In general, pregnancy is a happy event in a woman's life. Sometimes, this happy event can also have a more sorrowful side that is rarely discussed: miscarriage. It is surprising that it remains so taboo, given that it affects many women (almost 1 in 3 pregnancies). A new term has even emerged: natural pregnancy termination, to emphasize its natural and uncontrollable nature. In this article, we help you better understand what a miscarriage is, how to react in case of a miscarriage, and how to rebuild yourself.

What is a miscarriage?

Miscarriage is a spontaneous pregnancy loss before 22 weeks of amenorrhea , which corresponds to approximately 5 months of pregnancy, the point at which a fetus becomes viable. In most cases, the miscarriage is early , meaning it occurs before the 14th week of amenorrhea, which corresponds to the first trimester of pregnancy. If the pregnancy termination occurs between the 14th and 22nd week of amenorrhea, it is then called a late miscarriage .

In most cases, miscarriages are isolated, meaning that a woman experiences only one. They are quite common, since they concern approximately 15% of pregnancies . However, if a woman under 40 who is trying to have a child with the same partner experiences 3 consecutive early miscarriages, they are said to be recurrent. This situation is much rarer, accounting for 1.5% of pregnancies.

What are the causes and risk factors of a miscarriage?

What are isolated miscarriages?

In this case, age increases the likelihood of a natural pregnancy loss, as the risk is 12% at 25 years old and 50% at 42 years old. As for the cause, it is rarely investigated in this context, because it is due to a fetal development anomaly . In short, you are not to blame. The fetus was not viable, which is why we speak of a natural pregnancy termination: it is nature taking its course.

What are recurrent miscarriages?

If you have had 3 consecutive pregnancy terminations , the healthcare professionals who provide monitoring of your pregnancy will prescribe tests to look for a cause. There are several possible reasons, but the main ones are uterine malformations, an abnormality of the uterine cavity, genetic anomalies, hormonal disturbances, or blood clotting disorders.

We remind you that repeated pregnancy losses are much rarer, and this does not mean you will be unable to successfully carry a pregnancy.

There are also additional risk factors, such as excessive alcohol consumption, smoking or drug use, as well as obesity or deficiencies in vitamins B9 or B12. However, stress is not a risk factor for miscarriage, and apart from avoiding these factors, there is nothing that can reduce the risks.

What are the signs and symptoms of a miscarriage?

There are 3 main symptoms of miscarriage:

• Vaginal bleeding that may be more or less intense, continuous or intermittent, and bright red or brownish in color.

• Blood clots or brownish tissue expelled from the vagina.

• Pain in the lower back, around the abdomen, or pelvic cramps that resemble menstrual pains or contractions.

Bleeding in early pregnancy does not necessarily mean you are having a miscarriage. It is quite common during the first trimester, but if it is accompanied by pain, the likelihood of a miscarriage is higher.

What to do if you have miscarriage symptoms?

If you experience the symptoms described above, it is strongly recommended to consult a healthcare professional who can determine the exact cause of your pain or bleeding.

When to see a doctor or midwife?

If you have very heavy bleeding or feel very unwell—fever, low blood pressure, dizziness, or vomiting—it is best to seek emergency care to avoid any risk. However, if your bleeding is moderate, you can see a gynecologist or a midwife during the day, without too much delay.

How does the medical consultation take place?

During the medical consultation, the doctor or midwife will perform a pelvic ultrasound to determine whether this is a miscarriage. If the uterine cavity is empty, it means that the embryo and its tissues have already been expelled. It is also possible that the natural pregnancy loss is still ongoing and requires intervention to expel the remaining embryo and tissues.

What is the treatment for a miscarriage?

At the time of the medical consultation, if the miscarriage is not complete, the healthcare professional may suggest waiting for natural expulsion or assisting you. For this, there are medications and, in rare cases, surgical intervention. You have every right to request help, as natural expulsion can take up to 2 weeks, and it is understandable not to want to go through this.

If you require medication assistance, there is a medication that induces uterine contractions and helps to open the cervix. It works within a few hours. If you still have bleeding, surgery may be necessary, but this remains quite rare.

The surgical intervention, or curettage for a natural pregnancy termination, resembles the procedure performed for an abortion (or Voluntary Termination of Pregnancy). It requires a day hospital stay and anesthesia: local, regional block like the epidural , and rarely general. It is performed only if your situation absolutely requires it.

How to rebuild oneself after a miscarriage?

After a miscarriage, it is completely normal to feel overwhelmed, angry, and extremely sad. Even if you are told repeatedly that it is absolutely not your fault—and even if you know the numbers and causes—this period can be difficult to get through. For some women, healing and the desire for a new pregnancy can take a long time.

Can we talk about mourning?

We can absolutely talk about mourning after a miscarriage . You may experience the same emotions as during a "classic" mourning, because you invested yourself in this pregnancy. You were so happy, and the fact that it is ending makes you extremely sad. You will go through stages and rebuild yourself gradually. We can only encourage you to talk to a professional, friends, or family to express what you feel, rather than keeping these painful emotions to yourself.

Like everything, time does its work, and it varies from one woman to another. You may need a few days, weeks, or even several months. In any case, don't feel guilty. You have your own rhythm, and that's okay. The grieving process truly depends on each individual.

What precautions should be taken after a miscarriage?

After a miscarriage, doctors recommend not using tampons or menstrual cups for 2 weeks. It is also strongly advised to avoid sexual intercourse during this period. This allows your body to recover from this trauma. If you still experience pain or develop a fever, you should return to see a doctor.

How to prepare for a new pregnancy?

The desire for a new pregnancy after a natural miscarriage depends on each woman. Medically, ovulation and therefore menstruation return between 2 and 4 weeks after pregnancy termination. The earlier the cessation, the quicker menstruation returns.

Some gynecologists recommend trying for a new pregnancy soon after an early, isolated miscarriage, but in fact, it mainly depends on the emotional and psychological state of your relationship. Take the time to listen to yourself, talk about it, and feel ready to try for a new pregnancy.

Miscarriage is a painful step that many women go through. Accepting it is certainly not easy, but it is a first step in rebuilding, because nature often does things well and you are in no way responsible. Taking the time to listen to yourself, surround yourself with support, and talk about it is essential for grieving. This step is now part of your motherhood journey; perhaps one day, you will be able to take something from it: knowing that you can count on your friends and family, that this experience has strengthened your relationship, or that you have realized how strong and resilient you are. Take care of yourself; the entire team is here to support you during this time, and we are sending you lots of courage.