Pregnancy Loss

The loss of a pregnancy, even if it is early, can be devastating.  We understand that a bond is formed as soon as the pregnancy test is positive.  You begin making plans around the baby’s due date and start planning for the baby’s future.  Therefore, when the pregnancy doesn’t continue, the disappointment and grief can be overwhelming.  Not only have you lost the pregnancy itself but you have also suffered the loss of the hopes and dreams you had for your baby.  Dr. La and his staff are here to help guide you through the physical and emotional aspects of your loss.

Although you may not find solace at this time, it is important that you know that 25% of all pregnancies end in miscarriage and many more women than that miscarry before they even realize they were pregnant.  So pregnancy loss is very “normal” and it is very unlikely that there is anything wrong with you or your partner that caused this to happen.  The majority of miscarriages occur before 8 weeks, and most often the baby has a chromosomal problem that causes the growth to stop at an early stage.  Chromosomal problems occur right after conception when the cells are dividing and a “mistake” in cell division occurs. This means that there is nothing you, or we, can do to change the outcome.  It happens at the time of conception and it just takes us a few weeks to be aware of it.  The most important thing to remind yourself is that the pregnancy loss was not your fault regardless of what you did or did not do.

There is no testing recommended to evaluate for problems after one miscarriage.  Although it is very scary going into a next pregnancy, try to remember that the great majority of time the second pregnancy is fine.  While 25% don’t make it, 75% do make it.  Dr. La does like for you to wait until you have had two normal periods on your own.  Your cycle may occur 4-6 weeks after the miscarriage.   If you haven’t had a period 8 weeks following your miscarriage, do a pregnancy test because some people get pregnant again before they have their first period.

After 3 consecutive miscarriages, Dr. La recommends some testing to try and determine if he can prevent a 4th  miscarriage.  The testing includes blood work for both you and your partner to check your chromosomes as well some other tests for rare blood clotting disorders that may affect the pregnancy.  On very rare occasions, some people may carry an abnormal chromosome that may be transmitted to the baby while they themselves are totally normal.  Dr. La may also recommend a test to look at the shape and size of your uterus since some women have a uterine abnormality that predisposes them to miscarriage.  Dr. La may recommend high doses of folic acid, progesterone supplements, blood thinners or other treatments to try and reduce the risk of a 4th miscarriage.

Once you have been diagnosed with a miscarriage Dr. La may suggest one of three things.  1) Sometimes you may pass the fetus on your own and have a very heavy period which is usually safe if you are less than 8 weeks pregnant.  2) Dr. La may also give you a medication that will cause the fetus to be expelled more quickly.  3)  If you are 6 weeks or more, Dr. La will recommend a dilation and curettage (D&C) which is a minor outpatient procedure, performed under anesthesia, to remove the fetus with gentle suction.

It is normal to grieve for the loss of your pregnancy.  Sometimes the grief can last for weeks and is exacerbated by seeing other pregnant women or babies.  Sometimes people close to you are unable to find the right words to say or say the wrong thing.  Comments like “it was just meant to be” or “you will have another one; don’t worry” can be hurtful and insensitive and not place the appropriate importance on the loss you are feeling.  Sometimes your partner will grieve differently than you and may seem to “get over it” more quickly which can cause conflict.  It sometimes helps to talk with others who have suffered a miscarriage since they can understand how you feel.

If you are less than 8 weeks pregnant and have vaginal bleeding or cramping at home, you may not be sure if you are having a miscarriage.  If this happens, please contact our office and we will give you instructions.  If it is after business hours, contact our main number and either Dr. La or the physician “on call” will get back in contact with you.  Dr. La or the “on call” physician may tell you to rest and come in the following day for an ultrasound.  Dr. La generally recommends that you come to our office, rather than going to the emergency room, so that you do not have to subjected to a cold and clinical ER environment.  Unfortunately, there is nothing that Dr. La can do if you are in the process of a miscarriage so it is ok to wait until the next day to be seen.  Dr. La is not minimizing the problem by not sending you to the ER; there is simply nothing that anyone can do.  Hopefully, by doing an ultrasound the next day, Dr. La can reassure you that everything is OK since sometimes bleeding in early pregnancy can be normal.

If you have questions that are not addressed here, please talk with Dr. La.