Ugly Truth

• 1 in 5 pregnancies end in miscarriage.
• Pain in the abdomen, especially on one side, is a possible indicator of an ectopic pregnancy.
• Abdominal fullness, nausea, vomiting, lightheadedness, shoulder pain, and a strong urge to defecate without being able to do so are all signs that an ectopic pregnancy may have ruptured the uterine tube.
• Often the first sign of miscarriage is light spotting with abdominal cramping.
• Probability of the next pregnancy also ending in miscarriage rises with each subsequent miscarriage.

Often there is little to no support for those undergoing miscarriage. There are clinical websites that list the above facts in whatever arrangement they favor, and that’s it.
During my two previous miscarriages, there was no information on what to expect when suddenly not expecting, and it was terrifying to not know what my body was doing while simultaneously dealing with the misguided sympathy attempts from friends. I know by the odds that there are at least a few women on tumblr/the internet undergoing this process right now, so I wanted to cover the things that your doctor will do as well as the things that may happen in the next couple months, so that the terrible experience will hopefully be less awful (or at least, as less awful as something so terrible can be.)

• When you suspect a miscarriage or an ectopic pregnancy, go see your primary care physician instead of the emergency room. Losing a baby is a long process, and there’s often nothing that the ER can do for you that you can’t do less stressfully with your primary care doc.
• Your doctor will want you to retain the blood and tissue that you’re losing. There’s no graceful way to do this. It’s morbid. However, the blood and tissue is sent to a pathology lab where they will make sure that the miscarriage is complete by verifying that all of the baby tissue is present. This can help rule out complicating factors.
• Your doctor will also want to take a blood test for beta-HCG every other day for a test total of three days. This will give your doctor a baseline for completeness of miscarriage.
• Your doctor will also send you for an ultrasound to rule out complicating factors.

I was seeing a naturopath during my last miscarriage, and she was incredible. I don’t remember everything I was taking, and all of the treatments I did, and this will vary from doctor to doctor anyway. Choose the healthcare forum in which you feel most comfortable.
If, God forbid, things get worse and more complicated-

• Your doctor will refer you to a GYN surgeon. The tissue, beta-HCG levels, and ultrasounds will come into play here, as they give the surgeon an idea of what is going on.

In my case, I had a heterotopic miscarriage, which means I lost one from the womb and had a second baby stuck in the uterine tube. I bled for a month straight, which is too long, and burst my uterine tube. I bled internally for three days (and still went to class) before I had my surgical consult, and went into surgery same day.

• Recovery sucks. Your friends will say the most insensitive things. Some classic winners of the insensitive contest that I experienced were people offering to let me babysit their baby after they delivered in a couple weeks, people who offered to be a surrogate and have sex with my husband, and everyone who told me that I’d have another baby when God decided, as if a replacement would take away the pain. (which, by the way, pregnant again and hopefully healthy this time- but still get sad about the three babies I lost on a near daily basis.)
• Depression is normal. Make sure that you have a support system around you, and reach out to a therapist if you need to.
• You may start losing a lot of hair, thanks to postpartum hormone rushes.
• Miscarriage is hard on you mentally, physically, and spiritually. Give yourself space and forgiveness, especially if you’re taking longer to get back on your feet than you’d hope.

If you have any questions at all about miscarriage, I’m in the unique position of both having had multiple miscarriages and being in medical school, so I can research any questions you have that I don’t know, with an entire medical library at my disposal.