Miscarriage

Prior to my rainbow baby born this month, I had two back-to-back losses. The first was a missed miscarriage at 8 weeks, and I decided to have a natural home miscarriage as opposed to a D&C. I’d heard that it was very much like a “mini-labor,” and having had three children already, I was pretty sure I could handle it. Once things actually started happening though, it was a scary experience, one that would have been far worse if I hadn’t had other children to have an idea what to expect. The second was a spontaneous loss at 7 weeks.  In my effort to share the entire process of a miscarriage from start to finish, I spoke with other women who had suffered losses, read countless forums, and talked with my mid-wife in regards to what most can expect during and before a miscarriage. My miscarriages were rather typical of my findings, but I will caution that your experience may differ as every body is different.

When will the bleeding start during a miscarriage?

I decided to start here, because this factor and the next, pain, seemed the most variable. Some women, like myself, start spotting and slowly progress to heavy bleeding over the course of anywhere from a few days to a few weeks. Others seemed to have a very sudden gush-like bleed that arrives without warning. This is likely related to the cause of the loss and your personal hormone balance/drop rate.

What does a miscarriage feel like? Does it hurt?

A miscarriage is, in function, a mini-labor as many women suggest. Contractions cause the cervix to dilate so the tissue can be expelled. The pain you’ll experience from this depends on a variety of factors. For example, early losses tend to be less painful, because the fetus and sac are smaller, meaning the cervix has to open less. Women who have had children, and so stretched the cervix already, usually experience less pain. Pain tolerance and psychological state also are considerations. The pain level of a miscarriage can be quoted anywhere from “barely felt a thing” to “worst pain of my life.” As a mother of four, I’d rank my losses with bad menstrual cramps.

What happens during a miscarriage? How long does it take?

Once the pain begins, the bleeding will likely pick up to. For me, my early loss was mostly painless. I bled much like a period, but passed several large white-ish grey tissues pieces. The later missed miscarriage, it was 3 hours from the point where I felt the pain to finish. The later the loss, the more blood.  You’ll also see large clots in a late loss, I’d describe them as liver-like in appearance, many of my cots where hand-sized. This is normal. You’ll pass lots of clots long before the fetus, sac, and placenta itself.

Don’t stress yourself out more trying to examine each one worrying it’s your baby, you will know the placenta when you see it. One helpful recommendation I received from some of the women I spoke with was to use a colander. This eliminates the mess of trying pads (I do not recommend this, the blood is far too copious for pads) and the emotional shock of having to pull your baby from a toilet bowl, if you choose to do so. Which brings me to my next point…

How will I know when my miscarriage is complete? What do I do with the baby?

If you’ve never given labor, I highly recommend looking up some pictures of placenta just to avoid the guessing game. Placenta is often greyish in color and lumpy, it looks like tissue, not clot. There is a very clear difference. The sac will actually look like a sac, though it may also be burst, and appear as a thin membrane. Depending on how far along you were, you may also see your baby. Remember, that at 8-10 weeks even, your baby is about the length of 2 pennies side-by-side and not fully formed. It will not look like a miniature newborn.

What you choose to do with the tissue that comes out is really a matter of personal preference. You can take it to your care provider and request testing, though they often will not do so unless you have reoccurring losses. You can bury it. You can have it cremated. You can even cremate it yourself. I choose that route. There is so little tissue, a good hot bonfire does this fairly easy. Many women I spoke to just could not emotionally handle retrieving their baby, and flushed it. For me, I did not examine it closely, I only looked enough to try to confirm everything came out. You don’t even have to do that. You can have a care provider confirm this via ultrasound if you wish. Prolonged heavy bleeding or excessively heavy bleeding (soaking a maxi-pad every hour) are both signs you may have retained tissue. Any fever or signs of infection are also a seek-medical-attention situation.

What is it like after a miscarriage?

If there is someone you trust that can be present while you miscarry, not necessarily in the room, but in the house, this is highly recommended. My losses went smoothly, but after the later loss I tried to shower, and fainted from blood loss in the tub, luckily my husband heard me fall. Blood loss in particular is a major concern during a miscarriage. If you begin to feel dizzy or see spots, you need to get help. I was able to play with my kids and go to the grocery store within hours, but took a nap beforehand and ate. You’ll likely be tired, emotionally drained, and low on blood sugar (and blood for that matter) so try to eat even if you don’t feel hungry.

The bleeding after a loss is on-par with a period for most, and should last no more than 10 days. You may see more clots than you typically do.

The next installment of my miscarriage journey will be on trying to conceive again after a loss. You can read article one and two by clicking the links below:

Tips for Handling the Grieving Process
Missed Miscarriage or Misdiagnoses? What to Do if You’ve been Told You’re Miscarrying

After confirming that my baby had died at 10 weeks back in 2013, I was left trying to deal with the loss both physically and emotionally. In an aim to help other women handle their tragedy, I’ve chosen to share my story from start to finish in a series of short articles, so that other women who face what our family did are more prepared. You’ll find my story enhanced with research as well as information gleaned from talking to other women who have had miscarriages and health care professionals I met through the process to help answer questions you may find yourself asking.

Article two addresses handling the grieving process. Our family, unfortunately, suffered two miscarriages at almost the same time. My sister-in-law also had a loss at 10 weeks, one month before my own. She and I handle grief in very different ways offering a perspective from two different ends of the emotional spectrum. I tend to be quite logical. If you can “make sense” of things for me, I can cope, while my sister-in-law tends to be more emotional and less concerned with the details.

What might help you deal with your miscarriage if you are a logical thinker:

For me, research is what helped. I wanted to know why my baby died, why after three healthy pregnancies, I lost the fourth with no warning whatsoever. I never found a factual answer, it is quite difficult to determine why a miscarriage happens, but the most common reason for miscarriage is chromosomal abnormality.

Chromosomes are kind of like the genetic blueprint your baby’s body follows while developing. Sometimes that blueprint may become damaged or be missing portions. This could be from damage to the sperm or egg, poor egg or sperm quality, or just a fluke; it just happens sometimes. This is most often the cause of missed miscarriage, as the baby begins to develop properly, but is unable to finish. As there is no trauma or placental issue, there is often no bleeding and the body goes right on thinking it’s pregnant for weeks. My baby’s passing was estimated to have occurred at 8 weeks, however, I didn’t fully miscarry naturally until 11 weeks with no bleeding until just past 10.

Some outside factors are also believed to increase the risk of miscarriage in general, including hormonal imbalance (particularly low progesterone), poor maternal health, smoking, drug use, and maternal age.

When I realized that had my baby lived, he or she may not have been healthy or may have had lifelong disabilities due to chromosomal abnormality, I felt better about my loss. I asked myself the question, “If I could have chosen, between a full-term baby that wasn’t healthy and a first trimester loss, which would I choose?” The answer was the loss. It still hurt, I still wished my baby would have been OK, healthy and happy, but knowing that the miscarriage was a mercy made it hurt a little less.

What might help you deal with your miscarriage if you are more emotionally driven:

For my sister, it helped to stay surrounded by the people she loved. She didn’t just keep us around to distract her, she talked about it. She posted on Facebook about it. She wrote about it. She did everything she could to let that emotion out. Think about how you’ve handled sadness at other times in your life; maybe you journaled, listened to music, created art, went out with your friends. While this loss is different and may hurt more than others you’ve survived, those same coping mechanisms are a good place to start if you’re looking for peace.

Above all, know that no matter how you handle grief, this was not your fault. You could not have stopped it, no matter how all-powerful moms seem to be. Things happen in life that are well beyond our control. What is in our control is how we handle them. This is not to say that you can turn off the hurt, but that like all wounds this one will heal, even if it leaves a nasty scar.

You can read the next article in this series which covers what a miscarriage is like here.