[Warning: Graphic Content]
The double pink lines have appeared three times for me over the last two years. First, the unborn baby died at 9 weeks and I miscarried at 12 weeks; second, the fetus lasted a few days after an IVF cycle; and third, I miscarried at 6 weeks.
Despite being an intelligent, well-educated person, I felt bewildered at what my body was doing. Doctors and nurses were strangely mute. Friends almost never volunteered information, and when they did, they were vague. Women of my mother’s generation thought it was “unseemly” for a lady to talk of such things, preferring to feign ignorance. In desperation, I scoured the internet for information, invariably finding some online forum that would simultaneously encourage and terrify me.
There are a lot of things I wish I’d known before my first miscarriage. Here are a few.
1. Of the women who spot in their first trimester, 1/2 will go on to have a normal pregnancy. However, with a chromosomal disorder and/or recurrent miscarriages, the odds of that spotting being normal aren’t good.
2. Bright red spotting (other than implantation bleeding) is a warning signal and should always be reported to the doctor. Remember, though, that there’s rarely anything the doctor can do. Brown blood usually seems OK as long as it doesn’t turn red.
3. The time between the fetus’s death and a natural delivery varies dramatically from person to person and from pregnancy to pregnancy. I’ve heard everything from a day to 6 weeks. Sometimes the body won’t ever deliver naturally (or completely) and a D&C is required.
4. Your water will probably break. In my 9-week (12-week?) miscarriage, my water broke before the cramps started. In my 6-week miscarriage, the cramps came first and my water broke a few minutes before the fetus came out. In my 4-week, I didn’t see water but it could have been hidden by blood.
5. The miscarriage will probably take 3-4 hours. Start timing it when your water breaks or the cramps start, whichever comes first.
6. The cramps get closer together as you approach delivery. When they’re down to 1 minute apart, you’re getting very close.
7. “Pushing” with the contractions can lessen the pain and speed up the process. I waited to push until the contractions were less than a minute apart.
8. The pain is bearable. I didn’t take any pain reliever like aspirin or ibuprofen because I didn’t want to thin my blood when I was bleeding. Tylenol or Percocet might help if the cramps are really bad.
9. The bleeding is the color, but not the texture, of menstrual blood. It’s stickier, clots more and looks shiny and gelatinous.
10. The bleeding will be heavy until you deliver the fetus and endometrial tissue; then it will pretty much stop suddenly. You’ll continue to spot lightly with occasional clots for several more days. If you’re still bleeding heavily, you might not have finished clearing everything out of the uterus.
11. Your body will continue to produce HCG until your uterus is clear. This is why the doctors will make you keep coming in for blood tests. If you don’t clear everything, your HCG may not zero out, it may temporarily affect your fertility, and you’ll be at risk for infection.
12. The fetus and placenta/endometrium will probably come out separately.
9 (12?) weeks: 2 lime-sized clumps 10 minutes apart, accompanied by large clots.
6 weeks: one walnut-sized clump and then several grape-sized gelatinous clots a few days later.
4 weeks: one tablespoon-sized clump that was harder than the rest, followed by a regular period. (The doc said that was the endometrium, not a baby or sac.)
I welcome descriptions of the size and/or appearance of your natural miscarriage in the comments section. It would be nice to fill in some of the timeline gaps.
The one thing I have not included in this list is whether or not you’ll be able to see or any baby features. Personally, I did not. I tend to think that generally you can’t distinguish anything unless you’re pretty far along in the pregnancy, and at that point you’d have a D&C instead. I welcome comments on this, too.
13. Have a plan for the fetus. Your plan could be wrapping it in a towel and putting it in the trash; flushing it down the toilet; finding a place to bury it and saying a prayer; or bringing it in to the doctor for testing. It doesn’t matter what the plan is, but it is helpful to think about it now. Examine your spirituality and do what feels right.
14. Emotional support from a friend is indispensable. You may or may not find the specific miscarriage support you need from your significant other; that is OK. (See #15.) But recruit someone you trust to help you through this. Knowing that someone is thinking of you is amazingly helpful, even if they’re not there.
15. Don’t expect your significant other to have the same emotional reaction as you. Everyone processes their feelings in different ways and different times, especially in the opposite genders. This is happening to YOUR body, and YOU feel the physical pain, so it only stands to reason that YOU will feel this loss the most strongly and immediately.
16. For early miscarriages, don’t let the label of “chemical pregnancy” make you feel like you weren’t really pregnant. The embryo was there and it implanted.
17. The emotional pain will lessen over time. The grief comes in waves. In my case, I suddenly sobbed when I watched a little girl get on a school bus; when I heard a 41-week-pregnant woman wanting to “get this baby OUT;” when I learned that my two closest co-workers were due at the same time; and often without any specific provocation at all.
18. Hope is not lost. Most women will go on to conceive again with a normal pregnancy.