Call us if you are bleeding
If you lose blood early in pregnancy, do get in touch on 06 39 45 68 14. Even if you are unsure whether it is serious enough: rather one call too many than one too few. When to call sets out what you should always ring about.
How often it happens
About one woman in five has some bleeding in the first 16 weeks of pregnancy. In half of those cases the pregnancy ends in a miscarriage. There is more about other causes of bleeding under pregnancy complaints.
A miscarriage is a spontaneous ending of a pregnancy up to 16 weeks; the medical term is spontaneous abortion. In everyday Dutch the word 'abortus' means a deliberate termination, which is properly called abortus provocatus. That is why we prefer not to use the word with parents who have lost a pregnancy they wanted.
How a miscarriage happens
Miscarriages are usually caused by a chromosomal abnormality in the embryo that arose at conception. Such an abnormality is rarely hereditary and has no bearing on later pregnancies. Miscarriages are therefore not the result of physical effort such as cycling, nor of having sex. An internal scan does not cause a miscarriage either.
A pregnancy test says little
If you are bleeding, there is no point doing a pregnancy test to see whether you are having a miscarriage. The test can still show positive up to a month after the pregnancy has been lost, because the pregnancy hormone hCG is still present in the blood. A scan can often show a miscarriage, though before 7 weeks it is usually of little use. Do note: a scan during bleeding is always a snapshot and says nothing about how the pregnancy will go on.
How it goes
A miscarriage usually starts with cramping pain, like mild contractions, and bleeding that gets heavier. You lose clots and tissue; often it is over within a few hours and the pain eases. The bleeding can go on for another one to two weeks, getting lighter all the time. You can take paracetamol for the pain.
If the miscarriage does not start by itself, there are three options: waiting, medication that helps the womb contract, or a small procedure in hospital. We discuss together which suits you best, and refer you on if that is needed.
Call us straight away if you are bleeding very heavily — more than two sanitary towels an hour — if you develop a fever, or if you feel dizzy or unwell.
Afterwards
After a miscarriage your period usually returns within four to six weeks. Physically you can become pregnant again after that; when you want to is up to you.
A miscarriage is often a great loss, even when the pregnancy was still short. Grief, anger or emptiness are part of it, and everyone deals with that in their own way. If you would like to talk about it, do call us; we are glad to make an appointment to go through it with you.