is intended to provide educational support during what can be a very physically and emotionally difficult experience. While this information provides an overview of loss, it may not cover everything you need. Take the time to communicate your questions and concerns with your doctor.
All information is for educational purposes only. Information given is not intended to diagnose, prescribe, treat, mitigate, or cure any symptoms or disease. Please consult your doctor with any questions or concerns regarding your health. This information has been compiled by Kathleen Petersen, RN, and the Early Pregnancy Loss Association with the assistance of various medical professionals.
Types of Pregnancy Loss
Miscarriage: Sometimes called a spontaneous abortion, a miscarriage is the natural death of an embryo or fetus (baby) before he/she is able to survive outside the mother. Usually a pregnancy loss before 20 weeks gestation is considered a miscarriage; after 20 weeks gestation, a pregnancy loss is considered a stillbirth.
Missed Miscarriage: A missed miscarriage, also called a missed abortion, is an early pregnancy loss in which the baby has died but has not been expelled from the uterus. When a missed miscarriage occurs, three options are available: to induce labor to expel the baby, to have a dilation and curettage procedure, or to wait until the body recognizes the miscarriage and goes into labor on its own.
Ectopic Pregnancy: An ectopic pregnancy is a pregnancy in which the fertilized egg has implanted outside the uterus, usually in the fallopian tube. Unfortunately, this implantation is not compatible with continuing the pregnancy. Symptoms include pain, cramping, and vaginal bleeding. Ectopic pregnancies may require surgical intervention and can seriously threaten the mother’s health. Sometimes, the fallopian tube is damaged by the pregnancy.
Molar Pregnancy: A molar pregnancy is the implantation of an unfertilized egg. The unfertilized egg has some genetic material but not all, and while the cells often reproduce, the cells do not differentiate. The mass, or mole (sometimes called a “hydatidiform mole”), is not and will not be a baby. However, a molar pregnancy mimics symptoms of pregnancy and can produce very high levels of HCG (human chorionic gonadotropin) which is the hormone produced by the placenta after implantation. Mothers often feel all the symptoms of pregnancy, have a positive pregnancy test, and a uterus larger than the expected gestation.
Chemical Pregnancy: A chemical pregnancy occurs when a fertilized egg never fully implants in the uterus. Sometimes a very sensitive pregnancy test taken early will show positive for pregnancy, but then a woman discovers she is not pregnant when no pregnancy can be seen by an ultrasound or menstruation begins to expel the fertilized egg.
Early Miscarriage: An early miscarriage is a loss that occurs in the first trimester, before the 13th week of pregnancy.
Late Miscarriage: A late miscarriage is a loss that occurs in the second trimester, between the 13th and 20th weeks of pregnancy. Second trimester loss before 20 weeks is considered a miscarriage.
Recurrent Miscarriage: Recurrent miscarriage is indicated by three or more consecutive miscarriages.
Medical Care For a Miscarriage
D&C: Short for “dilatation and curettage,” a D&C is a procedure in which the cervix is chemically or mechanically dilated and a tool or vacuum is used to remove the remaining tissues following a miscarriage or missed miscarriage. This is usually done under anesthetics or sedatives. Mothers can experience vaginal bleeding, cramping, and mild to moderate pain after a D&C.
Medications: Sometimes medications may be given to help the woman’s uterus pass the baby. Natural Miscarriage: A natural miscarriage is an option chosen by the provider or the mother to allow the body to expel the embryo or fetus naturally. This can take from two to six weeks. Mothers can experience heavy bleeding, cramping, mild to moderate pain, and incomplete passage of all the tissues of the miscarriage (including retained placenta). Often, women experience a natural miscarriage before fetal demise is detected via ultrasound technology.
Medical Care for Ectopic Pregnancy
Most ectopic pregnancies require surgical intervention. After surgery, mothers will require rest, mild pain medications, and emotional support. Vaginal bleeding is to be expected. This can last from two to six weeks. An increase in vaginal bleeding should be reported to your doctor. If an ectopic pregnancy has caused the rupture of a fallopian tube, a mother can experience severe abdominal pain, vaginal bleeding, and shock. This is considered an obstetric emergency. Treatment of this condition may require additional days at the hospital.
Medical Care Following Pregnancy Loss - Your Physical Needs
Vaginal bleeding: As with any delivery, vaginal bleeding is to be expected following a miscarriage. This can last anywhere from two to eight weeks. An increase in vaginal bleeding can be a cause for concern and should be reported to your doctor.
Pain: Mild to moderate pain can be expected. Cramping is common as the uterus contracts to return to its original size. Acetaminophen or ibuprofen is often strong enough to make mothers comfortable following a miscarriage. Other supportive measures like ice, a heating pad, or warm baths (without soap or bubble bath) can be helpful.
Postpartum infection: Infection following a pregnancy is a very serious complication and can be fatal. It is important to not use any tampons or douches and to abstain from sexual intercourse until vaginal bleeding has stopped. Any change in vaginal discharge, foul smelling discharge, or fever should be reported immediately.
Emotional Care Following Pregnancy Loss
Grief: Some women and families experience deep feelings of grief following an early pregnancy loss. These feelings might continue long after the loss. It is appropriate to recognize this grief and to find support during this time.
Depression: Hormonal changes after a pregnancy can cause sadness, crying, and depression. Some professionals believe that postpartum depression can develop, even after early loss. This can be treated and should be reported to your provider or to a hospital emergency department for assistance.
All information is for educational purposes only. Information given is not intended to diagnose, prescribe, treat, mitigate, or cure any symptoms or disease. Please consult your doctor with any questions or concerns regarding your health.
Information has been compiled by Kathleen Petersen, RN, and the Early Pregnancy Loss Association with the assistance of various medical professionals.