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Miscarriage Signs & When to Call the Doctor

An odd ache or some light spotting doesn't mean you're miscarrying. But during the nerve-wracking first half of pregnancy, it's normal to worry over every strange sensation. Just as miscarriages have a range of types and causes, they have a range of symptoms too. Call your doctor whenever you experience something concerning. That funny feeling could be nothing, but finding out for sure gives you peace of mind.

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Facts on Miscarriage

The exact rate of miscarriage is unknown, because many happen before a woman even knows she's pregnant. It's estimated that 25 to 50 percent of all pregnancies are lost during the first 14 weeks, or the first trimester. In 2008, 18 percent of known pregnancies in the United States ended in miscarriage.

Miscarriage happens before the 20th week of pregnancy. The majority of known miscarriages occur before the 13th week, and only between 1 and 5 percent happen between 13 and 19 weeks.

Most miscarriages are caused by chromosomal abnormalities in the fetus. Hormonal problems, chronic health issues and trauma can cause them too. Your chance of having a miscarriage increases with your age. Lifestyle factors like drug use, smoking and heavy caffeine intake also increase your risk, but in most cases, women who miscarry did nothing to cause it to happen.

Miscarriage Signs

"It's not always possible to know what's normal and what's a possible or potential miscarriage," says Ruth Bender-Atik, national director of the Miscarriage Association in Yorkshire, in the north of England.

Bleeding is often a sign of miscarriage, but doesn't always signal a problem. In fact, according to the American Pregnancy Association, as many as 20 to 30 percent of pregnant women experience bleeding, and half of them go on to have healthy pregnancies. And while morning sickness may start fading after miscarriage, it's normal for this pregnancy symptom to disappear after the first trimester, around the time many miscarriages happen.

Complicating matters, Bender-Atik explains that some women never experience any troubling symptoms. "Some miscarriages are diagnosed at a routine scan, showing the baby died without any symptoms to alert the woman. This is called a silent or delayed or missed miscarriage."

Other times, a woman can tell something is wrong. Noticeable signs of a miscarriage include:

  • Abdominal pain that feels like very strong menstrual cramps
  • Pain or pressure in your lower back
  • Unusual vaginal discharge
  • Brown or red vaginal bleeding

Calling the Doctor

Contact your doctor as soon as you experience any of the symptoms of miscarriage. She can use a pelvic exam, blood tests and an ultrasound to determine whether you're still pregnant.

Sadly, there's little else your doctor can do for you if you are miscarrying. "[A doctor] may be able to offer advice, pain relief, comfort and support—and all those can help," Bender-Atik says. "But she's unlikely to be able to do anything to change the outcome." What your doctor can do is help you decide what steps to take next.

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Next Steps

Once your doctor confirms a miscarriage, she'll talk to you about how to remove the fetal tissue from your body. Your preferences, the type of miscarriage you had and how far along you were may factor into your doctors recommendations for how that happens.

If you weren't very far along, you may use what's called expectant management. Basically, this means letting nature take its course. You'll expel any tissue in the form of vaginal bleeding. It may take a few weeks for the process to finish. You may also opt to take medication that speeds this process up

Surgical management means your doctor will remove the tissue directly from your uterus. This is a minor surgical procedure done under local or general anesthesia. It may be done when you're further along in your pregnancy, or if tissue remains inside you after a period of bleeding.

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