Spontaneous loss of the fetus during the first 20 weeks of pregnancy is called miscarriage, spontaneous abortion or early pregnancy loss. Miscarriages occur commonly due to developmental abnormality in the fetus that decreases the chances of its survival in the future. Miscarriage is a common phenomenon and as many as 30% of the women have a miscarriage usually before they even realize they are pregnant.  How do I know if I'm having a miscarriage? How should you respond in case of miscarriage?

How to Know If I'm Having a Miscarriage

Keep your doctor informed; if you observe any changes or if you miscarry, go to your doctor immediately. Try to save your baby if possible because they can give a clue as to why you would miscarry and if any abnormality was present in the fetus. Also check out those miscarriage symptoms:

Signs of Miscarriage

Vaginal bleeding. In most cases, miscarriages begin with vaginal bleeding. There may be spotting or more commonly heavy bleeding. However, vaginal bleeding does not always mean a miscarriage. About 1 in every 4 women has spotting of blood in early pregnancy and not all of these women experience a miscarriage.

Abdominal pain. After vaginal bleeding there may be abdominal pain if you are having a miscarriage. This pain might feel like pelvic pressure or lower back pain and may be mild or severe. Sometimes there may be persistent cramping pain along with the bleeding. If there is both abdominal pain as well as bleeding, then chances are you are in fact having a miscarriage.

Rh negative mothers need an injection of Rh immune globulin after you notice bleeding, usually within 2-3 days. The immune globulin is not necessary if the father of the baby is also Rh negative.

What to Do If Miscarriage Occurs

In case of a miscarriage, there will be bleeding along with cramping for some time. During this time you can wear a sanitary pad but not a tampon. Do not be alarmed if the bleeding or cramping worsens; this usually happens when the body is trying to expel the products of conception i.e. the fetal tissue and the placenta. These products of conception may also include blood clots or have a grayish appearance. To relieve the pain, you can take an over-the-counter analgesic like acetaminophen.

Can It Be Something Else?

Sometimes, pain and bleeding are signs of ectopic pregnancy or molar pregnancy. Whatever the cause may be, it is important to seek the help of your doctor or midwife so that they can deal with the symptoms immediately.

How to Confirm a Miscarriage

A miscarriage can also be detected by your healthcare provider during a routine antenatal visit. The suspicion might arise if the size of your uterus is small or if they cannot hear the heartbeat of the fetus. Sometimes the vaginal bleeding or abdominal pain occurs weeks after the fetus stops developing.

The confirmation of miscarriage is done by an ultrasound or blood test. If your healthcare provider suspects a miscarriage, he or she may order these tests.

Learn more from the explanation of an expert about how do i know if i'm having a miscarriage:

What to Do If I Think I’m Going to Miscarry?

If unusual symptoms like vaginal bleeding or abdominal cramping occur, it is important to seek the help of your healthcare provider immediately. The doctor will then rule out whether the bleeding is from the uterus or from the cervix. Moreover, serum HCG levels are also checked to see if the level of the hormone is rising as it should or dropping. The tests are repeated in two to three days to compare levels with baseline HCG levels. 

An ultrasound scan is performed right away to rule out other cause of vaginal bleeding and cramping like ectopic pregnancy. If there is continued bleeding despite no visible problems, then a repeat scan after 7 weeks.

After seven weeks, the chances of a normal pregnancy are increased if an embryo with a normal heart beat is detected on the ultrasound scan. Even though the chances of a miscarriage are lowered, you might need another scan if you continue to bleed. If the new ultrasound scan shows a normal sized embryo but no heartbeat, then the baby did not survive.

On the other hand if the size of the baby and the amniotic sac looks small on the ultrasound and there is no heartbeat, it might be that you miscalculated your dates and the baby is not as old as you thought. In any case, to make the final diagnosis your doctor might order repeat blood tests and ultrasound scans in the next couple of weeks.

Bed Rest: To prevent an impending miscarriage, some caregivers prescribe bed rest. Although there is no evidence to support this theory, but bed rest is thought to reduce the chances of a miscarriage. Your doctor might also suggest abstinence from sex if there is associated bleeding or cramping. Normally there is no co-relation between sex and miscarriage but it is better to be cautious.

What Happens After a Miscarriage?

After having a miscarriage, there will be mild cramps in the abdomen like that seen during menstruation. Usually these cramps persist for a day or two and are followed by light bleeding for a week. These cramps will be observed even after you pass out the fetal tissue or have it removed. To manage the light bleeding and pain, use sanitary pads along with an oral over-the-counter painkiller like ibuprofen or acetaminophen. Avoid using a tampon, swimming, vaginal medication, sex and douching during this time.

You need to go to the doctor or emergency room immediately if there is any sign of infection (like fever, pain, and discharge from the vagina and foul smelling), pain in the abdomen or excessive bleeding (soaking one pad per hour). With heavy bleeding there is a chance that you might go into shock and experience dizziness and weakness, therefore call for help as soon as possible.

What About Future Pregnancy?

Miscarriages are pretty common. Having a single miscarriage is not a sign that there is something wrong with you or your partner but it is understandable to be worried about future pregnancies.

When to Try to Have Another Baby

After a miscarriage, it usually takes four to six weeks for your period to normalize. It does not matter whether you miscarried spontaneously or with the help of drugs, you will have to wait before you can try to have a baby again.

While some doctors say that it is okay to try to conceive after this period, others prefer that you wait for another menstrual cycle to finish so as to giving you time to recover from the previous ordeal. During this time it is better to use contraception because ovulation can start as early as two weeks after a miscarriage. 

Recover Emotionally from the Loss

Women generally take longer to recover emotionally from a miscarriage even if they are ready physically to have a baby.

For everyone, the method to cope with their loss is different. Discuss your feelings with your partner and see whether you want to wait or try again soon for another baby. During this time you can also go to a support group for help.

You can also get in touch with your caregiver who can then recommend a therapist to you.

If you have to explain the loss of your pregnancy to your other children then you should think about how to tell the incidence and then explain.

Tests that the Doctors Might Do

Depending on what your doctor considers appropriate, he or she can order blood and genetic testing after two or three consecutive miscarriages. Your doctor might even consider these tests if your age is more than 35 years or if there are associated medical conditions.

Women who experience a miscarriage in their second trimester or have a premature birth in their third trimester (due to cervical problems), are referred to a high-risk specialist even after a single incident. This is to ensure that the future pregnancies are managed carefully.