Early Miscarriage or Chemical Pregnancy Overview

An early miscarriage can be a difficult situation but they are a frequent occurrence. Estimates vary on exactly how common they are, but a conservative estimate is that at least 1 in 10 pregnancies ends in an early miscarriage. If it happens to you it can be both physically and emotionally traumatic. This quick guide will help you get through it. 

Symptoms of Early Miscarriage

If you have recently had a positive pregnancy test, symptoms that you could be having or have had an early miscarriage may include:

These symptoms can occur for reasons other than a miscarriage. If you experience any of them, you should not automatically assume that you're having a miscarriage. 

When to See a Doctor if You Suspect an Early Miscarriage

Even though it can be an emotionally draining experience, an early miscarriage isn't always a medical emergency. You should always go to the emergency room if you are having very heavy bleeding (such as soaking through a menstrual pad in under an hour) or if you're having symptoms of ectopic pregnancy, such as severe pain in the abdominal area, dizziness, or fainting. But in other cases, call your regular doctor. The follow-up at that time will depend on how far along you are in your pregnancy.

Very Early Miscarriage (Within a Week of a Missed Period)

With a very early miscarriage, you may not need to visit your doctor. If the bleeding begins within a day or two of getting a positive pregnancy test and looks like a slightly heavy menstrual period, you may wish to just repeat the pregnancy test in a few days. A negative pregnancy test would mean (usually) that you are no longer pregnant. You would most likely not require any kind of treatment after this kind of a miscarriage (which is often termed a chemical pregnancy—one that occurs before an ultrasound reveals a gestational sac).

That being said, you should always see a doctor whenever you're in doubt, or if you have any questions or concerns at all. Your doctor will be able to give you the answers you need.

Many women find it helpful to talk to their doctor about the emotional aspects of an early miscarriage or about the risk of a repeat miscarriage.

If It Has Been More Than One Week Since Your Missed Period

If you think you are having a miscarriage and more than a week has passed since your missed menstrual period, the best course of action is to call your family practitioner or OB/GYN (assuming you have no emergency symptoms). Your doctor will be able to order an hCG blood test and/or an early ultrasound in order to give you an idea of what's going on and potentially offer you a D & C or misoprostol if needed to speed things along or to deal with an incomplete miscarriage. If you are early enough, and your doctor gives you the OK, expectant management is also a sensible option—this means you wait to pass the fetal tissue naturally at home. 

Can You Stop an Early Miscarriage?

It's important to understand that doctors are not able to stop an early miscarriage that is in progress. They can only make sure that your own health is not in danger as a result of the miscarriage and offer you advice on how to move forward.

Early miscarriages, especially if they are one-time-only rather than recurrent miscarriages, are frequently related to chromosome defects in the fetus. In some ways, it can be considered "nature's way" of dealing with a baby who has a condition incompatible with life. Knowing that, however, is of little help as you cope with the emotions of miscarriage.

While you may feel somewhat reassured that there is nothing you did to cause the miscarriage, it doesn't ease the pain of losing your pregnancy.

The Aftermath of an Early Miscarriage

Feeling emotionally shaken by an early miscarriage is normal. Suddenly losing the pregnancy can be traumatic, especially if you had been trying to get pregnant. Be sure to give yourself permission and time to grieve the miscarriage as much as necessary.

As you are healing, talk to your doctor about when it is safe to try again after the miscarriage. It is an old wives tale that you must wait after a miscarriage to become pregnant again, and many people find it healing to begin trying again.

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