Whether you’re pregnant for the first time or have been pregnant before, the possibility of a loss early in pregnancy brings with it a torrent and whirling pool of emotions.
Are you worried that you might be having a miscarriage? Or even wondering what to do and expect here in Munich in case of early pregnancy loss?
Here are a few tips to help you gain a sense of what you may encounter during this confusing and turbulent time.
Signs of Early Pregnancy Loss
1. Weight loss
2. Mild to severe back pain, generally greater in intensity than menstrual cramps
3. A white-pink mucus
4. Feeling intense or even painful contractions every 5 to 30 minutes
5. Brown or bright red bleeding with or without the presence of cramps*
6. Tissue in conjunction with clot-like material passing from the vagina
7. A sudden decrease in the signs of pregnancy
8. A sense of no longer being pregnant
9. None of the above; sometimes pregnancy loss occurs without any warning sign
* Brown or bright red bleeding does not necessarily indicate a loss of pregnancy; as many as 20%-30% of pregnancies may experience some bleeding in early pregnancy. According to the American Pregnancy Association, 50% of these pregnancies in which bleeding occurs will continue on as ‘normal’ pregnancies. (Source: americanpregnancy.org)
Contact your OBGYN
If you are experiencing one or more of these symptoms during the regular business week, you are typically advised to contact your current OBGYN. When there is a concern about miscarriage, you’ll find that most practices will make an effort to get you in for an appointment sometime that day.
Regardless of where you find yourself going for a check-up, you can most likely expect a bit of a wait. Although you may have talked about your concerns with the assistant at the front desk of your OBGYN, it doesn’t necessarily mean that your OBGYN has been informed as to what your visit is about. This may mean waiting – in spite of how agonizing it is to sit in a waiting room full of strangers who likely have no idea as to what you’re going through.
Once you go in to see your OBGYN, s/he will most likely ask you more specific questions about your pregnancy and symptoms before suggesting how to proceed. In many cases, your doctor may want to do an ultrasound, a pelvic exam and order a blood draw in order to get a full picture of what is going on.
When doing an ultrasound, your doctor will likely be checking for signs of your baby, examining your ovaries and fallopian tubes, if necessary, or possibly even measuring the thickness of the uterine lining among other things. If you are curious about what your OBGYN is identifying, do not hesitate to ask him or her to explain what they are doing and why.
A pelvic exam may also be done in order to check the state of your cervix – specifically, to find out if it has begun to dilate or not.
Blood tests usually include a measurement of the pregnancy hormone beta HCG. This gives your doctor an idea about whether you have or possibly may miscarry and when the loss of pregnancy is complete and your body has returned to a non-pregnant state. Depending on the results of the first test, it may be necessary for you to return for several further blood draws over the next days or weeks. Your doctor will inform you about how to proceed depending on what information s/he is able to gather during your visit. Keep in mind that blood test can take one or several days before they are available as many practices send out blood samples to out-of- practice lab.
Before you go home, your doctor will outline what you can expect and let you know when you should come in again or head to a local clinic or hospital for further care.
Your doctor will likely be able to inform you about the kind of pregnancy loss you are doing through. You can read more about types of miscarriage here.
Going to the clinic
If, however, one or more possible pregnancy loss symptoms arise sometime between Friday and Sunday or on public holidays, you can receive care at a local clinic. Once you arrive at the clinic, it’s likely that you’ll have to register with general hospital admissions. They will take down your information and will then arrange for you to be examined by one of the on-call OBGYN either in the maternal-child area of the clinic or elsewhere.
Similar to your OBGYN’s office, you could be in for extensive wait times depending on the day and the staffing. You can expect similar tests to be done by the on-call OBGYN: ultrasound, a pelvic exam and blood test. Because clinics have their own in-house labs, you may be able to call later the same day or the following day to find out the results of your blood test. Before you leave the clinic, you will receive discharge papers documenting the care you received and the on-call doctor’s assessment including his/her recommendations for follow-up care. Like your OBGYN, s/he will explain what you can expect and when you should return for further care should it be necessary.
How you can expect to feel during and after early pregnancy loss
Just as becoming pregnant is a continuing physical and emotional transformation, so too is the experience of pregnancy loss – which can take a myriad of different forms with respect to the physical process itself, the length of time it takes for your body to pass your pregnancy, the timeframe your body needs to return to its natural rhythm and cycle and more.
There is no one path – no right or wrong way – to grieve your loss. You can expect waves of it to wash over you at varying levels of intensity at varying times. The physical transformation of the body and the spiritual and emotional transformation of the mind and soul become inextricably intertwined through the drastic shift in hormones and the ever-present and surging physical reminders of your loss: the bleeding, periodic to persistent nausea, hot flashes, exhaustion – some of the same symptoms you may have experienced while pregnant. This can feel confusing, thrusting you into a transitory state of oscillation between a sense of hopeful optimism that somehow you are still pregnant and the ever-emerging reality of pregnancy loss. Those first, precious few moments when you’ve finally managed to catch yourself up in thoughts of something else entirely can be interrupted in a mere instance by an emerging wave of nausea or by a minor shift in position followed by a surge of blood. Sometimes it all just leaves you feeling overwhelmed by a sense of being completely raw. One of the most important things to keep in mind is that it wasn’t anything you did or didn’t do. Pregnancy loss happens – and much more often than we think.
You are not alone
Unfortunately, early pregnancy loss is not uncommon. Some studies indicate that as many as 10-25% of all clinically confirmed pregnancies end in pregnancy loss. Every woman’s experience is unique. You don’t have to go through loss on your own. Reach out to your partner, a family member or a friend who practices the art of active listening and is able to hold space for you. You may even find it helpful to talk about your loss in different ways and at different times to different people.
Find additional, professional support:
The Counselling Center for Natural Birth and Parenting, e.V. (Beratungsstelle für natürliche Geburt und Eltern sein, e.V.), located at Häberlstraße 17, offers a range of support for parents who are or have experienced infant and pregnancy loss. For more information, contact the Beratungsstelle: (089) 550 678 - 0.
Engage the support of a postpartum midwife. You may be surprised to learn that the care of a postpartum midwife after pregnancy loss is covered by insurance. **More information on this to come soon.
The loss of your baby – no matter the stage of pregnancy – is a loss. You deserve love and support as you grieve in your own way, on your own time.
Holding you in my thoughts and heart.