What To Expect if You Have a Miscarriage

Too many of us have been in this heartbreaking situation: We are thrilled to find out we’re pregnant -- only to lose the baby.

It’s considered a miscarriage when this happens by week 20 of your pregnancy.

But what do you do if you realize you’re miscarrying? The easy answer: not too much. Let nature take its course. Then, after a short time, try again.

Let’s understand why miscarriages happen, what you’ll see and experience, and what steps you might take. (Spoiler: The basic message is, “Don’t panic.”)

The ABCs of Miscarriage

Call it miscarriage or spontaneous abortion — it’s your body expelling a fetus, naturally. It’s caused by chromosomal abnormalities half the time, sometimes by an “empty sac” with thwarted development, and it takes place during the first trimester – by week 13 -- in 80 percent of cases.

A few more numbers: About 10 percent of confirmed pregnancies end this way. Another 16 percent or so happen so early that the pregnancy wasn’t yet clinically identified.

Some pregnancies come and go without anyone knowing. If you’re trying to get pregnant,  you might find out within a couple of weeks by using an over-the-counter test. About 50 percent of pregnancies are unintended, though, hence the large number of unreported miscarriages.

What a Miscarriage Is Like

While every experience is unique, miscarriages typically play out a certain way.

Some women spot first; they find small bits of blood on their underwear. This could be a warning, or it could be nothing at all. Just wait and see what happens. The only reason to call the doctor is if you have such severe pain that you suspect you might have an ectopic pregnancy. That needs medical intervention.

Otherwise, this is common:

• You’ll have a heavy period. Early on, you might not even know that a miscarriage is happening; you might think it’s an especially challenging menstrual cycle.
• You’ll feel cramping. Ditto, if you cramp regularly during your period. The cramping is the uterus contracting so it can push out what no longer belongs there. In fact, the cramping might last for up to two weeks.
• It might look like blood clots. Especially early in a pregnancy, the discharge looks like blood with clumps. It’s often a dark red, resembling jelly or even raw liver.

What To Do During a Miscarriage

You really can’t do anything during a miscarriage. Double up on sanitary napkins or sit on the toilet, and let the process play out. The pregnancy wasn’t viable, so your body is clearing the way so you can try again in the near future.

Sometimes the body doesn’t miscarry fully, or at all. In those cases, it’s called a “missed abortion” and a doctor may need to complete the process with medical or surgical management. Your obstetrician might prescribe misoprostol, which gives the uterus a boost with its expelling. Or, you might have a simple D&C procedure in the office.

In most cases, though, just take a deep breath. This is not an emergency. In the morning, call your obstetrician’s office to see if you need an exam.

You might feel distraught, and this is perfectly normal. You must tend to your emotions and take care of yourself during this time.

Still, this is not the end of the road. About 85 percent of women who miscarry get pregnant again and successfully carry the babies to term.