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Miscarriage counseling

The loss of a young pregnancy, we call a miscarriage. An estimated 25,000 women experience this every year.

This is why our midwives are specialized in miscarriage counseling. You are always welcome to call us at the emergency number if you would like to chat with a midwife, have questions or concerns. We are here for you. Also now. Especially now.

What is a miscarriage?

A miscarriage is the loss of an early pregnancy. This is usually because an abnormality occurs during the coming together of the ovum and sperm. As a result, the fetus cannot grow normally and dies. A miscarriage is almost never due to a hereditary defect in the parents. Therefore, further investigation is not necessary after one miscarriage.

If you have a miscarriage, your uterus rejects all the pregnancy tissue along with the fetus and amniotic sac. Blood loss and abdominal cramps are common with miscarriage.

Most miscarriages occur before 12 weeks of pregnancy. Because the fetus has usually stopped growing for some time and is very small, it often cannot be seen. However, you do see tissue and possibly blood clots. If you are longer pregnant, you often have more blood loss and probably more abdominal cramps. Once all the tissue is out of the uterus, the blood loss decreases and the abdominal cramps quickly diminish. Sometimes you may see an amniotic sac. After a miscarriage, you still have about a week of blood loss that becomes less and less, just like a period.

How do you recognize a miscarriage?

A miscarriage can begin with increasingly light bleeding that becomes more after a few days. But it doesn’t have to. The miscarriage can also start all at once. Usually in a miscarriage, you have several hours of blood loss during which you see tissue debris. Often you will also have cramps, similar to severe menstrual pain. You may also lose blood clots. However, you can also have some blood loss during early pregnancy without it being a miscarriage. It may also be normal. Therefore, in case of bright red blood loss, call the emergency number so we can check with you.

It is also possible that no beating heart can be seen during your first ultrasound. This does not necessarily mean you will miscarry. If you are less than 6 weeks pregnant, it is normal that no heartbeat can be seen yet. Therefore, in that case, the midwife always makes another ultrasound 1 to 2 weeks later.

A pregnancy test can still give a positive result in a miscarriage because there are often still pregnancy hormones in your body.

When do I call the midwife?

For heavy bleeding (where you don’t feel well).
If you don’t feel well: dizzy, sweating and/or feeling like you’re going to pass out.
For extreme abdominal pain where paracetamol does not provide relief.
In case of concern.
In case of persistent blood loss and/or cramps after miscarriage.

Can you prevent a miscarriage?

You cannot prevent or stop a miscarriage. Not even by taking it easy or by medication.
It can be comforting to know that the pregnancy was usually disordered from the beginning. So that the miscarriage was a natural and logical consequence. Unfortunately, it happens; with nothing you can do to change it.
You cannot get a miscarriage from having sex, riding a bike or a horse, for example. Guilt is understandable, but unjustified.

I have a miscarriage, what now?

If it is determined with an ultrasound that the heart is no longer beating, but the fetus is still in your uterus, there are 3 options:

1. Wait and see: You can choose to wait until the miscarriage starts on its own. It usually occurs within 1 to 2 weeks after the first blood loss.

Waiting can do no harm medically and will not affect another pregnancy. If you later decide you still want medication or a curettage, you can still choose that.

If you choose not to wait, we will refer you to the hospital for a consultation with the gynecologist. This one will go over the following 2 options with you and help you make a choice.

2. Drug treatment: In drug treatment, an obstetrician or gynecologist will give you tablets called misoprostol in the hospital. You insert these at home, into the vagina. You then wait at home to see if the medication works. If the medication works, the miscarriage usually occurs after 1 to 2 days. The miscarriage then proceeds in much the same way as a spontaneously initiated miscarriage: with blood loss and abdominal pain. The drugs work in about 80-90% of women.

3. In-hospital intervention (curettage): This is a short surgical procedure in the hospital where you are hospitalized for a few hours. The gynecologist empties the uterine cavity through the vagina with a type of scraper, suction or tube.

The procedure takes about 10 to 15 minutes.

You will then be given a light anesthesia or a local anesthetic.

What can I expect if the miscarriage starts?

The course of a miscarriage is different for everyone. But it usually begins with vaginal bleeding that increases in quantity. Bleeding may increase within hours to days and be severe for a short period of time (6-12 hours). This may be accompanied by contraction-like pain, or severe menstrual pains. You may also lose clots or pieces of tissue (endometrium).
For abdominal pain, you may take 2 tablets of 500mg paracetamol every 6 hours as needed.

Fetal loss is not always obvious. After the pregnancy tissue is shed, blood loss and abdominal pain will subside. Bleeding after a miscarriage can last as long as two to three weeks, but it usually stops within about 10 days.

As long as you are losing blood, use sanitary pads – no tampons.
In addition, do not bathe or make love to your partner, due to risk of infection.

You do not need to catch the miscarriage to see if the miscarriage is complete. But you may catch it, of course. (You can do this by peeing through a colander.) It can help you process that your pregnancy went wrong. This is how you can say goodbye. You can keep the fruit in a container of cold water (water method). Burial is also possible if you wish.

The miscarriage is over, now what?

You can – if you want – get pregnant again immediately after a miscarriage. There are no medical reasons why you should wait. You may want to process the miscarriage and recover physically and emotionally first. You may feel tired and listless after a miscarriage. This is also because your hormone levels are changing again. When you are emotionally ready to get pregnant again is personal. You decide that with your partner. Of course you can come to us if you want to talk about your desire to have children.
It is impossible to predict when your period will start again. This usually occurs 4 to 6 weeks after the miscarriage.

Good to know...

A miscarriage usually occurs in the first 12 weeks.
25,000 women miscarry each year.
You cannot prevent a miscarriage.
If you have had a miscarriage, you are not more likely to miscarry in the next pregnancy.
The medical term for a miscarriage is “spontaneous abortion.
A pregnancy test can still give a positive result in a miscarriage because there are often still pregnancy hormones in your body.

Coping with pregnancy loss

Many women have a difficult time after losing their pregnancy. A miscarriage often has more impact than you can imagine beforehand. This applies to women and their partners.
The miscarriage, for example, means that your future is different from what you had imagined. This loss suddenly ends all plans and fantasies about this baby.
It’s also important to know: there is no set timeline for when the grief will end. Everyone experiences it differently. Everyone does it differently. Some have more trouble with it than others.
Give yourself what you need.

The tips below may help you:

Take seriously what you feel. Everything is allowed to be there: sadness, lack, guilt, disbelief, anger, a sense of emptiness. You may also feel resignation or even relief. You can. Nothing is crazy.
Talk about it. Maybe with a friend, with your partner, with your sister or your neighbor. Or with parents who have gone through the same thing. Of course, you are also welcome to join us.
Know that your partner most likely experiences and processes the loss differently than you do. That’s normal. It is valuable if you can talk about it, with each other and with others.
Do what feels right for you. At the moment it’s right for you. Put a nice figurine in your closet. Plant a tree in your garden. Choose a piece of jewelry as a keepsake. Write your unborn child a letter. Burn a candle regularly, or do something completely different, but choose what suits you, yourselves.
Read about it. Write about it. On facebook, there are closed groups where you can write about your experience, for example, the Miscarriage Moms group.

Notice that your energy is not coming back? Or that you keep pondering?
Then it is really advisable to deal with the loss of your pregnancy.
Feel free to call us at 0294-430317 and we will provide you with contacts of professionals in this field.

Need a listening ear?

We are here for you.
You can always call us on 0294-430317 or email us at praktijk@echocentrum-weesp.nl

Frequently Asked Questions

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