When a pregnancy ends without the body understanding this, it is called a missed abortion. Going through this is stressful both mentally and physically. It can be difficult to know how, why and what help you are entitled to. In this article, midwife Maria guides you through the typical process of a missed abortion.

How is a missed abortion detected?

A pregnancy that stops but does not result in any bleeding, or where the body does not realise that it has stopped, is called a missed abortion or missed or delayed miscarriage. The most common way of detecting a missed abortion is through an early ultrasound (or the ultrasound performed in conjunction with a combined ultrasound and blood test) showing that the pregnancy has stopped. This means that the embryo and pregnancy have stopped growing – usually a week or two earlier. It may also be that you have gone to the doctor because you have noticed symptoms that did not feel right, that you felt unwell in some way or had a scheduled visit for medical pregnancy planning and discovered that the pregnancy has stopped.

Missed abortions ares something that come as a shock to almost everyone, and which, for the pregnant person or the couple, can be difficult to accept and deal with. Let it sink in bit by bit. If you have supportive family or friends, let them take care of you so that you can focus your energy and thoughts on the reaction to the news.

The process
When a missed abortion is detected by ultrasound, you will receive information about the situation and what happens next. If bleeding occurs spontaneously within a day or two, no treatment is needed, unless the pregnant woman is able to wait to seek medical attention. The midwife or doctor who performs the ultrasound and determines that it is a missed abortion will send a referral to an abortion clinic for further care and treatment. It may then take a few days for the next visit to take place. Once there, another ultrasound is performed to confirm that the pregnancy has stopped and then a decision is made on the type of treatment to be given.

If the body has not started bleeding on its own, medical treatment is given in the form of tablets, or a curettage is performed. If tablets are given, these should be taken at home while waiting for a bleed, and it is important to remember not to be alone.

During the bleeding, you may feel a pain similar to a severe period pain in your stomach or back, radiating down to your groin and legs. You can take paracetamol to relieve the pain. The clinic may also have sent other pain relief medication. Any form of heat, such as showering and directing the jets at your stomach or back, can also help with the pain.

Bleeding can vary; bleeding that is similar in quantity to a heavy period is perfectly normal, but sometimes you can also see clumps of blood, the follicle or the structure of the embryo. This is not an easy thing to prepare for or go through. There are a thousand different emotions you may feel in this situation, and one thing that is important to keep in mind is that all emotions are acceptable and normal and should be taken seriously.

Common thoughts and feelings
It is common for pregnant people to feel disappointed that their pregnancy stopped, worry about why it happened or feel deceived by their body that led them to believe that the pregnancy was going as it should, as well as lots of other troublesome thoughts. Feelings of guilt may arise and thoughts that you have done something that led to a missed abortion. None of this is true! Virtually all missed abortions and miscarriages happen because something about the foetus and its development could not continue as it should. It may also be linked to the first few sensitive weeks, when the placenta is forming and the embryo is growing in the uterine wall, which prevented the pregnancy from progressing. So it’s not your fault, but all your feelings are completely normal.

You can get support
In order to process the grief, anxiety or the emotional reaction that comes along with this, it is important to get the right help for you. This can, for example, be through conversations and the opportunity to ask questions to a midwife or doctor. It can also be surrounding yourself with the people you feel safe and comfortable with.

Through the midwife at the midwifery clinic, you can book an appointment to get support in everything from the thoughts and feelings you have to any questions you may have. Likewise, there are counsellors at the abortion clinics with whom you can book an appointment. Ask at your visit so that you really get the support and help you need!

If you have a previous contact such as a psychologist or therapist, it may be safe to go to that person, or to someone you trust around you. The health center also has psychologists and the option of counselling.

The reaction to what you have gone through may come immediately, after some time or during a new pregnancy later on. There are no strange or wrong feelings, and you have the right to be supported in dealing with anything that affects you in a negative way.