by Lisa Blogger
First of all, if you're reading this for advice, I am very sorry that you're going through this. I've had two natural miscarriages, one at 8 weeks with a blighted ovum and one at 9 weeks with an embryo measuring only 6 weeks. I am not an expert on this by any means, and I do realize that every experience is different, but hopefully this will be of some help.
Pregnancy losses that occur prior to 20 weeks are called a miscarriage. While some pregnancy losses necessitate the use of a D & C, other pregnancies end without medical intervention or assistance. This write up is for a natural miscarriage.
Why You May Have a Natural Miscarriage (rather than using medical intervention)
Some doctors will take a "wait and see" approach once there is an indication of a potentially failing pregnancy, particularly if it is a first pregnancy. Other doctors are inclined to suggest natural miscarriage rather than a D&C due to the potential for post-D&C complications (scarring, for example, or if you are not good with anesthesia). If there is a possibility that you are off on your ovulation calculations, many doctors will not suggest a D&C until a second ultrasound a week later confirms that the pregnancy is not just progressing slower than expected.
What You Can Expect
While both of my natural miscarriages were different, there were also similarities. Both times, spotting was my indication that something was wrong, followed in both cases by an ultrasound that confirmed we were likely going to lose the pregnancy. After the ultrasound, things moved rather quickly the first time (I miscarried that evening), but more slowly the second (it took three days to complete).
In most cases, bleeding will begin to increase first. Cramps will begin, often mild but will intensify as the miscarriage progresses. My first miscarriage felt almost like what I've heard labor pains feel like, in that there was a rhythmic pattern to them and they were very intense at the end. When I was in the midst of one, it helped immensely to have a microwavable heating pad wrapped around my lower abdomen, and it was almost necessary that I was up and walking -- sitting still seemed to make the cramps worse. Also -- and this may sound odd -- but I somehow knew when I was going to pass a clot or tissue, because I had the urge to go sit on the toilet. As a result I did not bleed as much on a pad as some people might.
The cramps will be the worst while you are passing tissue or large clots. After this occurs, the cramping will subside and the bleeding will begin to taper off, although this may still take a day or so. Your doctor will likely want to schedule a series of betas to make sure that your levels are dropping to zero (some doctors will only test to <5).
Problems That May Arise and Ways to Troubleshoot
If you are bleeding so much that you are soaking a pad in an hour or less, you should go to the emergency room, as this could indicate hemorraging or other problems. Have someone drive you -- rapid blood loss could cause you to faint or pass out. It is possible that you will still need to have a D&C if there is retained tissue; a sign of this may be that you are still bleeding heavily after most of the tissue has passed. Your doctor will most likely want to do an ultrasound or at least a repeat beta to see whether your levels are not dropping off.
If you have seen your doctor for an ultrasound or other diagnosis prior to the miscarriage, try to remember to ask your doctor what their recommendations are and for a script for pain medicine if you think you'll need it. I know that it's an emotional time, but try to make sure you are looking out for your body as well. I was distraught the day of our ultrasound and was given no advice on what would be considered an emergency, when to call the doctor, or whether it was safe to take Advil or something stronger. Luckily I had online friends and resources that could tell me some of the things I describe here. When I was still reading loss message boards, I've seen many people ask whether they should try to get a tissue sample to their doctor for chromosomal testing. There are a few problems with that with a natural miscarriage, mainly that by the time you would be able to get the sample to your doctor it would likely be unusable, not to mention collection/storage and the emotional aspect of doing this.
I was extremely calm during my miscarriages, but extremely emotional afterwards. Be sure that you take some time for yourself if at all possible and just allow yourself to feel whatever you feel. It will help with the grieving process if you do not try to resume "normal" life immediately.