*Please note that this blog is not a substitute for medical advice, diagnosis, or treatment; Sweet Child O’ Mine is sharing general information about pregnancy loss. As always, please consult with your medical provider with any questions you may have regarding this information and/or your medical condition.
October is Pregnancy Loss month, and at Sweet Child O’Mine, we want to acknowledge all of the experiences you may have as someone who is trying to conceive, experiencing loss, or navigating pregnancy after a loss.
Having walked this path with many before and also having our own personal losses, we know and understand the pain and grief you are experiencing surrounding a pregnancy loss. The complexity of your experience is valid, and we are here to support you along your journey. This piece will touch on the topic of miscarriage and loss in general ways; your story, however, is unique. As always, we encourage you to take what works, leave the rest, and seek care from providers you feel seen and heard by.
Understanding Miscarriage
As many as one in four pregnancies can end in miscarriage. There are a few reasons miscarriages occur, but the exact cause is often unknown. Some of the reasons may include a genetic abnormality, atypical formation of the embryo, hormonal/progesterone deficiencies, thyroid issues, or a blighted ovum (where a placenta and sac forms but there is no fetus).
The age of the gestational parent can also be a factor. Per Evidence Based Birth, “the rate of spontaneous miscarriage (pregnancy loss before 20 weeks) climbs gradually with age (CDC, 2020). The increased risk of miscarriage in older pregnant people is related to both egg quality, hormonal deficiencies, and an increase in preexisting medical conditions.”
There are two primary types of miscarriages: Spontaneous Miscarriage (SAB) in which the birthing person starts bleeding and cramping spontaneously and loses the pregnancy. The second type is a Missed Miscarriage (MAB) where one does not experience bleeding or spotting but finds out via ultrasound that the baby does not have a heartbeat. When a baby stops developing, it may take a few weeks for hormone levels to drop and the body to realize that the pregnancy is not progressing.
The majority of miscarriages happen before the 12th week of pregnancy. That said, ~1-5% of miscarriages take place during weeks 13-19, also known as the second trimester. Some miscarriages require medical or surgical management, so it’s important for clients to check in with their care providers to understand their unique situation and treatment options.
Treatments for Miscarriage
There are several different ways to experience a miscarriage, including spontaneous, medication induced, dilation and evacuation (D&E), or induction.
Spontaneous: A miscarriage with a developed sac less than 10 weeks does not usually require a D&E (the medical term for the surgery involving Dilation of the cervix and Evacuation of the uterus) and the birthing person may be able to safely wait for the miscarriage to happen spontaneously. For pregnancies that are lost between 10-12 weeks, a person may experience a spontaneous miscarriage or may elect for a D&E.
Spontaneous miscarriages usually start with vaginal bleeding followed by lower abdominal cramping that feels like menstrual cramps. The cramping happens as the cervix opens. The bleeding is coming from where the placenta is separating from the lining of the uterus. This usually continues for a day or two and can get quite intense. Please reach out to us or your care provider to get more information about spontaneous miscarriages and what to expect.
Medication (misoprostol): If the birthing person is 10 weeks or less (developing sac), your providers can administer a medication called misoprostol to induce the miscarriage. The medication process will cause more severe cramping and is not always successful at getting everything completely evacuated the first time, but it does help to get things over quicker. Misoprostol is not usually recommended past 10 weeks. Again, please talk to us or your care providers to understand your options and needs.
D&E (dilation and evacuation): If the loss happens beyond 12 weeks, a D&E is often recommended as the safest way as bleeding can be excessive with other types of miscarriage. A D&E is a surgical procedure where the doctor manually dilates your cervix and uses a vacuum to extract the placenta, sac and baby. This is a fairly quick procedure with minimal stay in the hospital. The disadvantage of a D&E is that the baby may not be intact.
Induction: An induction is also done in the hospital by using medication to start labor. This is often recommended in loss past 15 weeks. This takes longer (several hours) because the cervix has to gradually open on its own. The baby may appear more intact if that is important for you to see and hold the baby.
All of this said, please discuss your options with your midwife or care provider.
Acknowledging Your Needs and Being With Your Grief
We invite you to treat the time after a loss with a great deal of compassion, kindness, gentleness, and support. This, too, is a postpartum experience. You will likely have physical needs, emotional needs, mental needs, and so on. Again, this will be unique for each person.
Physically, as you experience loss, you will likely need to draw from a range of comfort measures including things like Tyleonol, baths, changing positions, ice or hot packs, comfort foods, and time off of work.
Grief is a normal human emotion, AND it can be quite intense mentally and emotionally (even spiritually). Additionally, grief can show up as a spectrum or cycle of emotions including anger, sadness, loneliness, guilt, and inability to focus. Sometimes you’ll feel all the emotions at once, and other times you will move through stages. There’s no right or wrong way to grieve, and we encourage you to read more about grief.
It’s crucial to know who is on your support team and consider expanding that team to include a doula, therapist, psychiatrist, and/or a support group as you experience loss and grief. Many other women have likely experienced the same or similar thing you’ve expereience, but few talk about it. Don’t be afraid to open up to friends and family and talk to them about how you are feeling. You likely will find that many of them have gone through miscarriage and loss themselves and can provide comfort and space to hold you in your time of grief.
If you carried a baby that developed past 10 weeks gestation, you have the option of filing for a certificate of non-viable birth to have official state record of your pregnancy and baby.
- Under the Grieving Families Act, If a parent (s) wishes to file a certificate of nonviable birth, then the health care practitioner and/or health care facility will have 30 days to file a record with the Bureau of Vital Statistics. A new form DH 8000-HSPM, entitled Florida Certificate of Nonviable Birth has been created for such filing. Please contact your health care provider to request this filing.
Sweet Child O’ Mine Is Here For You
Your team of midwives is here to support you throughout your reproductive journey. If you are currently trying to conceive, experiencing loss, or navigating pregnancy, we would be honored to be a part of your team; reach out and let us know how we can support you!
Additionally, if you are curious about how a doula may be able to support you during your pregnancy, miscarraige, or loss journey, check this blog out. We highly encourage you to build a support team and plan around your loss experience.
Finally, if you need help and feel overwhelmed, we invite you to call the HelpLine at Postpartum Support International.
