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Print Posted on 06/27/2018 in Integrative Understanding of Infertility

Early Pregnancy Loss: What Don’t You Know Yet About?

Early Pregnancy Loss: What Don’t You Know Yet About?

Miscarriage is not the topic discussed enough. But it should be discussed. The doctors say that having a miscarriage is a relatively normal thing. According to the clinical statistics, as many as 75 percent of conceptions will result in miscarriages.

Even if the digital pregnancy test literally ‘SCREAMS’ that you are PREGNANT, still there is no absolute guarantee that your tiny handsome embryo–dude or your gorgeous embryo–lady will turn into a fetus. Therefore, many couples prefer not to tell that there would be a small bundle to anyone until after the 12–week mark. As if announced prior to this ‘viability mark’, the chances of miscarrying are nearly 75 percent. And after this week, the chances of miscarrying are much lower.

During the first 12 weeks, you will be like a bundle of nerves. Literally a bundle of nerves. The nervous tension will be blended with the content of your thoughts. It will be blended with all your sparkling emotions making them faded. It will make your gorgeous eyes filled with embarrassment. It will make your tone lower and your fingers trembling.

And if the worst happens, just whirl of embarrassing thoughts blended with confusing emotions appear in the mind. How did I get there? Why me? Why my baby? Why am I having a miscarriage? Why has it happened? Is something wrong with me? All versions of ‘WHAT IF…’ scenarios will be blended with confusion, shock, and sadness. It is the sadness you had never felt before. You feel ashamed to say openly how many Google searches you continued to do after months went by. You are scared to show your hurt. You feel utterly guilty reframing in your mind every moment you were holding your small bundle. And re–asking yourself: ‘Was it my fault?’ You still are not sure.

I want you to understand that is NOT YOUR GUILT. And you shouldn’t be ashamed of yourself for being involved in this situation. You shouldn’t feel guilty when the thoughts whirl in your mind. Your tiny dude or lady was just too perfect, too beautiful for this earth.

Many tiny embryos and tiny fetuses are living and dying without being even noticed. They just appear and disappear prior to the first ultrasound. But if the small bundle or bundles death occurs after the first ultrasound was done, that is utterly hurtful. And the most hurtful is the late pregnancy loss. It is more than heartbreaking experience. It literally disrupts everything that was so precious for you, including your self–confidence. Even in this situation, you should know that YOU CAN COPE WITH THIS HARD EXPERIENCE.

(1) Embryonic and early fetal death are very common situations but not everyone shares own experience. 

In the most cases, the early pregnancy loss starts with bleeding. If you know that you are pregnant, the bleeding is a strong indicator that something is wrong. And if the bleeding continues, you should immediately book an appointment with your doctor.

BLEEDING is the RED FLAG. BLEEDING that doesn’t stop ‘SHOUTS’ that you may have the miscarriage.

You were only about seven weeks pregnant and your embryo–dude or your embryo–lady was so small that was barely visible on the ultrasound, but your tiny bundle was there. They turned the monitor towards you, so you could glance at your tiny bundle for the first time. A tiny little grey tadpole–shaped thing surrounded by a black circle. Your tiny raspberry. So tiny, curled up, maybe has just fallen asleep, but definitely there.

“Do you see that tiny dot flashing there? That tiny sparkling dot? That is the heartbeat of the tiny heart.” After these words, your gorgeous eyes sparkled, your lips curled in an amused smile and your hands stopped trembling. You heard that they say that your tiny raspberry–sized bundle was okay.

IF the TINY HEART BEATS SLOWLY or TOO SLOWLY, it might also lead to the miscarriage. 

The ultrasound technician told you that you hadn’t miscarried. But the heart rate of the tiny dude or lady was really slow. After that, she said she couldn’t say whether the pregnancy was going to continue or not.

IF your hormone levels are great, but THE BLEEDING CONTINUES, probably you are miscarrying.

Your doctor told you that your hormone levels were great, and the bleeding should stop. After that, you were given a prescription for morning sickness. But for the next week, the bleeding continued.

PAINFUL CRAMPS and bleeding strongly indicate that you are having the miscarriage. 

You couldn’t handle the pain anymore. It reached its worst on this one day…the day you lost your tiny dude or lady. You thought you were getting the flu. You had the cramps, that meant a miscarriage, but the doctor sounded so sure. When the bleeding finally did stop, you noticed you felt different. You did miscarry. Your tiny dude or gorgeous lady would always be remembered as the little grey blip with the tiny flashing slow heartbeat. The only thing you have is the picture of the ultrasound to remember him or her by.

The other version may sound as the following. 

Every moment was sparkling, all the early ultrasounds showed that the tiny heart was beating not slow, the flashing light was bigger, and your tiny bundle looked more like a fetus. Nothing had predicted the worst to happen.

If you feel a STABBING PAIN and CRAMPING, you are losing your tiny bundle.

The pain started the previous night, feeling like light cramping. By 03.30 A.M. the next morning, you were tossing and turning in your bed. The pain was excruciating. You felt extreme cramps, with an almost stabbing feeling on your left side. You felt utterly nervous, even like a bundle of nerves. You tried to curl up in a ball, so confused about what was happening, although you felt that something was wrong.

The BLEEDING may start later, and the water may break spontaneously during the ultrasound. 

By 08.00 A.M. you were in the clinic. The pain was almost excruciating at this stage and you had noticed that you were bleeding. You rushed into the emergency department, bursting into tears whenever I had to tell someone what I thought was happening to me. The technician was making you the ultrasound searching for an inflammation, infection, swelling – something that would explain your pain. Then your water broke. You were transferred back to the emergency department. Your bed was wet beneath you, and your face and hair matted from tears. The doctor came into the room and confirmed what you already knew, you miscarried. You were sent many spring bouquets and recovery cards. You could glance at those bouquets but couldn’t even care for myself during several days after the miscarriage. Flowers stood, sparkling, proud and perfect. I was lost and exhausted.

Or the sequence of events may unfold like the written below.

The digital pregnancy test ‘congratulated’ you with the PREGNANCY. Then, reality began to set in. Your first doctor’s office visit was filled with anticipation and nervous tension. It was the perfect time to ask the nurses and doctors the nuanced questions about this mysterious time.

When you went in for your first ultrasound, after a few uncomfortable minutes, the nurse seemed to be having trouble locating a heartbeat of your tiny bundle. She said that it was probably just too early to detect. And suggested coming back next week for another visit. Nervously, you left the room and scheduled another appointment.

The seven anxiety–filled days later, you thought only about the tiny heartbeat. You came for the nine–week ultrasound to confirm the location of the tiny heartbeat. When you asked about the tiny beating heart, the nurse didn’t utter a single word for three minutes. After that she confirmed your thoughts saying accurately that there wasn’t a heartbeat. You had miscarried your tiny bundle. You were confused and shocked. After that, you felt the sadness. It was the sadness you had never felt before.

There are many other personal experiences of the miscarriage. But not everyone would like to discuss this.

(2) Classifying the early miscarriage

Though a miscarriage is defined as a pregnancy loss up to 20 weeks, most miscarriages occur during the first 13 weeks of pregnancy. In other words, most miscarriages occur in the first trimester. These miscarriages are called EARLY PREGNANCY LOSS.

There are several types of miscarriage – threatened, inevitable, complete, incomplete or missed.

Threatened miscarriage occurs when your body is showing signs that you might miscarry. You may have a little bleeding or lower abdominal pain but not excruciating. It can last days or weeks, but the cervix is still closed. It is hard to say for sure, would your tiny embryo turn into a ‘viable fetus’, or you will have the miscarriage.

Inevitable miscarriage may occur after a threatened miscarriage or without warning. There are usually a heavy bleeding and strong painful cramps. During the miscarriage, your cervix opens, and the developing tiny fetus, your tiny handsome dude or gorgeous lady will come away in the bleeding.

The complete miscarriage is the type of miscarriage when your fetus and all the pregnancy tissue has left your uterus. Bleeding may be heavy and may continue for several days. Cramping pain much like the labor pain. The pain may be excruciating as the uterus contracting to empty itself.

A missed miscarriage occurs when a tiny fetus dies, but your body does not recognize the pregnancy loss or does not expel the pregnancy tissue. As a result, the placenta may still continue to release hormones, so the mother may continue to experience the signs of pregnancy.

(3) What treatment options they can offer if you are in this position? 

There are three treatment options they can recommend to you. You may miscarry naturally. You may take a pill that would induce the miscarriage and speed up the process. Or you may have a D&C surgery (Dilation and curettage surgery).

WHAT IS A NATURAL MISCARRIAGE? Is it absolutely safe or not?

If the pregnancy is very early and the tiny embryo–dude or embryo–lady is 3–5 gestational weeks old, then the pregnancy loss has the symptoms of a heavy period. There won’t be too much pain.

BUT if you miscarry between weeks 6 and later, the pain is likened to labor. The contractions are almost unbearable, and the bleeding is heavy.

There may be so much blood. No one could prepare you for the level of bleeding that may occur. In fact, you can feel utter fatigue, fall unconscious because of bleeding, and have to be taken by ambulance to the hospital for an emergency dilation and curettage surgery. If you choose to miscarry naturally, ask your doctor to manage your situation and monitor this process not just one time in a week.

You may have an intrauterine fetal demise. It happens in about 1 percent of pregnancies. For this situation, your doctor may recommend you take a pill that would induce the miscarriage and speed up the process. But you should glance through the consequences that might entail this ‘MAGIC PILL’. 

An intrauterine fetal demise starts also with bleeding and cramping. But the fetus still has the chances to live. And it also may die, but the body won’t recognize immediately that miscarriage occurred and won’t expel the pregnancy tissue.

“I cannot say the pregnancy has ended yet because your Beta HCG levels haven’t dropped yet. Only in case if the levels would decrease, I will confirm the miscarriage. At present, you are still pregnant.” These words confused you. After that, the doctor added: “It’s possible that the pregnancy could be normal, but you are only two or three weeks along, so it’s hard to tell at this point. We will need to do the blood tests in 48 hours to determine if it has in fact ended.”

You were more than confused. You were shocked and scared. It was only yesterday that the Emergency Department physician had confirmed that the pregnancy was already over. But because your pregnancy was only a few weeks along, it wouldn’t have a heartbeat yet. Therefore you were told that you had had a miscarriage.

Two days later, your doctor called to confirm that yes, your pregnancy had indeed ended. And that your body would have a miscarriage.

Your options were as follows: you could either let the miscarriage occur naturally (with bleeding and cramps), take a pill that would induce the miscarriage and speed up the process, or have a D&C (Dilation and curettage surgery).

SOMETIMES TAKING the MISCARRIAGE INDUCING PILLS leads to a life–threatening situation.

“I had been warned that I would have heavy bleeding and heavy cramps. By 08.00 P.M., I had no bleeding. But I had severe cramping. My entire abdomen hurt. Was this normal? I had no idea. I tried to fall asleep. I tossed and turned throughout the night. When I woke up the next morning, my abdomen pain was excruciating. My abdomen was actually slightly swollen. And I was having severe shoulder pain with difficulty breathing. Again, I didn’t know if this was normal for a miscarriage. I called the ambulance as the situation was unmanageable.

At the emergency room, I had my ultrasound. The ultrasound wasn’t clear. I was supposed to be having a miscarriage, but there was blood around my uterus. I also knew that it might be an ectopic pregnancy. I was hooked up to a double IV and taken my temperature. My heart rate was low. They told me that my pregnancy was in fact ectopic. And that I would need to go into surgery right away, as it had ruptured in the fallopian tube, and I was now bleeding into my abdomen. My normal miscarriage had turned into the worst possible life–threatening situation.

I was prepared for surgery, but I lost control over my emotions. There was a chance that I could use a lot of blood and need a blood transfusion. There was a chance I could lose one or both of my ovaries or fallopian tubes. I had to sign paperwork that dealt with the exposing of the fetus. Overwhelmed was an understatement.”

CONCLUSIVE REMARKS:

Every pregnancy is the absolutely unique phenomenon. It should be the utmost accurately monitored by the experienced doctor. If you have at least one symptom like these: BLEEDING, PAINFUL CRAMPS, STABBING PAIN in your LOWER ABDOMEN, SWOLLEN ABDOMEN, FLU SYMPTOMS, FEVER, or SEVERE SHOULDER PAIN, YOU MUST call your doctor and Ambulance. The TIME is EVERYTHING. And the life–threatening situation may occur if you lost the time. It is the mystery of life – some things can give you such beauty for such a short period of time, feeling like they would last forever but also were terminated before they really had a chance to shine.

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