A miscarriage before week 12 is considered an early miscarriage, which is the most common period when a miscarriage occurs. However, this does not mean that you will have to deal with both physical and psychological problems. In this article, our midwife Maria goes through everything that happens during an early miscarriage. 

Most miscarriages occur before week nine of pregnancy and after week twelve it is much rarer for a miscarriage to occur. The early miscarriages often start with bleeding, which in quantity is usually like a heavy period, then continues for a few days or up to two weeks. The bleeding can last up to four weeks, but most commonly last one to two weeks and decrease in amount over time. While bleeding is occurring, pain is often experienced that is localized to the lower abdomen and back. Some experience pain radiating down into the groin and legs. 

What happens is that the uterus contracts after the miscarriage. As the uterus is a muscle, the pain is felt both where it is and can radiate to the lower back, groin and legs because it presses against nerves leading there.

The bleeding that occurs can be both fresh and old blood, so the color can vary from bright red to dark red. It is also common for clots to appear. Sometimes the pain comes before the bleeding appears and sometimes the bleeding comes before the pain, which means that there is no clear line for how a miscarriage occurs as it is individual and differs from time to time. 

If you suspect that you are having a miscarriage, it is good not to be alone. A miscarriage is tough to get through and if it happens, it is important that you get support from someone you are safe with. Pain relief in the form of heat, shower, tens machine, wheat pillow or pain-relieving tablets such as Alvedon are recommended during an ongoing miscarriage - also make sure you get both food and drink even if it is the last thing you think of.

Early miscarriage - when to seek care

If there is so much blood that you bleed through a thicker pad for an hour, if there is blood running down your legs or if you cannot manage the pain shall you seek medical care. You can contact your midwife at the midwifery clinic or 1177 for advice and guidance and to get information on where to seek physical care. If you feel that you need immediate care, you should go to the nearest gynecological emergency department. Even if the bleeding looks scary, you can wait at home as long as the pain is manageable and the bleeding is reasonable. 

Feelings during and after a miscarriage

Emotionally, the reaction can be immediate, but it is just as common that it comes later and that it takes time to process what has happened. We all have our own story to tell, and the situation you have to go through can create all kinds of reactions and emotions both during and after the miscarriage. Feeling sad that the pregnancy has ended is common, as is feeling guilty that you think you have done something wrong that led to this happening. Your partner may also feel guilty because he thinks that the sperm was of poor quality and prevented the fetus from continuing to live and the pregnancy from being completed. Thoughts that you or you are not worthy of being pregnant or becoming parents are common, as are feelings of jealousy towards those who are pregnant or having children. It is also common to feel ashamed and embarrassed that you had a miscarriage. This may be particularly difficult if you have told people around you about the pregnancy. All this is very common emotions, but this does not mean that these thoughts are true. Neither of you caused the miscarriage and a miscarriage is usually because the fetus had some abnormality and could not develop. Other reasons why miscarriages happen are that the pregnancy could not attach properly to the uterus or that cell division did not go properly. So whatever the reason for your miscarriage, you are not the cause of the abortion. 

There are different ways to get professional support to deal with the emotions after a miscarriage. Your midwife, a counselor at a gynecological clinic or an abortion clinic can all offer support sessions. You can also get support from a counselor or a psychologist through your health center. If you already have a counselor, you can turn to him or her to talk about your feelings and emotions in connection with the miscarriage. Perhaps there is also someone in your family or surroundings that you trust who you can talk to? Miscarriages are so common and although the number of unreported cases is high, we know that around 20% of all pregnancies end in miscarriage, which means that there are probably more people around you than you think who have gone through the same thing.

When can I get pregnant again?

Once the bleeding stops, you may ovulate again and when you do, your body is physically ready to get pregnant again. However, you need to find out if you are emotionally ready, which is a completely different matter. Your mind has to catch up with your body and it has to take its time. 

If bleeding continues for more than two weeks, it is recommended to contact a gynecologist for an examination and to confirm that the miscarriage is complete. In some cases, additional treatment may be needed, with medication or scraping, if there is residue left in the uterus. So if you have bleeding that has not stopped after two weeks, contact a gynecologist to get the right help.

Last but not least, allow time for both the physical and psychological impact during and after a miscarriage. It takes different people different amounts of time to heal.