The most common symptom of miscarriage is vaginal bleeding, which may be very light or heavy. Abdominal cramping, similar to what you may experience just prior to or during your menstrual period, may accompany the bleeding. The cramping can vary from being fairly mild to severe and extremely painful. On the other hand, sometimes women experience spotting during early pregnancy due to implantation of the fertilized egg into the uterine lining and also a few women notice spotting at the time they would normally get their monthly periods, for other reasons. Remember, not all spotting and bleeding is a sure sign that you are miscarrying. However, any bleeding is considered a threat of a miscarriage and if you experience any signs such as spotting, bleeding, cramping (with or without lower back pain), fever or chills and passing tissue or clots, you should call your doctor right away.
Once symptoms occur, there is usually nothing that can be done to prevent a miscarriage. Some doctors may order bed rest, although this has not been proven to help prevent an inevitable miscarriage. Most doctors advise limited physical activity and abstinence from sex if you are experiencing any signs of a miscarriage.
Your doctor may perform a pelvic exam to see if your cervix is closed. If your doctor finds that your cervix is dilated (open), this is a sign that a miscarriage is likely to happen. Sometimes, a doctor may do an ultrasound to determine if the baby is still viable or if a miscarriage has already taken place. Many times, doctors order special blood tests to check HCG (Human Chorionic Gonadotropin) levels. By following HCG levels for a matter of days, your doctor will be able to tell if a miscarriage is occurring, due to abnormal levels, decreasing levels or levels that don’t multiply as they should.
If you miscarry at home, most doctors prefer you to try to collect and save any tissue you pass in a clean container and bring it with you to your doctor’s office. It will be analyzed to help determine the cause of the miscarriage, as well as to make sure the miscarriage was “complete”. A complete miscarriage means there is no tissue remaining in the uterus which may require medical intervention, such as a D&C to prevent infection.
Once a miscarriage has been diagnosed, your doctor needs to determine if you have passed all of the tissue from your uterus. Most of the time, miscarriages require no treatment and the uterus empties on it’s own similar to a heavy period. Some women opt to wait for the placental tissue to pass on it’s own naturally, as long as no signs of infection or severe bleeding occurs.
Certain times, a D&C (dilatation and curettage) is required if some tissue is suspected to still remain in the uterus. This is called an “incomplete miscarriage” and can lead to heavy bleeding and infection. A D&C is a minor surgery, which is performed on an outpatient basis in the doctor’s office or hospital. It is done with local anesthetic and has some potential risks involved, which you should discuss with your doctor beforehand. Whether you decide to let your body expel the tissue on it’s own or choose a D&C, it will be very difficult psychologically either way. It’s an individual decision that requires discussion between you, your partner and your doctor.