Miscarriage. "The spontaneous loss of pregnancy before the 20th week" is how the Mayo Clinic defines this term. If it were after the 20th week, we wouldn't be talking about miscarriage, but instead Stillbirth, because the only distinction between the two terms is time. Miscarriage is common, affecting 10-15% of people who know they are pregnant.
Many who have experienced miscarriage share of how very little empathy or compassion gets shown toward the family who is experiencing this type of loss. The terms are so different: miscarriage, like an awkward load of shopping bags; stillbirth has the distinction of being recognized as a type of birth.
We are not telling anyone to feel, but are acknowledging a discrepancy that affects how people are treated. So we want to share a bit more about miscarriage, to broadening dialogue and offer some visibility to an experience, an end, and as a part of the spectrum of birth.
One of the realities of miscarriage is that if it occurs, a pregnant person may need the help of medical professionals for something called a D&C, or a dilation and curettage. Most pregnant people who experience a miscarriage in the first ten weeks of pregnancy can safely miscarry without a D&C. However, after ten weeks, it may be necessary for help to ensure that all of the fetal tissue is removed. The D&C can consist of using suction or scraping the uterine lining.
A D&C does not need to happen in a hospital. Your doctor's office or surgical center with outpatient care is usually an option. If general anesthesia will be used, care from a family member or friend is necessary for transportation afterward, and monitoring for 24 hours.
Returning to work is typical after 2-3 days. However, healing after a miscarriage can take months or longer.
If a D&C is necessary, one can expect the procedure to last about 15 minutes, although one may spend 5 hours or more before being discharged. Bleeding, blood pressure, and recovery from anesthesia are all monitored, and an antibiotic is most likely administered to help prevent infection.
If a miscarriage happens at home, it may take place over a few hours, days, or weeks. Having care from your provider is needed eventually, to ensure your body has released all of the tissue and placenta.
Regardless of where your miscarriage takes place, the emotional and physical needs each person needs require delicate compassion.
Physically, a person's body will need months before hormones will return to pre-pregnancy levels. A person's uterus also takes weeks to return to pre-pregnancy size. Bleeding, cramps, and soreness are common. A person may also need weeks before their regular menstrual cycle returns.
Emotionally, the feelings of grief are extensive and varied for each person. Miscarriage is a loss. Miscarriage is a death. Also, miscarriage, at any stage can change how a person walks through the world. Many do not feel comfortable talking or sharing their experience, thinking they are alone.
Like the loss of any close loved one, miscarriage is often treated without due respect and is thought to be something "to get over." Phrases like, "at least you know you can get pregnant," continue to circulate and isolate the person in the experience. As Brene Brown says, "rarely, if ever, does an empathic response begin with 'at least.'"
Grief, however, cannot be “recovered” from. The stages of grief are researched and continue to have thoughtful discourse added to the dialogue. Recently, grief is being discussed not only as a cycle that starts and stops but is something a person carries for their lifetime, and their life expands around the pain.
And families all around us are doing just that: expanding themselves to continue their lives after a miscarriage. 10-15 people out of 100 are experiencing this loss. It is incredibly common. It can even be seen as one potential “normal” complication of pregnancy, but it is never easy.
The story of real miscarriage is that it is common, and taboo. It makes people uncomfortable, because grief is uncomfortable. But just as we hope to celebrate the joys of life with the people closest to us, having people near who can also be with us as we experience pain is part of parenthood too.