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How to tell you're having a miscarriage: signs and symptoms

“We wish that people would just talk openly about it because they’d realize so many other people have been through this, too.”
/ Source: TODAY

It’s a sobering fact: Every time you get pregnant, there’s a chance of miscarriage. For every 100 women who know they are expecting, 10 to 15 will lose the baby before the 20th week of pregnancy, the March of Dimes estimates.

Signs of a miscarriage
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“It’s so common,” Dr. Daniela Carusi, director of general gynecology and surgical obstetrics at Brigham and Women’s Hospital in Boston, told TODAY.

“We wish that people would just talk openly about it because they’d realize so many other people have been through this, too.”

Doctors also want women to know there’s an excellent chance of having a healthy, uncomplicated full-term pregnancy the next time around.

“This is like a speed bump,” said Dr. Iffath Hoskins, a clinical associate professor in the department of obstetrics and gynecology at NYU Langone Medical Center.

“For the average patient, you can walk away and go back to as normal a life as you possibly could in your fertility expectations.”

Here are expert answers to your miscarriage questions:

What are the different miscarriage symptoms and signs?

Most miscarriages happen in the first trimester.

The first sign is usually vaginal bleeding or cramps that feel a lot like strong menstrual cramps, Carusi said. But most women who have bleeding in the first trimester don’t have a miscarriage so it doesn’t necessarily mean you are losing the baby, she added.

Sometimes, women have no symptoms at all and only realize something is wrong when the doctor doesn’t find the baby’s heartbeat during a check-up, Hoskins noted. Other symptoms can include lower back pain or abdominal pain, she said.

When should I contact my doctor?

“If you feel something different in your pregnancy… or anything that just doesn’t make sense — it shouldn’t be happening — the best thing to do is to contact your provider,” Hoskins said.

You don’t need to rush to a clinic, but get in touch with your doctor and see if the issue is something you can watch at home, or need to come in and be evaluated, she advised.

How long does a miscarriage last?

It depends on the patient. Passing the placenta and the sac can take an hour or a few hours. That’s when a woman is going to feel the strongest cramps and have the most bleeding.

A woman can either pass the pregnancy tissue on her own, or doctors can help remove it with a procedure called dilation and curettage, Hoskins said.

How long do you bleed after a miscarriage?

Bleeding is natural and normal for up to two weeks after a miscarriage and should taper off over that time, both doctors said.

When will I get my period again?

In general, expect a period within about six weeks, Carusi said. Let your doctor know if it doesn’t come back within that time frame.

What causes a miscarriage?

Most miscarriages happen when chromosome mistakes in the egg or sperm make it impossible for the baby to develop, the National Institutes of Health says. Too many or too few chromosomes — which carry our genes — will result in an abnormal pregnancy.

“It’s Mother Nature’s way of saying, ‘This one didn’t start off right,’” Hoskins noted.

The other most common answer to the “why” question is that doctors just don’t know.

“I do tell patients it’s almost certainly not anything that she did,” Carusi said. “So many things have to go exactly right for a pregnancy to implant and grow and unfortunately, things go wrong along the way.”

The big point to remember: It’s not the mother’s fault. It’s not what she ate or drank, both doctors said. The risk of miscarriage rises with age and is greatest for women who become pregnant after 40.

Is getting pregnant after a miscarriage possible?

Yes, most women will go on to have a healthy, full-term pregnancy, both doctors emphasized.

If you miscarried the first time you became pregnant or after already having a child, your chances of having a normal pregnancy the next time around are 90 percent or higher, Hoskins said.

“Women often tend to feel like there’s something wrong with them and they can’t carry a baby, but that’s definitely not true,” Carusi said.

If you have had several miscarriages, the chances are still 85 percent or higher that you’ll have a baby the next time, Hoskins noted.

How soon after a miscarriage can you get pregnant?

The traditional advice is to wait three months before trying to conceive after a miscarriage, both doctors said. But a recent study found there's no physiological reason to wait.

Carusi tells patients to wait until they’ve had at least one natural menstrual cycle so she knows their hormones have gone back to normal. She also advises them to hold off until they feel psychologically ready.

How can I support my partner?

A woman who has had a miscarriage may worry her spouse will feel that she’s not going to be an “effective child bearer,” so partners need to be reassuring, Carusi said.

“[Reinforce] that it was an accident of nature,” she advised. “Express faith in her that she’s healthy and she’s going to have a healthy baby.”

Recognize that if you’ve had a miscarriage, you may be OK at first, but fall apart emotionally a week later, Hoskins noted. Reach out to a doctor for help whenever you need it.

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