Märta Cullhed Engblom

ByMärta Cullhed Engblom

Midwife and doula

Unfortunately, it is not possible to prevent a miscarriage. As many as between 15 and 20% of all pregnancies end in a miscarriage. The first sign is a menstruation-like bleeding. However, bleeding is common in early pregnancy and does not necessarily mean there is a problem. During a miscarriage, you continue to bleed until the uterus has expelled the entire pregnancy.

The bleeding is often heavier than a regular period, and you may see clotting, called coagulates. Occasionally, you can see tissue remains. Many women also have strong menstrual cramps. You do not need to seek emergency care, but can wait and contact your antenatal clinic/maternity clinic for advice. If it is the start of, or an ongoing miscarriage in early pregnancy, there is nothing that can be done to stop or prevent it. Your body can normally take care of this without medical attention.

However, if you aside from the bleeding experience severe abdominal pain in your lower abdomen or on one side, or if you are bleeding and feel generally unwell, get emergency medical care. Bleeding in combination with severe pain on one side of your abdomen could be a sign of ectopic pregnancy (the egg has not attached itself inside the uterus but outside, most often in the fallopian tube). This can quickly become a life-threatening condition if left untreated since the fallopian tube can rupture, causing massive bleeding in the abdomen.

Missed abortion—or missed miscarriage–means that the miscarriage is delayed, and it takes time, sometimes several weeks, before the body expels the fetus. It is first noticed when the woman starts to bleed or during an ultrasound exam. Typically, all the symptoms of pregnancy continue although the fetus has died.

Many women who suffer a miscarriage blame themselves. It’s important to remember that you cannot cause a miscarriage via stress, exercising or heavy lifting. Nor can you cause a miscarriage by flying in an airplane. When you’re pregnant, all you can do is to take as good care of yourself as possible. Eat a variety of nutritious food, exercise, rest when you are tired, and don’t smoke, drink alcohol or use drugs. Taking a folic acid supplement may have a preventive effect since folic acid reduces the risk of defects in the embryo. Be extra cautious in regard to medication, and consult your midwife or healthcare provider if you need to take medicine. Other than that, there is nothing you can do. Trust your body and trust that it will do what it needs to do.

If bleeding does lead to a miscarriage, the most common cause is that there was something wrong with the baby, which caused your body to reject the pregnancy so it could start over again. An infection can cause a miscarriage or if you have an underlying condition that increases the risk of a miscarriage. For the most part, the body takes care of passing the pregnancy tissues itself. But at times, it is necessary to perform a procedure called dilation and curettage (D&C) to ensure that the uterus is completely empty. Bleeding after a miscarriage should gradually lessen and ultimately stop. If you develop a fever, if the bleeding or reddish-brown discharge starts to smell bad or increases, or if you feel pain in your lower abdomen, it could be a sign of an infection in your uterus. Get emergency medical care. The infection will be treated with antibiotics.

After a miscarriage, avoid taking a bath in a tub, and swimming in lakes, the ocean or pools as long as you are bleeding. Avoid using tampons and use condoms during sex. As long as you are bleeding, you uterus is still healing and there is a greater risk of infection.

Having a miscarriage does not lower your chances of conceiving again. After a miscarriage, your body will recover quickly and you can conceive again after a few weeks.

For most women, a miscarriage is associated with emotions. All types of emotions are OK. If you are grieving, allow your grief to take up as much space as it needs. Your body can also grieve after a miscarriage. If you or your partner, if you have one, need counselling, the antenatal clinic/maternity clinic usually works with a counsellor. Don’t hesitate to get help. If you have several miscarriages, an investigation will normally be done to determine if there is a cause that can be resolved. If you have had one or more miscarriages before this pregnancy, it’s natural to feel more anxious. Many women carry this feeling up until the baby is born and they can see with their own eyes that everything is fine.

Sources: - Bratt, A. (2014). Vänta på barn: Fertilitetsboken. Bonnier Fakta. - Kaplan, A. (red.) (2009). Lärobok för barnmorskor. (3., omarb. uppl.) Lund: Studentlitteratur.