Going through a missed abortion in the second trimester is a very tough experience for most people. In this article, we try to summarise what is happening and common feelings that you may experience.

When a pregnancy stops before week 22+0, it is called a missed abortion. It is usually discovered during a planned ultrasound or because the pregnant woman seeks care for some reason. It is unusual for the pregnancy to stop during the second trimester, but it does happen and it is terrible to go through both mentally and physically.

Reasons why a pregnancy stops can be that there was a foetal abnormality, for example, a chromosomal abnormality or organ damage. It can also happen because of an underlying disease in the pregnant person which means that the pregnancy cannot develop and grow, because something in the circulation in or from the placenta to the foetus has not been normal. It can also be due to some kind of abnormality or anatomical impact on the uterus.

What happens
If the news of a pregnancy ending comes during a planned ultrasound, the news will certainly come as a shock and it can feel both unreal and nightmarish. The midwife or doctor performing the examination will ensure that the pregnant person receives information about further care and treatment. A referral is then sent from the ultrasound clinic to a gynaecologist or abortion clinic at a hospital. In that department, another ultrasound will be performed to confirm that the pregnancy has stopped. If this is the case, a plan is then made as to how and when the treatment should take place.

When the pregnancy has passed week 13, medical treatment is offered in the same way as an abortion. This means that tablets are given to make the uterus contract and to get everything out. When a missed abortion occurs between weeks 13 and 22, the pregnant person then remains in the clinic or ward longer than for a missed abortion earlier in the pregnancy. This is because the longer the pregnancy has continued, the more like childbirth it tends to be, and then both support and follow-up care are needed.

How it feels
The contractions that occur when everything is about to come out are like severe period pains and are usually localised to the lower abdomen, lower back and radiate down into the groin and legs. There may be a feeling of pressure against the abdomen or buttocks, which may be unpleasant. You will be in the hospital when you go through this, and the medical staff will guide you and be there for all your questions. You will then stay in hospital until everything has come out and an examination has been performed to see that there are no residues left. If there are residues left, a supplementary scraping can be performed.

The pain associated with the contractions can come as intervals with pauses in between, but it may also be a constant feeling that the uterus is contracting. It is usually compared to severe period pain. There are different types of pain relief available, both in the form of heat, TENS machines, tablets or injections and some hospitals also offer other pain relief methods. Before treatment begins, a conversation with a counselor or psychologist will be offered, and this support is also available afterwards.

Common thoughts and feelings
Reactions and feelings can come immediately but also later on. In order to get the right support for you, it is usually recommended that you talk to the person or people you feel comfortable with and trust. This may be a friend, family member, midwife at the clinic or contact person at the health centre. The important thing is that support you need is provided and that you make sure you get the support you need.

Common emotions that usually emerge are anger, sadness, guilt, shame and envy of others who get to continue their pregnancy and the journey to becoming parents. It is both reasonable and normal to react in different ways to a missed abortion – both because of the news itself, but also because of having to go through the treatment. Guilt and shame do not change anything, but are difficult to bear. So, if you have these feelings: talk to the person or people you trust. You will need to recover both physically and emotionally afterwards, so you also need to talk to the responsible doctor before you go home from the hospital about whether you should take sick leave or not.

After a missed abortion
Bleeding usually lasts for one to two weeks after the treatment is finished. If you suspect that you have an infection, such as a high fever and abdominal pain or bleeding that smells different than it did before, you should contact a gynaecological emergency clinic or abortion clinic.

When the bleeding has stopped, you can start to ovulate again and if you were told nothing else in connection with the treatment, then your body is then ready to get pregnant again. But! You decide when it feels okay for you to get pregnant again. There is no right time, only when your body and mind are both ready.