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From heartbeat to heartbreak: What to know about miscarriages

Nikki Stevenson

Nikki Stevenson

Nikki is a parenting writer and a mom to three wild boys who keep her on her toes (and occasionally make her question her sanity). With over 15 years of experience in the parenting industry, she has more tips and tricks than Mary Poppins on speed dial. When she's not typing away at her keyboard, you can find her sipping on coffee, hiding in the bathroom for five minutes of...
Created on May 22, 2024 · 9 mins read
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Trigger warning:This post deals with sensitive subjects such as miscarriage and pregnancy loss. If you or someone you know has been impacted by issues raised in this story, help is always available. Please call the SANDS 24-hour support line on 1300 072 637 or visit their website here. Trying to have a baby can be an anxious time. Your heart sinks when only one line shows up on the pregnancy test kit, but it skips a beat when two faint lines appear for the very first time. It beats faster, gets to work, and bursts with joy when it hears the sound of another heartbeat—a tiny one, evidence of life growing inside mom—a healthy pregnancy.


But the heart is fragile and even the thought of losing that heartbeat can send it spiraling into panic and stress. Unfortunately, most miscarriages occur in at least 15% of confirmed pregnancies and are diagnosed with a lack of a fetal heartbeat.

Talking about the 'M' word


Between figuring out when your ovulation window is, hoping your partner’s sperm count will be good enough, and actually trying to fall pregnant, there are a lot of stressful factors at play. But without question, the most heartbreaking occurrence is losing a baby.

A miscarriage is the loss of a pregnancy up until 19 weeks gestation. From 20 weeks on, it is defined as stillbirth. Tragically, according to the Gidget Foundation, one in five pregnancies ends in miscarriage before 20 weeks, with most losses happening in the first 12 weeks, or the first trimester.


Why do miscarriages happen?


One figure suggests that in Australia alone, around 285 miscarriages occur in a single day. Unfortunately, many couples are unable to talk about their loss or express their grief. Many try to understand what has happened.

Was it something they ate? Could they have done anything to carry on and have a healthy baby? What can they do in future pregnancies to ensure a complete and successful pregnancy? And the most common – why do miscarriages happen?

A miscarriage is a ‘spontaneous abortion of the developing fetus by the uterus’ and it is the most common complication that occurs during the first trimester. Regardless, an early pregnancy loss doesn’t hurt any less and leaves most women confused as to ‘why them.’ Here are some possible reasons:

Chromosomal abnormalities
Occasionally, during a developing pregnancy, cells may fail to divide properly and cause anomalies in the pregnancy tissue. This haphazard chromosomal abnormality then interferes with the baby’s ability to grow normally and results in the body expelling the fetal tissue. For example, chromosome abnormalities can cause an anembryonic pregnancy where an embryo fails to develop.

Around 50-80% of miscarriages are due to chromosomal abnormalities.

Risk factors like maternal age
While age isn’t a big thing to worry about, it can certainly be a factor when determining reasons for miscarriages. Advanced maternal age, 35 and above, also increases the risk of experiencing those annoying chromosomal hiccups.

Health issues
Although our bodies are incredible, there are moments when they require additional support. It can be difficult for a pregnancy to last due to conditions such as immune system abnormalities, diabetes, or thyroid problems.

Uterine abnormalities and incompetent cervix
Sometimes the uterus may fail to act as the perfect home for the growth and development of a fetus. There can be a dent on the top (arcuate uterus), a partition in the uterus (septate uterus), a double uterus, or even an absent one—a host of reasons that can hinder nurturing life. 

Similarly, weak cervical tissues, aka, an incompetent cervix, also increase miscarriage risk.

Infections
Certain infections during pregnancy can be dangerous, just as getting a cold can throw us off. Certain STIs or the rubella virus can make it difficult for a pregnancy to go well. An infection in the uterus can also lead to a septic miscarriage, which requires antibiotics and suction evacuation of the uterus ASAP.

Risk factors related to lifestyle
Everybody has habits, but some of these may not be the best for a developing child. Drinking alcohol, smoking, and exposure to dangerous chemicals like polyfluoroalkyl substances (PFAS) can increase the risk of miscarriage.

Trauma or injury
Although our bodies are strong, there are moments when they require rest. Serious accidents or injuries sustained while pregnant can have a devastating effect on the mother and baby and occasionally result in miscarriage.


What are the 5 symptoms of a miscarriage?


From heavy bleeding to abdominal pain, here are the 5 symptoms of a miscarriage:

  1. Bleeding: One of the most common signs of a miscarriage is bleeding from the vagina. The bleeding may start as light vaginal spotting before turning into a brownish discharge or bright red clots.
  2. Lower abdominal cramping: A pregnant person at risk of miscarriage may experience cramping and pain in their lower back.
  3. Heavy bleeding: Pregnancy tissue and fluid are passing out of the vagina.
  4. Contractions: Intense cramping pain in the stomach, similar to those of contractions or severe period pain.
  5. Fever: A common side effect that accompanies any of these symptoms.

Understanding the different types of miscarriages


What is an incomplete miscarriage?
If the placental tissue or parts of the baby are left behind in the uterus even after the miscarriage has started, it is known as an incomplete miscarriage. 

Symptoms can vary from mild to severe, depending on the stage of pregnancy at which the miscarriage started. These include severe bleeding, intense cramps, and passing pregnancy tissue.

An ultrasound examination can help determine the internal situation and if an incomplete miscarriage is diagnosed, a dilation and curettage (D&C) procedure becomes necessary to remove the remaining tissue. Although a D&C is uncomfortable, it helps avoid any complications in the future.

What is a complete miscarriage?
A complete miscarriage is when the embryo is expelled from the uterus along with all the pregnancy tissue. In this case, the bleeding and pain subside quickly.

What is a missed miscarriage?
A missed miscarriage, aka a missed abortion, takes many parents by surprise. This is when the embryo dies (no heartbeat) and there are no other symptoms, such as bleeding or pain.

What is a recurrent miscarriage?
While one miscarriage can happen to anyone, 3 or more consecutive miscarriages in a row are defined as recurrent miscarriages. Recurrent miscarriages or repeated miscarriages happen to around 1-2% of women and require further testing, including blood tests, to understand the problem and find treatment options.

Other types of miscarriages include an inevitable miscarriage (a miscarriage that will happen) and a threatened miscarriage. A threatened miscarriage is when there is some bleeding in early pregnancy with lower backache but the cervix stays closed. In this case, the pregnancy can continue.

What is my risk of miscarriage by week?


In the initial weeks of pregnancy, from the moment you learn you are pregnant until approximately week 4, there is a great chance of miscarrying (around 20%).

Most people are usually unaware of their pregnancy during this phase – approximately 80% of miscarriages happen this time and are mistaken as heavier periods. The risk significantly drops to 2%-4% once you enter the 8-13 weeks window. You are considerably safe once you enter the 14th week since the risk of miscarrying drops significantly to 1%.

What happens if you miscarry at home?


It may be hard to spot the possible signs of miscarriage. Sometimes, a miscarriage can happen so quickly that there isn’t time to get to the hospital. If that happens:

  • Stay calm and call your doctor or midwife immediately.
  • If you are alone, try and get a support person over to be with you.
  • Use pads to help manage the bleeding.
  • If possible, save any pregnancy tissue so you can have it tested to help find out why your miscarriage occurred.

Expectant or natural management


Natural or expectant miscarriage refers to waiting for the miscarriage to happen on its own, without any external or medicinal interference. While the exact moment a miscarriage will occur naturally is unknown, pain and bleeding should start to occur in around 7–14 days and last no longer than 2 weeks.

Patients who are uncertain about the impact of their decisions, tend to wait out and prefer the body’s natural mechanism of flushing out an unhealthy embryo, rather than opting for external interference.

Healing from a miscarriage


Who can I talk to for advice and support?
While your family and friends can be your biggest rock in such emotionally trying times, do not hesitate to contact your healthcare provider if you have any concerns.

You can also contact Red Nose Grief and Loss, or The Pink Elephants, to help you navigate through your loss. Remember to find ways to channel your grief. Cry it out, journal, or take a trip. Do what you need to heal and be unafraid to ask for assistance and support.

How long does it take to get over a miscarriage?
Women who have miscarried often find the thought of being pregnant again too much to bear. Some women may choose to take time before trying to conceive again, to give their bodies and hearts time to heal and process what has happened.

Others may yearn to be pregnant again, despite the fear and anxiety.

Some mamas even find that a miscarriage gives them a newfound appreciation for pregnancy that they didn’t have before—and find comfort in symptoms such as morning sickness or breast tenderness, seeing these as small reassurances of the baby inside them.

Remember, looking after your mental and physical health is important. Ensure you surround yourself with a loving support network and take the time you need to process your grief.

Frequently asked questions


1.  What are the first signs of miscarriage in early pregnancy?
Light bleeding or spotting is often the first sign of a miscarriage. The vaginal bleeding becomes heavier as the cervix dilates.

Remember, any kind of bleeding during pregnancy is serious and should always be raised with your doctor.

2. How soon after miscarriage do pregnancy symptoms disappear?
After miscarrying, pregnancy symptoms such as nausea, tender breasts, and fatigue usually vanish in a matter of days. Following a miscarriage, cramping and bleeding may persist for around two weeks. While everyone’s experience will be different, it’s important to seek medical attention if you’re still feeling unwell and continue to bleed for an extended period in the weeks after your miscarriage.

3. What does an early miscarriage look like?
While each person’s experience of an early miscarriage is unique, common symptoms include cramps or abdominal pain, as well as heavy vaginal bleeding that frequently exceeds the amount of a regular period. Additionally, some people may pass tissue or blood clots from their uterus. Others may experience stomach discomfort, lower back pain, or a reduction in pregnancy symptoms like nausea or tender breasts. 

4.  How long does miscarriage bleeding last?
Miscarriage bleeding differs from person to person and giving an exact estimate is difficult but it could continue for a few days or a few weeks. The duration depends on various factors, such as your general health and the stage of the pregnancy.

Bleeding from a miscarriage can be inconsistent as well; with varying flow, pauses in bleeding, etc. If a miscarriage happens early on in the pregnancy, bleeding may last for a few days. If it occurs at a later stage, bleeding may persist for a few days (as long as 4 weeks.)

Sources


Miscarriage (2023) Pregnancy, Birth and Baby. Available at: https://www.pregnancybirthbaby.org.au/miscarriage

Miscarriage (2021) Gidget Foundation. Available at: https://www.gidgetfoundation.org.au/grief-and-loss/miscarriage

What is miscarriage? (2022) Miscarriage Australia. Available at: https://miscarriageaustralia.com.au/understanding-miscarriage/what-is-miscarriage/

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