A friend of mine just found out that the baby she had known about for all of a week or so is not viable. Basically, that means there is no heartbeat, no baby. She should be six weeks pregnant, and the embryo measured at five weeks. That means it stopped growing a week ago.
That brought back memories. My first pregnancy ended almost exactly like my friend’s. I began light spotting nine days after I found out I was pregnant, about at the six week mark. An ultrasound revealed an embryo marked at around five weeks with no detectable heartbeat. A follow up ultrasound a week later revealed, basically, nothing. No sac, no detectable embryonic mass, nothing. It was over. Truthfully, it never was. What was even more heartbreaking, for both me and my friend, is that your body still feels pregnant. Breasts are swollen and tender; waistband still tight; still nauseous and retching at smells; still fatigued, tired, and weepy. It seems a cruel trick of nature.
It is said that approximately 30% of pregnancies end in early miscarriages, some even before the woman knew she was pregnant. Some women assume they had a slightly late, marginally heavier than normal, period. An early miscarriage refers to any that occur before 20 weeks of pregnancy, but a large percentage of these miscarriages are in the first trimester, or before 12 weeks of pregnancy.
One so-called miscarriage is a blighted ovum. A blighted ovum happens when a fertilized egg attaches to the uterine wall, but an embryo does not develop. An ultrasound will show no sign of an embryo. The placenta continues to grow for a short while, and pregnancy hormones will rise, leading a woman’s body to believe that she is still pregnant. She may have had a positive pregnancy test because of the hormone levels. Only an ultrasound will reveal an empty sac, or just an empty uterus. It is thought that a blighted ovum is the cause of about 50% of early miscarriages, and is most generally the result of chromosomal problems. It is important to understand that, to you and your partner, you have lost a baby, and it is important to grieve as you would any other loss.
Most other early miscarriages are the result of a fetus that is unhealthy and probably will not survive until the end of pregnancy. Some causes are:
Chromosomal abnormalities (as many as 50% of early miscarriages) like Down’s Syndrome.
Low progesterone levels. Progesterone initially is provided by a small cyst in the ovary. After 9-10 weeks, the placenta should provide enough progesterone on its own. If not, a miscarriage will result.
Infections and diseases such as CMV (cytomegalic virus), chlymadia, streptococcus or even undetected diabetes in the mother can cause miscarriage in the first trimester.
The age of the mother plays a factor. About half of all pregnancies in women over 40 years old ends in miscarriage.
Sometimes, you will never know what caused a miscarriage. It’s hard for a prospective mother to realize that sometimes things just happen. It is easy to blame yourself, and to feel that you failed in the most important job of all-to protect your child. But the truth is, the fetus would not have survived the pregnancy anyway. And one miscarriage doesn’t mean you will have another one. I have gone on to have two healthy little girls since my miscarriage.
Signs that you may be having a miscarriage include:
Spotting. Some spotting may be normal, but it’s a good idea to call your health care provider for an ultrasound or heartbeat check.
Bleeding. Heavy bleeding, especially with blood clots, needs to be reported to your doctor immediately.
Abrupt and early ending of pregnancy symptoms. Breast tenderness and nausea usually subside by the end of the first trimester, but if these symptoms end abruptly earlier in the pregnancy, it could indicate a miscarriage.
Most of the time, fetal tissue and uterine lining will expel itself. You can talk with your doctor about a D&C;, or dilation and curettage to remove remaining tissue from the uterus. Many women, including me, feel that this procedure provided some closure. Some women continue bleeding for a few weeks after the surgical procedure, but some do not. In my case, I had no more bleeding after the outpatient surgical D&C; for my early miscarriage.
Here are a few things to remember if someone you know and love suffers an early miscarriage. Don’t remind her that something must have been wrong with the baby and it wouldn’t have lived anyway. Now isn’t the time for that comfort. Don’t ask if she “did something” that might have caused it. A mother’s guilt is hard enough to live with. Don’t ask how soon she will try to get pregnant again. That is up to her, her partner, and her body. Don’t tell her it wasn’t a baby anyway. To her, it was and is. When you have a miscarriage, you don’t just lose a baby. You lose all the hopes and dreams and love and anticipation tied up that positive pregnancy test.
Just hug her and say you are sorry for her loss. That’s enough.
