By Nancy Ripton
Are you bleeding during pregnancy? Read this first.
If your symptoms are minor, rest and listen to your body. Ask yourself: Is it just a muscle cramp? Am I overtired? Are my blood sugar levels normal? If you see any blood at all—even minor spotting—you should call your doctor. Your doctor is familiar with your pregnancy and will be able to do a quick assessment as to whether you should stay at home and relax or come in for a quick check-up.
If bleeding is heavy and accompanied by cramps you need to go to the emergency room. “Heavy bleeding, especially with cramps, is much more likely to be a miscarriage,” says Dr. Doug Wilson, department head of obstetrics and gynecology at the University of Calgary. The hospital will perform an ultrasound to confirm that status of your pregnancy.
For some women, the symptoms are obvious because a miscarriage can include the actual expulsion of tissue. Most of time this happens on the toilet and the tissue can look like blood clots. “If you can, collect the tissue in a clean jar or container,” says Dr. Wilson. This is especially important for women who have had multiple miscarriages because testing can be done to help determine why a miscarriage is occurring.
Once a miscarriage has been confirmed, a woman will need one or more ultrasounds to confirm that all the tissue has been removed. When a pregnancy is lost, hormonal changes in the body will usually cause the uterus to expel any developmental tissue. However, this can take a while for some women. Sometimes there are emotional or physical reasons to speed things up.
“Medication is usually the first course of action, unless there is heavy bleeding or increasing pain, as trying to avoid surgery is best,” says Dr. Wilson. If that doesn’t help, doctors will perform a dilation and curettage (D&C) surgery to open up the cervix and remove the contents of the uterus. There is the possibility of endometriosis, heavy bleeding, weakening of the cervix or other complications with this procedure, so a D&C is usually done as a last resort in pregnancies that are beyond the first trimester.
The doctors who authored Canada’s Pregnancy Care Book (Robert Rose) state that there is no reason to delay trying again after you’ve experienced a miscarriage. “Traditionally, women have been advised to wait for two to three normal menstrual cycles before trying to conceive again, but there does not seem to be any harm in conceiving sooner.” Check with your doctor to find out if it’s okay to start trying right away. In the meantime, you should think about contacting a reproductive specialist to find out why your miscarriage happened, especially if it’s not your first. “By the time you’ve had two or three consecutive miscarriages, it’s definitely time to ask why,” says Beverly Hanck, executive director of the Infertility Awareness Association of Canada.
Find out more about why miscarriages happen here.