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Miscarriage

Unfortunately, a pregnancy doesn't always go well. The first period of pregnancy often comes with some anxiety. During the early development of the embryo, abnormalities in the chromosomes can occur and the pregnancy will end in miscarriage. In that case there is a defect in the embryo, which means it is not viable and is rejected. Vaginal blood loss and menstrual pain can be a first sign of miscarriage. During the first scan it may be discovered that there is no heartbeat. In about one in ten women, the pregnancy unfortunately ends in miscarriage in the first 16 weeks.

Is it possible to prevent miscarriage?

A miscarriage is often unavoidable and comes without you being able to change anything. There are some myths about miscarriages. It is perfectly safe to have sex, ride a bike, a horse or a motorcycle during (the first period of) pregnancy. This will not cause a miscarriage! A good start to your pregnancy is important, of course, so you can make sure you have a healthy lifestyle and avoid risks during pregnancy. Risk factors include alcohol and drug use, an irregular lifestyle and severe obesity. Certain medicines can also cause miscarriage. Are you on medication? We will discuss any increased risk with you.

It is a fact that your age can play a role in the risk. As you get older, the risk of miscarriage increases:

  • Under 35 years of age; about 10% chance of miscarriage
  • Between 35 and 40 years of age; about 20% chance of miscarriage
  • Over 40 years of age; about 40-50% chance of miscarriage
  • Over 45 years of age; about 50% chance of miscarriage

When should you contact us?

If you think you are having a miscarriage, please contact us. You and your midwife will decide together whether an ultrasound is appropriate based on your complaints. Blood loss doesn't always lead to miscarriage. In the beginning of pregnancy, one in five women suffers from vaginal blood loss.

Please contact the emergency number: 036 54 00 266 (key 1) for any of the following complaints:

  • Abdominal pain that persists
  • Fever above 38 degrees (both during and after miscarriage)
  • Severe blood loss

Signs you may be having a miscarriage

Signs of miscarriage in the first pregnancy period may include: vaginal blood loss, menstrual pain and decreasing pregnancy symptoms such as morning sickness or tense breasts. Unfortunately, if the scan shows you are having a miscarriage, there is nothing you can do to stop it. Contact your midwife and together we will discuss whether you can wait and see or need to go to the hospital for treatment.

Wait and see

If you have a miscarriage in the first weeks of pregnancy, it often starts automatically – within two weeks. You will have abdominal cramps much like a heavy period and the blood loss increases. A miscarriage at 12-16 weeks can be more severe. The embryo will be larger and you can lose blood clots. There's a slight chance of severe blood loss, but if this happens to you, you can call us right away. Even if you are in doubt, you can always contact us. Sometimes, after a miscarriage, the blood loss can increase and the abdominal pain can persist. In that case you will have a scan. There may still be some pregnancy tissue in your uterus that needs to be removed. As soon as the foetus has left your body, the pain will decrease almost immediately. Blood loss also decreases rapidly and is comparable to your last menstrual days. Due to the risk of infection, it is important not to use tampons. The advantage of waiting for a spontaneous miscarriage is that there is no risk of infection or damage to the uterus and/or cervix. And please remember that there are no risks for a new pregnancy.

Treatment with medication

You can also opt for medication. The gynaecologist or midwife will prescribe you tablets to insert vaginally, that will trigger a spontaneous miscarriage. This miscarriage will cause abdominal pain and blood loss. Keep in mind that these medications do not always work and the medication works for about 50% of women. If your miscarriage does not start, curettage will be necessary. When treated with medication, there is no risk of infection or damage to the uterus and/or cervix and there is no risk for a future pregnancy.

Curettage

If curettage is necessary, this entails a minor surgical procedure in the hospital. Under a short general anaesthetic, the uterus is emptied with a suction device via the vagina. It is a minor gynaecological procedure, but it is important to be properly informed about the treatment. After curettage, about 1 in 20 women experience complications. This may include severe blood loss, an infection or damage to the uterus and/or cervix. Adhesions of the uterine mucosa may also occur, which sometimes makes it slightly more difficult to get pregnant again.

Processing a miscarriage

Sadness and disappointment can make you feel empty after a miscarriage. You will need time to recover both physically and emotionally. We will be happy to help you and offer you all the support you need.

Physical

Your body often recovers within six weeks after a miscarriage. It is quite a big deal, and you'll probably feel tired and listless for a while. Know that it's also due to the change in your hormone levels. After the miscarriage, you can still have some blood loss and brownish discharge for up to two weeks. Usually, your next period will start again after about six weeks. Physically, you can try to get pregnant again.

Emotional

Everyone is different, as are the reactions and emotions in the event of miscarriage. Take the time to process your emotions. Often, women are concerned with the question as to why things went wrong. Please know that you would not have been able to do anything to prevent your miscarriage! Knowing that you are able to get pregnant in the first place may offer some consolation. And it will certainly help to talk to your partner or friends about your miscarriage.You may also be worried about the ‘chance of repetition’. 80% of women who have had multiple miscarriages still go on to carry a pregnancy full-term.

The question about 'chance of recurrence' is probably also haunting your mind. Know that 80% of women who had multiple miscarriages still get a full-term pregnancy.

Support from your midwife

Talking about your miscarriage can be a relief and a comfort. We will take all the time you need to share your emotions. Do you feel the need for a follow-up? Be sure to request a consultation with your midwife about:

  • The course of your pregnancy
  • Questions about any subsequent pregnancy
  • Emotions or anxiety you may experience

Getting pregnant again?

If you are pregnant again after a miscarriage, you may be particularly anxious at this time. Sometimes women no longer trust their own bodies and feel insecure. We understand that. If you are pregnant again – or want to become pregnant again – please contact us in advance so that we can discuss any questions or ambiguities you may have and how we can reassure you.

We'd love to talk to you about your desire to have children, also after a miscarriage.

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