A chemical pregnancy is an early miscarriage that usually happens before the pregnancy reaches five weeks and before most women know they’re pregnant. Chemical pregnancies are caused by chromosomal problems with the developing baby. Chromosomes are blocks of DNA, which contain instructions for your baby’s development.

Symptoms of a chemical pregnancy:

• A heavier than normal period
• More menstrual cramping than usual
• Low hCG levels (this is the pregnancy hormone)
• Lack of common pregnancy symptoms like morning sickness or breast soreness after a positive pregnancy test

Causes of an early miscarriage:

• Imbalanced hormones
• Genetic abnormalities in the embryo
• Lack of proper implantation in the uterus
• Low body weight

Between 10-20 percent of all pregnancies end in early miscarriage. But the actual number may be higher because these women didn’t know they were pregnant.  The loss of a chemical pregnancy may be mistaken for a normal period, or a late period.

How is a chemical pregnancy diagnosed?

When women start menstruating shortly after a positive blood test or pregnancy test. In this case, the doctor may want another blood test to measure her hCG level. If that blood test shows the pregnancy hormones are decreasing rather than increasing, the diagnosis will be a miscarriage of a chemical pregnancy. They may also diagnose it if there’s a positive pregnancy test but the fetus can’t be seen on an ultrasound.

If you have any bleeding during your pregnancy, with or without pain, it’s very important to get it checked out.

What is the treatment for a chemical pregnancy loss?

These miscarriages happen at such an early stage that they generally resolve naturally and you will physically recover quickly.  However, your emotional healing may take longer. Any miscarriage, even early ones, can cause you to feel a sense of grief and loss. It’s important to know these feelings are normal and everyone deals with loss in their own way.

Can I Prevent a Chemical Pregnancy?

There’s nothing you can do to prevent a miscarriage. However, you can help decrease your risks by managing any chronic conditions you have, such as thyroid problems, diabetes, polycystic ovary syndrome (PCOS) or high blood pressure. Avoid smoking, using illegal drugs and other risky behaviors.

When you’re ready to try getting pregnant again, our Ultimate Fertility Resource Guide provides the information you need on fertility, tips on how to get pregnant faster, and how to boost fertility through sometimes simple tweaks to your lifestyle and approach. The guide is easy to read and meant for anybody wanting to increase their ability to conceive. It’s a free download and includes coupon codes for essential products. Even free Nightfood Nighttime Ice Cream.

Want to Know More?

• After a Miscarriage: Surviving Emotionally
• After a Miscarriage: Getting Pregnant Again
• Miscarriage: Supporting Friends & Family Through Loss

Sources:

• Mayo Clinic: Blighted Ovum. What Causes It?
• Grow by WebMD

The post Chemical Pregnancy appeared first on American Pregnancy Association.

Why Call Them a “Rainbow Baby”?

The term Rainbow baby has gained popularity among parents in the baby loss community. It symbolizes hope, healing and something beautiful after a dark and turbulent time. This is much like the rainbow’s symbol of promise and light.

Expecting a Rainbow Baby

Most women who lose a baby will get pregnant again. Your body takes time to heal, but it’s your mental state that will often take the longest to recover.
Expecting again can raise a slew of conflicting emotions like guilt, relief, excitement, and sadness. You can go through every emotion, grieve the way you want to grieve, and celebrate this new pregnancy however you like. You might want to keep it to yourself until your pregnancy becomes visible, and that’s OK, too.

Honoring a Pregnancy Loss and Celebrating a Rainbow Baby

It’s important to take time to grieve after the loss of a child and to understand the grieving process. Grief is a very personal and complex emotion. Even if you’re anticipating a joyful new arrival, you can still mourn for the baby you lost.

Some steps may help you through the grieving process:

• August 22 is Rainbow Baby Day can help you commemorate by encouraging you to share your story, in social media, with friends, in a support group.
• Create a memory of your baby. Plant a tree or a garden in honor of your child. Some hospitals offer to make hand and footprints of your baby as a keepsake, take pictures, or give them a christening.
• Seek support. This could mean joining a grief group, talking with people you know who have lost a baby, or even just talking with your spouse. M.E.N.D. is a good starting point.
• Grieve with your partner. We all deal with grief differently, and during this time, our emotions can be everywhere at once. Talk to your partner about how they’re feeling and communicate throughout the pregnancy about your wishes and worries.

If you’ve experienced infant loss, please check out the following resources:

• March of Dimes
• Share Pregnancy and Infant Loss Support
• International Stillborn Alliance

The post What is a Rainbow Baby? appeared first on American Pregnancy Association.

Warning Signs of Miscarriage

If you experience any or all of these miscarriage symptoms, it is important to contact your health care provider or a medical facility to evaluate if you could be having a miscarriage:

Bleeding may start as light spotting, or it could be heavier and appear as a gush of blood. As the cervix dilates to empty, the bleeding becomes heavier.

The heaviest bleeding is generally over within three to five hours from the time heavy bleeding begins. Lighter bleeding may stop and start over one to two weeks before it completely ends.

The color of the blood can range from pink to red to brown. Red blood is fresh blood that leaves the body quickly. Brown blood, on the other hand, is blood that’s been in the uterus a while. You may see discharge the color of coffee grounds, or near black, during a miscarriage.

Exactly how much bleeding you’ll experience depends on a variety of circumstances, including how far along you are and whether or not your miscarriage is progressing naturally. Let your doctor know if you fill more than two sanitary pads an hour for two or more hours in a row.

Other miscarriage symptoms may include:

• Mild to severe back pain (often worse than normal menstrual cramps)
• Weight loss
• White-pink mucus coming from the vagina
• True contractions (very painful happening every 5-20 minutes)
• Tissue with clot like material passing from the vagina
• A sudden decrease in signs of pregnancy

Most miscarriages occur during the first 13 weeks of pregnancy. Pregnancy can be such an exciting time, but with the great number of miscarriages that occur, it is beneficial to be informed about all potential miscarriage symptoms.

What Causes Miscarriage?

During the first trimester, the most common cause of miscarriage is chromosomal abnormality – meaning that something is not correct with the baby’s chromosomes. Most chromosomal abnormalities are the cause of a damaged egg or sperm cell or are due to a problem at the time that the zygote went through the division process. Chromosomes are tiny structures inside the cells of the body that carry many genes, the basic units of heredity. The reasons for miscarriage are varied, and most often cannot be identified.

Other Causes of Miscarriage Include (but are not limited to):

• Infection
• Exposure to environmental and workplace hazards such as high levels of radiation or toxic agents
• Hormonal irregularities
• Improper implantation of fertilized egg in the uterine lining
• Maternal age
• Uterine abnormalities
• Incompetent cervix (The cervix begins to widen and open too early, in the middle of pregnancy, without signs of pain or labor.)
• Lifestyle factors such as smoking, drinking alcohol, or using illegal drugs
• Disorders of the immune system including lupus, an autoimmune disease
• Severe kidney disease
• Congenital heart disease
• Diabetes that is not controlled
• Thyroid disease
• Radiation
• Certain medicines, such as the acne drug isotretinoin (Accutane®).
• Severe malnutrition.
• Group B beta strep.

Note: There is no proof that stress, or moderate exercise or sexual activity causes miscarriage.

What are the Chances of Having a Miscarriage?

• Women under the age of 35 yrs old have about a 15% chance of miscarriage
• An increase in maternal age affects the chances of miscarriage
  • Women who are 35-45 yrs old have a 20-35% chance of miscarriage,
  • Women over the age of 45 can have up to a 50% chance of miscarriage
• A woman who has had a previous miscarriage has a 25% chance of having another (only a slightly elevated risk than for someone who has not had a previous miscarriage)

Types of Miscarriage

Miscarriage is often a process and not a single event. There are several types of miscarriages and they all may have different miscarriage symptoms. You may hear your health care provider mention types of miscarriages:

• Threatened Miscarriage: Some degree of early pregnancy uterine bleeding accompanied by cramping or lower backache. The cervix remains closed. This bleeding is often the result of implantation.
• Inevitable or Incomplete Miscarriage: Abdominal or back pain accompanied by bleeding with an open cervix. Miscarriage is inevitable when there is a dilation or effacement of the cervix and/or there is a rupture of the membranes. Bleeding and cramps may persist if the miscarriage is not complete.
• Complete Miscarriage: A completed miscarriage is when the embryo or products of conception have emptied out of the uterus. Bleeding should subside quickly, as should any pain or cramping. A completed miscarriage can be confirmed by an ultrasound or by having a surgical curettage (D&C) performed.
• Missed Miscarriage: Women can experience a miscarriage without knowing it. A missed miscarriage is when embryonic death has occurred but there is not any expulsion of the embryo. It is not known why this occurs. Signs of this would be a loss of pregnancy symptoms and the absence of fetal heart tones found on an ultrasound.
• Recurrent Miscarriage (RM): Defined as 3 or more consecutive first trimester miscarriages. This can affect 1% of couples trying to conceive.

Related Issues

• Blighted Ovum: Also called an embryonic pregnancy. A fertilized egg implants into the uterine wall, but fetal development never begins. Often there is a gestational sac with or without a yolk sac, but there is an absence of fetal growth.
• Ectopic Pregnancy: A fertilized egg implants itself in places other than the uterus, most commonly the fallopian tube. Treatment is needed immediately to stop the development of the implanted egg. If not treated rapidly, this could end in serious maternal complications.
• Molar Pregnancy: The result of a genetic error during the fertilization process that leads to the growth of abnormal tissue within the uterus. Molar pregnancies rarely involve a developing embryo, but often entail the most common symptoms of pregnancy including a missed period, positive pregnancy test and severe nausea.

Understanding early fetal development and first-trimester development can give you a good idea of what is going on with your pregnancy, and help you know what your health care provider is looking for when there is a possible miscarriage occurring.

Miscarriage Treatments Options

The main goal of treatment during or after a miscarriage is to prevent hemorrhaging and infection. The earlier you are in the pregnancy, the more likely that your body will expel all the fetal tissue by itself and will not require further medical procedures.

If the body does not expel all the tissue, the most common procedure performed to stop bleeding and prevent infection is a dilation and curettage, known as a D&C. Drugs may be prescribed to help control bleeding after the D&C is performed. Bleeding should be monitored closely once you are at home; if you notice an increase in bleeding or the onset of chills or fever, it is best to call your physician immediately.

Prevention

Since the cause of most miscarriages is due to chromosomal abnormalities, there is not much that can be done to prevent them. One vital step is to get as healthy as you can before conceiving to provide a healthy atmosphere for conception to occur.

• Exercise regularly
• Eat healthily
• Manage stress
• Keep weight within healthy limits
• Take folic acid daily
• Do not smoke

Once you find out that you are pregnant, the goal is to be as healthy as possible, to provide a healthy environment for your baby to grow in:

• Keep your abdomen safe
• Do not smoke or be around smoke
• Do not drink alcohol
• Check with your doctor before taking any over-the-counter medications
• Limit or eliminate caffeine
• Avoid environmental hazards such as radiation, infectious disease, and x-rays
• Avoid contact sports or activities that have a risk of injury

Emotional Treatment for a Miscarriage

Unfortunately, miscarriage can affect anyone. Women are often left with unanswered questions regarding their physical recovery, their emotional recovery and trying to conceive again. It is very important to keep the lines of communication open with family, friends and health care providers during this time.

Some helpful websites that address miscarriage and pregnancy loss include:

• www.mend.org
• Pregnancy Loss Support

Ways that we can help. If you are concerned or have questions, you are welcome to contact our helpline or alert our prayer team by sending an email.

Compiled using information from the following sources:

1. Current Obstetric & Gynecologic Diagnosis & Treatment Ninth Ed. DeCherney, Alan H., et al, Ch. 14.
MedlinePlus [Internet]. Bethesda (MD): National Library of Medicine (US); [updated 2006 Feb 23]. Pregnancy Loss; [updated 2006 Feb 22; reviewed 2006 Feb 7; cited 2006 Feb 23].

2. Planning Your Pregnancy and Birth Third Ed. The American College of Obstetricians and Gynecologists, Ch. 15.

Williams Obstetrics Twenty-Second Ed. Cunningham, F. Gary, et al, Ch. 9

The post Symptoms & Signs of Miscarriage appeared first on American Pregnancy Association.

Carrying your developing baby to full term is the objective of any pregnancy.  Most losses during the first trimester are because of chromosomal abnormalities. Second trimester or later losses are often a result of an incompetent cervix.

What causes an incompetent or weakened cervix?

A weakened cervix can be caused by one or more of the following conditions:

• Previous surgery on the cervix
• Damage during a difficult birth
• Malformed cervix or uterus from a birth defect
• Previous trauma to the cervix, such as a D&C (dilation and curettage) from termination or a miscarriage
• DES (Diethylstilbestrol) exposure

How will I know if I have an incompetent cervix?

Incompetent cervix is not routinely checked for during pregnancy and therefore is not usually diagnosed until after a second or third-trimester miscarriage has occurred. Women can be evaluated before pregnancy, or in early pregnancy by ultrasound if they have any of the factors that are potential causes of incompetent cervix. Diagnosis can be made by your physician though a pelvic exam or by an ultrasound. The ultrasound would be used to measure the cervical opening or the length of the cervix.

How often does an incompetent cervix happen?

An incompetent or weakened cervix happens in about 1-2% of pregnancies.  Almost 25% of babies miscarried in the second trimester are due to incompetent cervix.

Prevention

You can’t prevent an incompetent cervix — but the experts at the Mayo Clinic suggest the following tips to help promote a healthy, full-term pregnancy.

• Seek regular prenatal care. Prenatal visits can help your doctor monitor your health and your baby’s health. Mention any signs or symptoms that concern you, even if they seem silly or unimportant.
• Eat a healthy diet. During pregnancy, you’ll need more folic acid, calcium, iron and other essential nutrients. A daily prenatal vitamin — ideally starting a few months before conception — can help fill any dietary gaps.
• Gain weight wisely. Gaining the right amount of weight can support your baby’s health. A weight gain of 25 to 35 pounds (about 11 to 16 kilograms) is often recommended for women who have a healthy weight before pregnancy.
• Avoid risky substances. If you smoke, quit. Alcohol and illegal drugs are off-limits, too. In addition, get your doctor’s OK before taking any medications or supplements — even those available over-the-counter.

What treatment options are available?

The treatment for an incompetent or weakened cervix is a procedure that sews the cervix closed to reinforce the weak cervix. This procedure is called a cerclage and is usually performed between week 14-16 of pregnancy. These sutures will be removed between 36-38 weeks to prevent any problems when you go into labor. Removal of the cerclage does not result in spontaneous delivery of the baby.
A woman would not be eligible for a cerclage if:

• There is increased irritation of the cervix
• The cervix has dilated 4cm
• Membranes have ruptured

Possible complications of cervical cerclage include uterine rupture, maternal hemorrhage, bladder rupture, cervical laceration, preterm labor and premature rupture of the membranes. The likelihood of these risks is very minimal, and most health care providers feel that a cerclage is a life-saving procedure that is worth the possible risks involved.

Want to Know More?

• Pregnancy Nutrition
• Exercise During Pregnancy

Compiled using information from the following sources:
William’s Obstetrics Twenty-Second Ed. Cunningham, F. Gary, et al, Ch. 9.
Danforth’s Obstetrics and Gynecology Ninth Ed. Scott, James R., et al, Ch. 4.
Incompetent cervix. (2019, July 25). Retrieved from

The post Incompetent Cervix: Weakened Cervix appeared first on American Pregnancy Association.

Experiencing a pregnancy loss means that you are probably feeling more sadness than you ever thought possible. Having a miscarriage can be very difficult. The emotional impact usually takes longer to heal than physical recovery does. Allowing yourself to grieve the loss can help you come to accept it over time.

What are emotions I might feel after a miscarriage?

Women may experience a roller coaster of emotions such as numbness, disbelief, anger, guilt, sadness, depression, and difficulty concentrating. Even if the pregnancy ended very early, the sense of bonding between a mother and her baby can be strong.
Some women even experience physical symptoms from their emotional distress. These symptoms include:

• fatigue
• trouble sleeping
• difficulty concentrating
• loss of appetite
• frequent episodes of crying
• broken or suffering relationships with family or friends
• self-harm/suicidal attempts or actions

The hormonal changes that occur after miscarriage may intensify these symptoms.

What should I expect After a Miscarriage?

The grieving process involves three steps:

Step 1: Shock/Denial

“This really isn’t happening; I’ve been taking good care of myself.” “Maybe the doctors are wrong…maybe I’m still pregnant.”

We’re not going to lie to you, it’s going to be a difficult thing to accept. Talk with your doctor about what this might look like physically for you. When will your hormone levels return to normal? How long might you still have symptoms for? This may give you more guidance into what to expect, and talking about practicals surrounding the situation may feel cold, but it may give you more to grasp at as you try to understand what this means for you.

Step 2: Anger/Guilt/Depression

“Why me? If I would have…” “I’ve always wanted a baby so bad, this isn’t fair!” “I feel sadness in my life now more than ever.”

You may feel angry – angry at your doctor, your partner, yourself, God, your situation…you name it. Maybe you think the doctors could have done more, or you’re angry that your partner isn’t consoling you in just the right way, or that he’s not as torn up about it as you are. If you have strong spiritual beliefs, you may yell at God or be angry that “He let this happen.”

But most of the time, you’re angry at yourself. You might even feel guilt and question if it was your fault as if you could have done more. The incredibly important thing we want you to know is that with miscarriage, it’s not your fault. As hard as it is to hear, it is a natural occurrence, and even if you were doing all the right things, it may still happen anyway.

When something goes wrong, we all stretch to find someone, something to blame. With miscarriage, there’s not really anyone or thing to blame, and it leaves us grasping for some way to make sense of what happened, leaving misplaced anger and guilt. And as you’re experiencing all these confusing emotions, all of this can lead to depression.

The one thing we can tell you is to get help. Talk about what’s going on with your partner, a trusted friend, a counselor, or a spiritual leader or mentor. If you’re not ready to talk, write it down. If you’re angry, write a letter and get it out of your system. Listen to some music, cry in the shower, go for a long walk with your dog (if you have one). Find some way to experience these strong feelings but in a safe way.

Step 3: Acceptance

“I have to deal with it, I’m not the only one who has experienced this. Other women have made it through this, maybe I should get some help.”

This is what this expected roller coaster of emotions has led to this is real, isn’t it? This is really happening. Once you get to this point, you are ready to look this in the eye and figure out how to live with your loss. Acceptance doesn’t mean that you’re okay with what happened, that you’re not still experiencing a million emotions – it simply means that you confirm in your mind that this is real.

That doesn’t mean it’s easy from this point on, it just means that you know and understand what you’re dealing with. This is the time that a lot of women and their significant others are able to seek counseling or support groups, or are able to open up about their experiences.

Each step takes longer to go through than the previous one. There are unexpected and sometimes anticipated triggers that lead to setbacks. Examples of potential triggers include baby showers, birth experience stories, new babies, OB/GYN office visits, nursing mothers, thoughtless comments, holidays, and family reunions.

How can I survive my pregnancy loss?

Respect your needs and limitations as you work through your grief and begin to heal.
As you work through this difficult time:

• Reach out to those closest to you. Ask for understanding, comfort, and support.
• Seek counseling to help both yourself and your partner. You don’t have to face this alone.
• Allow yourself plenty of time to grieve and the opportunity to remember.

How Women and Men Grieve Differently:

Generally, women are more expressive about their loss and more likely to seek support from others. Men may be more action-oriented, tending to gather facts and problem solving, and therefore often do not choose to participate in support networks that consist of sharing feelings. This does not mean he is not grieving. Often men bury themselves in work when they are grieving.

Parents experience different levels of bonding with a baby. The bond between a pregnant woman and the baby growing inside her is unique.  A woman can begin bonding from the moment she has a positive pregnancy test. Bonding for the father may start as he experiences physical signs of the baby, such as seeing an ultrasound picture or feeling the baby kick.

However, especially for men, real bonding may not develop until after the baby is born. This is why men may seem less affected when the loss of the baby occurs early in pregnancy. These differences may cause strain in your relationship as you try to come to terms with the loss.

After a Miscarriage, You can help your relationship to survive by:

• Being respectful of and sensitive to each other’s needs and feelings.
• Sharing your thoughts and emotions by keeping communication lines open.
• Accepting differences and acknowledging each other’s coping styles.

Understanding Your Healing Rights:

Healing doesn’t mean forgetting or making memories insignificant. Healing means refocusing.
You have the right to:

• Know the facts about what happened and potential implications for the future. Seek answers to your questions, look at the medical records, and take notes.
• Make decisions about what you would like to do with your maternity clothes and baby items. Others might try to make quick choices for you; instead, use others to help you figure out what option is best for you.
• Protect yourself by avoiding situations that you know will be difficult. Set realistic goals for yourself.  For example, focus on coping throughout each day rather than the entire week.
• Take time to grieve and heal. There is no set time allotment for healing nor is it something that can be rushed.
• Receive support even though this may not be easy for you. If you feel out of control or overwhelmed, consider seeking help from a counselor, therapist or support group to help guide you through the grieving process.
• Be sad and joyful. It is okay to feel sad at times but the key is to not let it control you. Others have survived their grief, and in time you will too. Do enjoyable things because laughter and joy are healers. Remember that celebrating bits of joy doesn’t dishonor your loss.
• Remember your baby. Healing doesn’t mean forgetting or making memories insignificant. You may want to name your baby. Some women find comfort by doing something tangible like planting a tree, selecting a special piece of jewelry with a birthstone, or donating to a charity. On the anniversary you may want to share a special time with your partner.

Helpful Websites and Books:

• Parents or other family members who have experienced the loss of a baby between conception and the first month of life can receive a free March of Dimes bereavement kit by contacting the Fulfillment Center at 1-800-367-6630 or at bkit@marchofdimes.org
• Other Helpful Websites:
  • www.mend.org
  • www.thelifeididntchoose.com
  • www.babyloss.com
  • www.miscarriagesupport.org.nz
• Helpful Books:
• Miscarriage: Women Sharing from the Heart — by Shelly Marks, Marie Allen
• Miscarriage: A Shattered Dream — by Sherokee Isle, Linda Hammer Burns
• Surviving Pregnancy Loss: A complete sourcebook for women and their families — by Rochelle Friedman and Bonnie Gradstein

Compiled using information from the following sources:

1. March of Dimes.

2. Miscarriage Support Auckland Inc.

The post After a Miscarriage: Surviving Emotionally appeared first on American Pregnancy Association.

What can I expect physically after a miscarriage?

Some women experience the following physical effects:

• Vaginal bleeding, similar to a menstrual period, may last up to a week after a miscarriage.
• Light bleeding, or spotting.
• Depending on your menstrual cycle, normal periods should resume in 3-6 weeks.
• Lower abdominal pain similar to menstrual cramps may last up to 2 days after the miscarriage.
• Breast discomfort, engorgement or leaking milk; ice packs and a supportive bra may relieve discomfort. This discomfort usually stops within a week.
• Some pregnancy hormones remain in the blood for one to two months after a miscarriage.

How can I prevent infection after a miscarriage?

After you have been examined by a doctor, there are several things you can do until the bleeding stops to help prevent infection.
These include:

• Using sanitary pads rather than tampons. Wait until your next period before using tampons again.
• Do not douche
• Do not go into swimming pools or hot tubs
• Take showers instead of baths
• Do not have sexual intercourse

Also, if your doctor prescribes antibiotics for you, it is very important to take the antibiotic exactly as prescribed until all the medication is gone. (Even if your symptoms improve after only a few days of taking the antibiotic, keep taking them until they are gone!)

When can I return to my normal activities?

You may resume normal activities as soon as you feel able. However, it is wise to ask your doctor for more specific instructions regarding any vigorous or strenuous exercise after a miscarriage.

Want to Know More?

• Pregnancy After Miscarriage
• Most Common Pregnancy Complications

The post After a Miscarriage appeared first on American Pregnancy Association.

Getting pregnant after a miscarriage

There is no perfect amount of time to wait before trying to conceive again, but many healthcare providers encourage woman to wait at least a few months to strengthen the chance of a healthy pregnancy. If a woman’s body isn’t ready to support a pregnancy by the time that she conceives again, she faces an increased risk of experiencing a repeat miscarriage. It takes time for the uterus to recover and for the endometrial lining to become strong and healthy again.

Medically, it is safe to conceive after two or three normal menstrual periods if tests or treatments for the cause of the miscarriage are not being done. Some physicians routinely recommend that couples wait six months to a year before attempting another pregnancy in order to come to terms with their loss, whereas other physicians feel there is no compelling reason to wait so long.

What are the chances of having another miscarriage?

Many couples who experience a miscarriage worry that it will happen again. Fortunately, at least 85% of women who have had one loss will go on to have a successful pregnancy the next time, as will 75% of those who have experienced two or three losses.

When should a specialist be consulted before attempting to get pregnant again?

Your health care provider can refer you to the appropriate specialist in maternal-fetal medicine, genetics, or reproductive endocrinology who can help you have the best treatment to increase the chances of a healthy pregnancy.
You may want to consider seeking help if you:

• Have had two or more miscarriages
• Are over age 35
• Have an illness that may affect your pregnancy (such as diabetes)
• Have experienced fertility issues

How do we decide when to try again?

Deciding when to try again is a decision only you as a couple can make. Another pregnancy won’t replace the lost pregnancy but may help you by refocusing your attention. If there were medical complications with your miscarriage, make sure to discuss the plans to try again with your health care provider first.

How soon after a miscarriage can you get pregnant?

Your next pregnancy might not be as joyful as you would like because you’ve learned that life doesn’t always go according to your plans. You can’t say it’s your first, but it is also difficult to say you are a parent.
The following are recommendations to make this time a little easier:

• Ask that your pregnancy be monitored carefully.
• You may want to avoid early preparation for the baby’s arrival. Some couples find it helpful to request that baby showers be held until after the arrival of the baby.
• Some people will make suggestions about what you should do or not do to make this pregnancy successful because they are also invested emotionally in your pregnancy. The easiest way to handle their suggestions is to listen, and then do whatever you, your partner, and the medical team feel is best.
• Your birth experience might be bittersweet because memories may resurface about your loss. You will probably need to do some grieving in addition to celebrating your new baby.
• Your parenting may be influenced by your past loss so moments of panic might occur, especially when the new baby is ill, or too quiet.
• You may feel the need to protect yourself from more sorrow so you might be cautious bonding with your new baby until you’re certain he or she is safe and healthy.
• If you feel you are struggling, speak to your healthcare provider about possible support groups or counselors who could help you through this difficult time.

Want to Know More?

• After a Miscarriage: Surviving Emotionally
• Our Ultimate Fertility Resource Guide provides the information you need on fertility, tips on how to get pregnant faster, and how to boost fertility through sometimes simple tweaks to your lifestyle and approach. The guide is easy to read and meant for anybody wanting to increase their ability to conceive. It’s a free download and includes coupon codes for essential products. Even free Nightfood Nighttime Ice Cream.

Compiled using information from the following sources:
Pregnancy, Childbirth and the Newborn: The Complete Guide. Simkin, Penny, P.T., et al, Ch. 3.
Miscarriage Support Aukland Inc, https://www.miscarriagesupport.org.nz

The post Pregnancy After Miscarriage appeared first on American Pregnancy Association.

Why do stillbirths happen?

If you have had a stillbirth or are supporting someone through this difficult experience, you probably are in desperate need of knowing why this happened. An autopsy is normally the best way to diagnose a cause for stillbirth, but this is not always a standard procedure. Inquire about your hospitals’ procedures when handling stillborn babies and the cause of death. If a normal procedure is not to have an autopsy, seek to find out how you can request if that’s what you and your family desire.

The Most Common Known Causes Include:

• Placental Problems: Women with placental abruption or a pregnancy-related form of high blood pressure called preeclampsia or pregnancy-induced hypertension, have twice the risk of abruption or stillbirth as unaffected women. Sometimes insufficient oxygen and nutrients can also contribute to a baby’s death.
• Birth Defects: Chromosomal disorders account for 15-20% of all stillborn babies. Sometimes a baby has structural malformations that are not caused by chromosomal abnormalities but can result from genetic, environmental or unknown causes.
• Growth Restriction: Babies who are small or not growing at an appropriate rate are at risk of death from asphyxia (lack of oxygen) both before and during birth, and from unknown causes.
• Infections: Bacterial infections between 24 and 27 weeks gestation can cause fetal deaths. These infections usually go unnoticed by the mother and may not be diagnosed until they cause serious complications.
• Other infrequent causes of stillbirth include: umbilical cord accidents, trauma, maternal diabetes, high blood pressure and postdate pregnancy (a pregnancy that lasts longer than 42 weeks)
• Unfortunately, despite efforts to find out why, the cause can not be determined in about one-third of stillbirths.

What are some factors that increase a mother’s risk of stillbirth?

• Women 35 years old or older
• Malnutrition
• Inadequate prenatal care
• Smoking
• Alcohol and drug abuse
• African-American ethnicity

How is a diagnosis made?

Most women usually notice that their baby isn’t very active and become worried about what this could mean. An ultrasound can confirm that the baby has died and in some cases determine the reason why.

Can stillbirth be prevented?

Improvements in medicine have decreased the number of stillbirths. Today women with high-risk pregnancies are carefully monitored through routine ultrasounds and/or fetal heart rate monitoring. If potential problems are identified, early delivery may be necessary.

The following are steps you can take to help prevent stillbirth:

• A daily “kick count.” Starting at 26-28 weeks of pregnancy, take time each day to record your baby’s movements. If you familiarize yourself with what is normal for your baby, then you are more likely to notice when something does not feel right. If you notice a sudden decrease in movements, contact your health care provider. An ultrasound can normally confirm if there are any potential problems.
• Avoid drugs, alcohol, and smoking as these can increase your risk of stillbirth and other pregnancy complications. Contact your health care provider immediately if you have any vaginal bleeding in the second half of pregnancy.
• If you have had a previous stillbirth, future pregnancies should be monitored closely so that all necessary steps can be taken to prevent another pregnancy loss.

Compiled using information from the following sources:

1. National Stillbirth Society

2. March of Dimes, https://www.marchofdimes.com

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With any loss, grief can come in many different ways. The initial shock and numbness will eventually fade to other very intense emotions. The grieving process is different for everyone, with the one common thread being a pain. Allowing yourself and others to experience this in individual ways can be vital to eventual healing.

What should I do if my baby has died?

As you are trying to cope with the heartbreaking news, you will also have to face an uncomfortable dilemma. If your baby has died before labor begins you will probably be given the choice of what type of birth you would prefer; this is not an easy decision to make. Giving birth naturally may give you a little more time to work through the shock and begin the grieving process.

How long can you keep a stillborn baby?

Generally, it is medically safe for the mother to continue carrying her baby until labor begins which is normally about 2 weeks after the baby has died. This lapse in time can have an effect on the baby’s appearance at delivery and it is best to be prepared for this.

Some women prefer to be induced as soon as possible because it is emotionally difficult for some women to think of carrying their deceased baby in the womb. If labor has not started after two weeks, induction would become necessary to avoid dangerous blood clotting. A cesarean is usually only recommended if complications arise during labor and delivery.

How will I recover physically after having a stillbirth?

After you give birth to a stillborn baby, your body needs time to heal as it would in any birthing situation. Your doctor will probably recommend taking it easy, to give your body time to heal. A few days after you get home from the hospital, your breasts may fill with milk. The milk will normally disperse within a few days, but your breasts may feel sore and tender for a while.

This experience can be upsetting because it is a reminder of your loss. Try taking a warm bath to ease the discomfort. You may continue to bleed off and on for a few weeks. If you continue to bleed beyond three weeks, have a fever, or cramping, it is important to contact your healthcare provider.

Saying hello, goodbye, and making memories:

After the tests are completed, you will usually have the choice to spend time alone with your baby. You can find comfort in looking at, touching, and talking to your baby. Most parents find it helpful to make memories of this precious time that will last a lifetime.

Here are a few ways you can make memories with your baby:

• You can give your baby a bath and dress them in a special outfit. Before leaving the hospital you can take a piece of this clothing to have as a keepsake.
• You can take pictures of your baby.
• The hospital staff can give you an imprint of handprints and/or footprints.
• You may want to take a lock of your baby’s hair.
• It may seem odd at first but you can read a story or sing a lullaby to your baby.
• If you would like, the nurse can record your baby’s measurements.
• You probably have also named your baby by now. Be sure to tell the hospital staff as soon as possible so all documents can have your baby’s name listed.
• You can have your baby christened or blessed while in the hospital.
• A baptism certificate will also be given to you to keep.

You will be able to spend as much time as you need with your baby, but at some point, you will need to say goodbye. This will probably be one of the most challenging things to do because it is so final. Allow yourself to cry; expressing emotion is natural in the grieving process. Having the keepsakes will remind you that a part of your baby will always be with you.

What can I expect when I leave the hospital?

You normally will be allowed to leave the hospital when you are physically ready. Leaving the hospital may be filled with a mix of emotions. You may be feeling ready to get to the safety and security of your own home, but at the same time dealing with the anger and sadness of not having a baby to take home with you. Having a supportive family around can help you get through this. Some parents have found it helpful to have a family member move all the baby items into a spare room before they get home so that these can be gone through at a time when the parents feel ready.

What about my family members?

With the loss of your baby, your family members will also grieve. Your baby is someone’s granddaughter, brother, cousin, nephew or sister. It is important for your family members to spend time with the baby. This will help them come to terms with their loss. If you have other children, it is very important, to be honest with them about what has happened by using simple and honest explanations.

It is your decision whether you would like the children to see the baby. Ask for a Child Life Specialist at the hospital; these are trained professionals who can help you prepare your children for the heartbreaking news, and prepare them to see the baby if you wish.

How do I tell people about our loss?

Telling family members and friends can be emotionally draining and overwhelming. You may want to have one family member be “in charge” of telling others about what has happened, about funeral arrangements, and ways they can help.

What should I do about a funeral or memorial service?

A social worker or chaplain at the hospital can help you make funeral arrangements. Most funeral homes will provide a free coffin, burial or cremation for stillborn babies. Although there may be other expenses, this contribution will alleviate some of the financial strain. The date of the service will depend on when the hospital releases your baby. The length of the service, as well as the number of family members you want present, is entirely up to you. This may be very difficult for you, but also comforting to know your baby is at rest.

What should I do with the baby items?

The time will come when you are ready to sort through your baby items deciding what do to do with them. Ask a friend or relative to help you find out what store return policies are and assist you in getting items returned. Put items that you want to keep, together in a special box that you can get into when you need to. Try not to make any hasty decisions such as giving everything to charity; you may regret this later. You may want to give some items to charity, return some back to the store and keep some for the next baby.

How can I help myself grieve?

The following are things you can do to help yourself get through this difficult time in your life:

• Talk to people about how you feel
• Joining a support group may help you feel less isolated; it is good to know someone else understands what you are going through.
• Write about your feelings in a journal. You may want to write a letter to your baby.
• Make something for your baby such as an album, or plant a tree in the baby’s memory, or anything that makes you feel that you have done something.

Healing will take time. Little by little the emptiness that you feel in your heart will lessen and you will learn to live your life again. You will have new dreams and hopes for the future and your outlook on life will change. This means you are beginning to accept your loss, not forget it.

Pregnancy after stillbirth

The chances of having another stillbirth are very small. In fact, most women will give birth to a healthy baby after experiencing a stillbirth.

When to try again is something only you and your partner can decide. You will probably be physically ready before you are emotionally ready to start trying again. Future pregnancies will be tougher for you if you do not come to terms with your loss. Some professionals recommend you wait for at least a few months or up to a year before trying again to give yourself time to grieve.

Helpful Books:

• A Rose in Heaven — by Dawn Siegrist Waltman
• I’ll Hold You in Heaven — by Jack W. Hayford
• Am I still a Big Sister? — by Audrey Bernheimer Weir and Susannah Hart Thomer

Helpful Organizations:

• Compassionate Friends: (877) 969-0010.
• Share Pregnancy and Infant Loss Support:
• GriefNet:
• Hannah’s Prayer: (775) 852.9202.
• M.E.N.D. (Mommies Enduring Neonatal Death):(972) 506.9000.
• https://www.emptycradle.org/

Compiled using information from the following sources:
National Stillbirth Society,
March of Dimes,
Share Pregnancy & Infant Loss Support, Inc.

The post Stillbirth: Surviving Emotionally appeared first on American Pregnancy Association.

A blighted ovum (also known as “anembryonic pregnancy”) happens when a fertilized egg attaches itself to the uterine wall, but the embryo does not develop. Cells develop to form the pregnancy sac, but not the embryo itself. A blighted ovum occurs within the first trimester, often before a woman knows she is pregnant. A high level of chromosome abnormalities usually causes a woman’s body to naturally miscarry.

One of the first things you need to know if you have been diagnosed with a blighted ovum is that this is a loss.  Give yourself time and permission to grieve.  This is a type of miscarriage, and you can help yourself in the grieving process by learning more about surviving a miscarriage.

Blighted Ovum Symptoms

A blighted ovum can occur very early in pregnancy before most women even know that they are pregnant. You may experience signs of pregnancy such as a missed or late menstrual period and even a positive pregnancy test. Many women assume their pregnancies are on track because their hCG levels are increasing.

The placenta can continue to grow and support itself without a baby for a short time, and pregnancy hormones can continue to rise, which would lead a woman to believe she is still pregnant. A diagnosis is usually not made until an ultrasound test shows either an empty womb or an empty gestational sac.  It is possible that you may have minor abdominal cramps and minor vaginal spotting or bleeding.

What Causes a Blighted Ovum?

A blighted ovum is the cause of about 50% of first trimester miscarriages and is usually the result of chromosomal problems. A woman’s body recognizes abnormal chromosomes in a fetus and naturally does not try to continue the pregnancy because the fetus will not develop into a healthy baby. This can be caused by abnormal cell division, or poor quality sperm or egg.

Is a D&C Necessary?

This is a decision only you can make for yourself. Most doctors do not recommend a D&C for an early pregnancy loss. It is believed that a woman’s body is capable of passing tissue on its own and there is no need for an invasive surgical procedure with a risk of complications.

A D&C would, however, be beneficial if you were planning on having a pathologist examine the tissues to determine a reason for the miscarriage. Some women feel a D&C procedure helps with closure, mentally and physically. Others feel like a D&C is an invasive procedure that can make the loss more traumatic.

How You Prevent a Blighted Ovum?

Unfortunately, in most cases, a blighted ovum cannot be prevented. Some couples will seek out genetic testing if multiple early pregnancy losses occur. A blighted ovum is often a one-time occurrence, and rarely will a woman experience more than one. Most doctors recommend couples wait at least 1-3 regular menstrual cycles before trying to conceive again after any type of miscarriage.

Want to Know More?

• After a Miscarriage: Surviving Emotionally
• After a Miscarriage: Getting Pregnant Again
• Miscarriage: Supporting Friends & Family Through Loss

Compiled using information from the following sources:
Current Obstetric & Gynecologic Diagnosis & Treatment-Ninth Ed. DeCherney, Alan H., et al, Ch. 14.
March of Dimes

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