EARLY PREGNANCY LOSS (Commonly known as miscarriage) 

As parents who have recently had a miscarriage or fear that your pregnancy may be about to end, you may be quite overwhelmed by the feelings you are experiencing. The early loss of a pregnancy means not only the loss of that potential baby/child, but also dreams of parenting and hopes for the future. You may be feeling quite alone and that no-one else understands what is happening to you. We would like to help by discussing some of the questions most people ask. 

What Is a Miscarriage? 

The medical term for miscarriage is “abortion”, which is usually defined as an interruption of pregnancy before 20 weeks. This does not imply the pregnancy is unwanted. Medically under 20 weeks, the baby is known as a foetus. 

An abortion can present in a variety of ways but usually there is some bleeding and there may be some cramp like pain. In some cases the bleeding and pain cease and the pregnancy progresses. However, if the bleeding continues and the pain that you are experiencing worsens this will be due to the opening of the neck of the womb (cervix). This may lead to complete or partial expulsion of the products of your pregnancy. A curette is often required to clear products of your pregnancy from the lining of the womb. 

Unfortunately, early pregnancy loss occurs much more frequently than most people believe. Studies have shown that up to 1 in 5 pregnancies end in early loss. 

There are many suggested causes for early pregnancy loss, such as foetal abnormality, infection and hormone imbalance. But in most cases the cause remains unknown. It would be very rare indeed for it to be a consequence of some action taken by the mother. You should discuss possible causes with your doctor but do not be surprised if no cause is evident. 

Will I Have To Go To Hospital? 

Admission to hospital may or may not be needed. The doctor may recommend hospitalisation for rest and investigation. 

Every effort will be made to admit you to a suitable ward but bed constraints sometimes make it difficult to accommodate particular requests. Naturally, management will vary. 

In some cases your doctor may recommend a D and C (dilation and curettage). This involves having a general anaesthetic to enable the removal of any remaining tissue. Generally you can except to be discharged the same day or next morning. If your pregnancy has passed 16 weeks, you may find lactation begins (your milk “comes in”) within a few days of leaving hospital. Following discharge from hospital, if your breasts are causing you discomfort, please contact your doctor. 

How Will I Feel After My Early Pregnancy Loss? 

No matter at what stage of pregnancy, your loss is very real and you may find yourself overwhelmed by a confusion of feeling. Some of the feelings most commonly voiced are “I feel numb, I can’t believe this is happening to me” “I feel guilty - was it because I did....?” “ I feel a need to talk to people about my dead baby - not to have them say it was only a miscarriage and all for the best”, “I feel my partner doesn't understand. He hadn’t got used to my being pregnant.” “My partner is devastated - this was his first baby.” “I feel so angry - why didn’t ... listen to me when I said I thought something was wrong?” “Why did this happen to me?”

Society has not always acknowledged the close bond which can form between parents and their expected baby. It can only add to the pain and loss if your grief and mourning is looked upon as “unnecessary”.

What Happens To The Baby?

Unless parents request otherwise, babies routinely go to histology for tests to try to discover the cause of the miscarriage. Individual hospitals have their own policy which covers the cremation or burial of babies born before 20 weeks gestation. Be reassured staff will deal humanely with your baby.

In some hospitals, the babies are cremated communally. Even though it is not a legal requirement, some parents may choose to cremate or bury their baby. This can be arranged through a funeral director, or in some cases, depending on the policy of the hospital, parents may be able to simply take their baby home to bury themselves.

It is possible to have a memorial service for your baby and this can be discussed with the hospital chaplain or your own Minister. It may help to discuss your options with the hospital social worker.

You may find that you need time to make your decision and arrangements but in the meantime it is important to tell the hospital before the baby goes to pathology that you are considering burial or cremation.

Dealing With Loss And Grief

 Individuals deal with their loss and grief in different ways. You may experience feelings of sadness, denial, guilt and anger as you face your loss and the healing process of grief begins.

Pregnancy loss at any point may raise deep issues of meaning. “How can I understand or make sense of what seems so unjust?”

A chaplain is available at all times and your nurse can contact the chaplain or your own religious representative for you.

My Partner Feels Left Out. What Can We Do?

Your partner may find the events in the hospital very difficult. He may feel powerless and helpless, while at the same time experience intense emotions. These can easily be ignored in his concern for you. It is important that you both share your grief, talk to each other about your feelings and needs. There is a need to understand and respect that each will grieve differently. Your partner should be included in discussions with your doctor, hospital staff or counsellors and given every opportunity to express his own grief.

What Shall We Tell The Children?

Children cope very well with the truth and will find their own way of facing their disappointment. If there are other children at home, be honest with them. Tell them what has happened and let them share in your grieving, if you feel it appropriate.

When Shall I Start Another Pregnancy?

There is no magical time to wait before becoming pregnant again. Most people find they are ready to welcome a new pregnancy when they have come to terms with the loss.

Discuss the medical aspect with your doctor. If you feel the need for emotional support, ask for a referral to a suitable counsellor or contact CRADLE.

I Would Like Some More Information

Occasionally after leaving hospital, you may feel confused or uncertain about what actually happened. If you feel a need for more medical information, contact your doctor or the CRADLE SUPPORT GROUP, Ph 0438 272 353.

SOME HELPFUL BOOKS AVAILABLE

COPING WITH MISCARRIAGE By Cuthbert Van Eden and Long

WHEN THE DREAM IS SHATTERED By Judith and Michael Murray

LOSS OF BABY-Understanding Maternal Grief By Margaret Nicol

THE REAL PREGNANCY GUIDE By Vivienne Parry

Most libraries have an extensive range of these books.

CRADLE NT also has a comprehensive book library.