Content Warning: This post contains discussions of miscarriage and early loss. Due to its heavy content, we suggest you take breaks when necessary, and check in with yourself. We also encourage you to have a support person accessible to you — whether learning alongside you, in the next room, or a phone call away.
We’ve said this before and we’ll say it again—you can’t talk about pregnancy without talking about miscarriage. 20% of all pregnancies end in miscarriage, that’s no small number. And even though it affects over 23 millions birthing people across the globe every year, it’s still one of the least discussed topics when it comes to reproductive health.
A miscarriage can be a heart-wrenching experience that affects countless individuals and families. In order to move through this experience, we find it helpful to understand not only what takes place within your body during a miscarriage and afterward, but also some of the common reasons why miscarriages can occur. In this blog post, we delve into the causes of miscarriage, the physiological processes involved, post-miscarriage expectations, and the medical options available for support and guidance.
Some Miscarriage Statistics
- About 10 – 20% of pregnancies end in miscarriage, with 80% of miscarriages happening in the first trimester (before the 12th week of pregnancy).
- It can take a few weeks to a month or more for your body to recover from a miscarriage. It may take longer to recover emotionally, and that’s ok.
The majority of people who miscarry go on to have healthy pregnancies later.
Now that we’ve covered that, let’s move on to some more basic information around why a miscarriage can happen, what exactly is happening to your body, and what to expect during and after.
What are signs of loss? (Meg Pirie, 2022)
Intuition
Trust the pregnant person’s gut feelings. If they mention that something feels off, odd, or weird at any point during the pregnancy, listen to them. Take these as valid and valuable reasons to suggest seeking the opinion of a healthcare provider. The pregnant person is the one who knows their body best and it’s our responsibility to listen to their concerns no matter how small they may seem.
Lab work, lab results
Lab work and lab results (urine samples, blood tests, etc.) can give you more information and point to indications that there may be abnormalities in the fetus or pregnant person — that could result in infant loss.
Ultrasounds
Ultrasounds can detect movements, size, and heart tones of the fetus. Should there be discrepancies with the gestational age of the baby and the ultrasound results, there might need to be a discussion about the health and/or medical care of the fetus and/or pregnant person.
Cramping, bleeding
Unexpected bleeding, sometimes called a “bloody show”, when there is no bleeding to be expected. Loss might also look like excessive cramping or contractions before 36 weeks that may be indicating early labor and premature birth. To note: there are conditions that can occur whose main symptom is bleeding – that is not a miscarriage, reach out to your care provider to confirm this.
Loss of fetal movement
Loss of movement is usually first detected by the pregnant person, if they feel like the fetus has not moved in a certain amount of time. In the three trimesters of pregnancy, movements can feel different. If there’s suspicion that there has been a decrease of movement within the last couple of days, do a kick count and call your care provider immediately. To note: an anterior placenta and early fetal development may prevent you from feeling noticeable movements.
Lack of heart tones
Often detected during ultrasounds, the lack of heart tones indicates that the baby may be passing/has passed in the womb
Why Does a Miscarriage Occur?
Content Warning: This next section contains discussion and description of substance use. Please read with care.
Miscarriages, which refer to the spontaneous loss of a pregnancy before the 20th week, can be attributed to a multitude of factors:
Genetic Anomalies: Chromosomal abnormalities in the developing embryo or fetus are a primary cause of miscarriage. These genetic issues may hinder proper fetal development, leading to a miscarriage as the body recognizes the abnormality.
Parental Health Conditions: Certain parental health conditions, such as uncontrolled diabetes, hypertension, or autoimmune disorders, can increase the risk of miscarriage.
Uterine Abnormalities: Structural issues with the uterus, including fibroids, polyps, or a septate uterus, can interfere with implantation and fetal development.
Hormonal Imbalances: Hormonal irregularities, such as insufficient levels of progesterone (which supports the uterine lining), can impede the ability to maintain a pregnancy.
Infections and Illnesses: Infections or illnesses during pregnancy can pose a risk to both the birthing person and the developing fetus, potentially leading to a miscarriage.
Advanced Parental Age: As birthing people age, the risk of miscarriage increases. This is often attributed to a higher likelihood of chromosomal abnormalities in older eggs.
Substance Use: (Unmonitored, unregulated, and excessive) Smoking, alcohol consumption, illicit drug use, and exposure to environmental toxins can elevate the risk of miscarriage. For more information on harm reduction during pregnancy, download this helpful toolkit. For support with substance use in your pregnancy (in BC), you can self refer to the FIR Program.
Hormones & Your Body After Loss & Pregnancy
Each person going through loss will be affected differently, based on the type of miscarriage as well as personal factors including:
- Your health and wellbeing before pregnancy.
- The environment you are healing in, and returning to (and the community supporting you).
- How far along your pregnancy was.
- The clinical practices and methods used during your miscarriage.
Each of the above will affect your healing, from the physical and physiological impacts to emotional, mental, spiritual and relational ones. Learn more about the different kinds of loss, stages of loss, as well as additional resources, here.
The effects of pregnancy loss can last up to weeks for some folks. These include
physiological effects, such as bleeding and cramping – which may continue for up to two weeks or more after your miscarriage.
Your hormones will have adapted according to how far along your pregnancy was interrupted. HCG tends to wane more slowly, but will eventually disappear completely. Estrogen and progesterone will fall back to their pre-pregnancy state as well.
If you have a tender chest and/or nausea/vomiting, these symptoms will pass, but you may be left with fatigue, anxiety, insomnia, or depression as your hormones balance out and you regulate in all the other aspects of your being. For support on understanding when these symptoms may pass, reach out to your care provider for a more individualized timeline – additional support from wellness practitioners (acupuncture, herbalist, RMT, etc) and your mental health supports (therapist, psychiatrist, etc) may be supportive for any extended healing.
Duration
The duration of your miscarriage will depend on the length of your pregnancy and method of completion. If you use medical or surgical management, it may be faster than body-led miscarriages (expectant management). However, this varies widely by individual; we can’t give a precise estimate. Be patient with yourself and your body.
Common Medical Interventions
Beyond the assistance of medication and care providers, some people experiencing loss require more interventions and support.
Most commonly, people experiencing loss may be prescribed medications to help them calm down, such as benzodiazepines.
Other interventions may include:
- Further exploratory ultrasounds or procedures like a D&C (Dilation and Curettage) or Aspiration to make sure your uterus is free of any tissue or to consider if you have symptoms of infection.
- Blood transfusions if your blood loss is high and/or iron is low.
Emotional Support
Emotional support is paramount throughout the miscarriage journey. Reach out to friends, family, or support groups, and consider consulting a mental health professional for guidance and coping strategies. You can also hire a doula to support you with your loss.
Are you looking for more information or to support someone through pregnancy loss? Check out these other articles from Brood:
Trying to Conceive: Brood’s Guide to Navigating Miscarriage and Loss
Supporting People Through Pregnancy Loss
A Doula’s Guide to Infant Loss (CW: this post discusses infant loss)
Miscarriages are complex and emotionally challenging events, often influenced by various factors. Understanding why they occur, the physiological processes involved, and what to expect afterward empowers people to navigate this difficult journey. Knowing the available medical options and seeking emotional support are vital steps toward healing and resilience. Remember that you are not alone, and there is help available to guide you through this trying time. If you’re looking for more guidance and support in navigating this experience, check out our Miscarriage & Loss online course, which is FREE for the month of October.
