Early Pregnancy Loss

Early pregnancy loss (also known as miscarriage or spontaneous abortion) happens when a pregnancy ends on its own before the 20th week. It is more common than you may realize. It is estimated about one in four pregnancies end this way, but the actual number may be higher. This is because many miscarriages happen before many people realize they are pregnant.

Though it’s a natural part of life, experiencing a miscarriage can bring deep sadness, confusion and even guilt. At Banner Health, we understand the pain of early pregnancy loss. We’re here to support you with care and compassion. 

What does not cause miscarriage?

It’s natural to wonder if something you did caused a miscarriage. But in most cases, they happen for reasons beyond your control. Many common activities and experiences do not increase your risk, including:

• Regular exercise: As long as you are healthy, moderate exercise is safe during pregnancy. Speak with your health care provider about what activity level is best for you.
• Sex: Sexual intercourse is generally safe during a healthy pregnancy.
• Stress: While high stress can affect your overall well-being, it is not a direct cause of miscarriage.
• Birth control pills: Use of birth control pills before getting pregnant will not raise the risk.
• Vaccinations: Getting vaccines like the flu, whooping cough or COVID-19 will not cause a miscarriage. Instead, they are recommended to protect both mother and baby.

What can cause early pregnancy loss?

In most cases, a miscarriage is not something you can prevent. Most miscarriages happen due to a problem with the chromosomes in the fetus. About half to two-thirds of early pregnancy loss is linked with extra or missing chromosomes.

Chromosomes are in each cell of the body and carry the blueprints for how we develop and function. If an egg or sperm has more or fewer chromosomes than normal, a baby will have an abnormal number. This can lead to miscarriage.

Some health issues can also increase the risk of an early miscarriage, including:

• Structural problems: Physical problems with the placenta, cervix or uterus
• Chronic conditions: Health issues like high blood pressure, uncontrolled diabetes or autoimmune diseases
• Infections: Various infections including untreated gonorrhea (a sexually transmitted infection), HSV-1 or HSV-2, parvovirus B19, cytomegalovirus (CMV), toxoplasmosis and Zika   
• Hormonal imbalance: An underactive or overactive thyroid or polycystic ovary syndrome (PCOS) can affect hormone levels

Risk factors

Other factors can also raise the risk of miscarriage, even if they don’t directly cause it:

• Age: People over 35 are more likely to experience chromosomal problems 
• Past miscarriage: Having one or more previous miscarriages (recurrent miscarriages) 
• Lifestyle factors: People who smoke, use illegal drugs or drink too much caffeine or alcohol
• Weight: Being underweight or obese 

Signs of miscarriage

Most miscarriages happen during the first trimester of pregnancy (the first 13 weeks). If you notice any of these signs, contact your health care specialist right away:

• Vaginal bleeding, from light spotting* to heavy bleeding
• Cramping or pain in your lower belly
• Bloody tissue or clots passing from the vagina
• A sudden stop in pregnancy symptoms, like nausea or breast tenderness
• Dizziness, lightheadedness or feeling faint

*Some spotting or light bleeding early in pregnancy can happen. One of the most common causes is due to implantation when the fertilized egg implants (attaches to) the uterine wall. However, it’s best to get checked out by your provider. 

Sometimes, a miscarriage happens without symptoms. This is called a missed miscarriage. It’s often discovered during an ultrasound exam or scan of the baby. 

Call your provider if you experience heavy bleeding that soaks a pad in an hour, fever, chills, severe pain or foul-smelling discharge. These could be signs of infection or complications that need treatment. 

Diagnosing miscarriage

If you have symptoms or concerns, see your health care provider. Depending on how far along you are in the pregnancy, your provider may use different methods to determine a pregnancy loss.

These may include:

• A pelvic exam to see if the cervix is open or dilated
• A blood test to check pregnancy hormone levels
• An ultrasound test to look at the uterus and placenta and for the baby’s heartbeat and growth

Treating pregnancy loss

Treatment for pregnancy loss focuses on ensuring all pregnancy tissue leaves the body safely and completely. Pregnant people are at risk for bleeding, pain and infection if some of the tissue is left behind in the uterus after a pregnancy loss.

Your health care specialist will guide you through your choices and recommend the best option based on your situation, health and preferences. These options may include:

• Watch and wait: Sometimes the body clears the tissue, which can take a few weeks. While this option can be emotionally challenging, it is often safe. Your provider will monitor you to ensure there are no signs of infection or heavy bleeding.   
• Medication: Your provider may prescribe medicine, such as misoprostol, to help your body pass the remaining tissue. This medicine causes the uterus to contract, which can help clear the tissue faster. For a short time, you might experience cramping and heavier bleeding. This method can often be done at home. 
• Procedure: In some cases, a minor surgical procedure called dilation and curettage (D&C) is needed. This procedure clears the tissue from the uterus to prevent infection or prolonged bleeding. A D&C is typically performed in a hospital or outpatient setting and has a quick recovery time. 

Emotional recovery

Coping after a miscarriage takes time. Be kind to yourself and allow space to heal physically and emotionally. You might feel sadness, anger, guilt or even relief. All these feelings are normal.

Remember, a miscarriage is not your fault. It does not mean you won’t have a healthy pregnancy in the future. Talking to someone you trust can help. This could be your partner, a friend or a therapist.

Support groups are also helpful. Sharing your story with others who have been through the same thing can bring comfort. 

Trying again after miscarriage

Many people wonder when they can try to get pregnant again. Talk to your health care specialist about what’s right for you. In many cases, it’s safe to try again after one or two normal periods (menstrual cycles). 

Your provider may recommend tests if you have had more than one miscarriage. These can look for possible issues that might need treatment before you try to get pregnant again.

Preventing miscarriage

While not all miscarriages can be prevented, there are steps you can take to lower your risk before and during pregnancy:

1. Regular check-ups: Your provider can monitor your health and address any concerns early on.
2. Eat a healthy diet: Maintain a balanced diet with plenty of fruits, vegetables, whole grains and lean proteins. Avoid harmful foods like raw fish and unpasteurized dairy that can put you at risk.
3. Get enough folic acid: Folic acid is important for a healthy pregnancy. Take a prenatal vitamin with folic acid as recommended by your health care specialist. 
4. Avoid smoking, alcohol and drugs: These can harm your pregnancy.
5. Manage health conditions: Work with your provider to keep conditions like diabetes and high blood pressure under control.
6. Stay active but don’t overdo it: Moderate exercise can help you stay healthy but avoid high-risk activities that could cause injury.

You’re not alone

Banner Health offers resources and expert help, whether it’s medical care or emotional support. If you are ready to talk, we are here to listen. Contact us today to learn how we can help you through this journey.