What is a miscarriage?

A miscarriage is the losing of a pregnancy in the first sixteen weeks of the pregnancy. Most of the times the first signs of a miscarriage are vaginal bleeding and stomach ache. A pregnancy where bleeding occurs, will however definitely not always end in a miscarriage. At least one in seven pregnancies ends in a miscarriage. That means that twenty thousand women experience a miscarriage yearly in the Netherlands. It can be a coincidence and bad luck if someone has more miscarriages.

Almost always, a miscarriage is caused by a mistake during the fertilization of the ovum with the sperm. The embryo will not be compatible with life in that case. If the embryo will not develop properly, nature thinks it is a logical solution to stop the growth and to push off the embryo. It usually doesn’t occur because of genetical defects, so there are no consequences for a next pregnancy. The loss of a healthy embryo occurs rarely.

Process of a miscarriage
Sometimes a miscarriage occurs without you knowing. During a check up at the midwife, there will not be a heartbeat in that case or they notice the miscarriage during an ultrasound. Most of the times, however, a miscarriage is associated with stomach ache and bleeding. Pain can radiate towards the back or upper legs and can even look like contractions.

Pregnancy phenomena usually decrease just before a miscarriage.

For more than half of the miscarriages, pushing off the embryo occurs within a week. Most of the times you will see blood clots and an amniotic sac and possibly an embryo, depending on how far the pregnancy had progressed. Usually the stomach ache will subside after pushing off the embryo and the bleeding will get similar to a menstruation. Try to collect the blood clots and amniotic sac in for example a bucket, so the midwife can possibly see if the miscarriage is complete.

The miscarriage is diagnosed
The cause is usually a predisposition disorder of the embryo, which makes treatment impossible. Medicine, rest or quitting work are useless. A miscarriage cannot be caused by sports or sexual intercourse either.

If there is definitely a miscarriage there are a few possibilities:

  • Waiting for the miscarriage to occur spontaneously.
  • Curettage: a surgery under mild anesthesia, in which the uterus will be cleaned.
  • Sometimes the miscarriage will be started with medicine. The gynaecologist will inform you about when this is a possibility.

Waiting is safe and by waiting for the natural process in the first week after signs of bleeding and/or stomach ache, up to forty percent of the curettages can be prevented. There is also another solution: waiting for a while and then, when necessary, a curettage.

Physical recovery is usually fast after a miscarriage. Up to one or two weeks after the miscarriage, there is bleeding similar to a menstruation usually. After this bleeding the body is recovered enough for a new pregnancy. Getting pregnant does not get more difficult because of a miscarriage. After about four to six weeks the menstruation usually occurs again.

A bleeding often causes insecurity in the pregnancy. Sadness can be intense during a miscarriage. The plans for the future of the expected baby end abruptly. Apart from sadness a feeling of disbelief, emptyness and failure of your body can develop. These feelings are very understandable. Time is necessary for the processing and there is no reason to deny or hide the feeling.

Everybody processes a miscarriage in his own way. Try to talk about it with people in your surroundings or with your midwife. Sometimes it helps to write about your feelings. A healthier lifestyle or less stress could not have prevented the miscarriage. It is true that smoking and drinking alcohol increase the chance of a miscarriage a little. The chance of a miscarriage is also a little increased above the age of 35 years.

When do you call the midwife?

  • When heavy bleeding occurs, a lot more than a menstruation. Definitely when seeing stars and (inclination to) passing out.
  • Persistent cramps or persistent heavy bleeding. This can mean that a remnant of the pregnancy is still present in the uterus. A curettage is usually necessary in that case.
  • Fever, more than 38 degrees Celsius.
  • Anxiety

If you have questions after a miscarriage or curettage, you can always contact us.