A miscarriage before week twelve is counted as an early miscarriage, which is the most common period for a miscarriage to occur. However, this does not mean that you, as someone going through a miscarriage, are plagued with both physical and psychological problems. In this article, we go through everything that happens during an early miscarriage.

Most miscarriages occur before week nine of a pregnancy, and after week twelve it is much more rare to have a miscarriage. Early miscarriages often start with a bleeding which is usually similar to a heavy period, which then continues for a few days or up to two weeks. The bleeding can last up to four weeks, but most commonly it lasts one to two weeks and decreases over time. While the bleeding is ongoing, pain is often experienced which is localised to the lower abdomen and back. Some experience pain that radiates down the groin and legs.

Bleeding and pain
What is happening is that the uterus contracts after a miscarriage. As the uterus is a muscle, the pain is felt at the site of the uterus and can radiate to the lower back, groin and legs because it presses on the nerves that lead there.

The bleeding can be both fresh and old blood, which means that the colour can vary between bright red and dark red. Lumps are also common. Sometimes, the pain will come before the bleeding, 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 person to person.

If you suspect you are having a miscarriage, it’s important not to be alone. A miscarriage is tough and if it happens, it is important that you get support from someone you feel comfortable with. Pain relief in the form of heat, a shower, tens device, heating pad or pain-relieving tablets such as paracetamol is recommended for an ongoing miscarriage – also make sure you get both food and drink, even if it’s the last thing on your mind.

When you should seek medical attention
If there is so much blood that you bleed through a thicker pad for an hour, if blood is running down your legs or if you cannot handle the pain, you should seek medical attention. You can contact your midwife at the midwifery clinic or health care services for advice and guidance and to get information about where you can seek physical care. If you feel that you need treatment immediately, you should go to the nearest gynaecological emergency department to you. Even if the bleeding looks bad, you can wait it out at home, as long as the pain is manageable and the bleeding is reasonable.

Feelings during and after a miscarriage
Emotionally, a reaction can come immediately, but it’s just as common that it comes later on and that it takes time to process what has happened. We carry our history with us, and the situation you are forced to go through can create all kinds of reactions and emotions both during and after the miscarriage. Feeling upset that your pregnancy has ended is normal, as is guilt for feeling that you did something wrong, which led to this happening.

Your partner may also feel guilty because they think that their sperm was of poorer quality and meant that the foetus could not continue to live and the pregnancy could not be carried to term. Thoughts that you are not worthy of being pregnant or becoming parents are common, as is jealousy of those who are pregnant or have children. It is also common to feel ashamed and embarrassed that you had a miscarriage. It may be particularly difficult if you have told the people around you about your pregnancy. These are all very common feelings, but that doesn’t mean that these thoughts are true. Neither of you caused the miscarriage, and a miscarriage is usually due to the foetus having some abnormality and not being able to develop. Other reasons for miscarriages are that the foetus could not attach properly to the uterus or that cell division did not proceed correctly. So regardless of why it happened, you are not the one who caused the terminated pregnancy.

There are various options to get professional support to deal with your emotions after a miscarriage. Your midwife or counsellor at a gynaecological clinic or an abortion clinic can offer supportive counselling. You can also receive support from a counsellor or a psychologist through your health centre. If you already have a counsellor, you can turn to them to talk about your feelings and emotions related to your miscarriage. There may also be someone in your family or support group that you trust and who you can talk to? Miscarriages are very common, and although there are a large number of unreported cases, 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 can ovulate again, and when that happens, your body is physically ready to get pregnant again. However, you need to feel that you are ready emotionally, which is a completely different matter. Your mind has to catch up with your body and you have to let this take its time.

If the bleeding lasts more than two weeks, it is recommended that you contact a gynaecologist for an examination and to confirm that the miscarriage is over. In some cases, it may be that additional treatment is needed, involving drugs or curettage, if there are residues left in your uterus. So, if your bleeding has not stopped after two weeks, contact a gynaecologist to get the right help.

Last but not least – take the time you need, for both the physical and psychological impact during and after a miscarriage. It takes different people a different amount of time to heal.