A miscarriage often starts with bleeding. Midwife Sally-Jane Cameron shares the basics.
Fact: In early pregnancy, 50% of bleeding results in a miscarriage
. This is a scary and very sad time for the parents. It does not matter how many weeks a woman is when she loses her baby, it is devastating and something that she carries with her for the rest of her life.
The medical term for a miscarriage is a spontaneous abortion. If you hear these words then do not be alarmed, they do not imply that you had anything to do with the miscarriage. The word abortion
has very negative connotations, but it is just a medical term. If your care provider uses the word and it is painful for you, ask them to rather use miscarriage.
Doctors will do a scan to see if there is a heartbeat and to see if the body has started to expel the contents of the pregnancy. Looking at that screen and seeing no heartbeat, and hearing no reassuring sound, is the moment that all mothers dread. The hope is finally gone and you have to deal with the loss of your baby.
If the scan shows that body has expelled all the contents and the uterus is empty, it is known as a complete miscarriage, and there is usually then no need for the doctors to do anything further. They will check that your cervix is closed and tell you to monitor that the bleeding stops, and that you do not get a fever which may indicate infection. Some may give you precautionary antibiotics.
If there is no heartbeat, but the uterus has not expelled the contents yet, or some tissue remains, then the doctors will need to perform a procedure called a D&C ( Dilatation and Curettage), in which they remove any leftover tissue in the uterus.
As pregnant women facing this loss, the temptation is to try and find something we did wrong, but often when doctors do a scan they see that growth of the foetus stopped quite a few weeks earlier, and nothing you did caused the miscarriage.
After 20 weeks it is known as a stillbirth if the baby does not survive. The most common causes are uterine abnormalities, a knot in the cord, an accident or severe trauma to the uterus, infection or placental abrupture. These babies are usually born through the induction of labour, although occasionally they may be small enough to be taken out by D&C.Treating late pregnancy bleeding
If it’s found you have not had a miscarriage, you and the baby will be monitored. You will get IV fluids if you are losing a lot of blood, and treatment will depend on the cause of the bleeding.
Placenta Previa will always result in a caesarian birth as the placenta is blocking the cervix. If you are over 36 weeks the doctors may deliver the baby immediately. If you are less than 36 weeks they will give the baby medication to mature its lungs and try to stop any contraction, and keep you on bed rest until after 36 weeks.
You and baby will be closely monitored during this time, as the blood loss can be severe.
: the baby will be monitored closely to see that it is getting enough oxygen and nutrients from the placenta. If you are more than 36 weeks they may proceed to delivery and again if less than 36 weeks they will try give you medication to mature the baby's lungs, try to stop any signs of labour and prolong pregnancy as long as it is safe for you and the baby.
Uterine Rupture. You will need immediate surgery to try and save the lives of both you and your baby. Doctors might have to remove your uterus. If the damage is not too severe, or you wanted to have more children, they may try to repair the tear.
Find out about bleeding in early pregnancy
and later pregnancy
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