Pregnancy Loss: What You Should Know

Am Fam Physician. 2007;76(9):1347-1348

See related article on pregnancy loss.

What is pregnancy loss?

Pregnancy loss is when your pregnancy suddenly ends with the death of the fetus. It usually happens in the first trimester (zero to 12 weeks), but it can also happen in the second trimester (13 to 27 weeks) or third trimester (28 weeks or more). A loss that happens during the first 19 weeks of pregnancy is called a miscarriage. A loss in the 20th week or later is called a stillbirth.

How common is it?

About one in five pregnancies ends within 24 weeks (six months). A second trimester loss happens in about one to five pregnancies in every 100. Stillbirths are rare in the United States. Less than one in 100 pregnancies end in stillbirth.

Why does it happen?

Doctors don't always know what causes a pregnancy loss. It can depend on when it happened. There may be genetic problems like Down syndrome. Birth defects can also cause a fetus to die. Pregnancy loss can happen if you are very sick, have an immune disorder, or have problems with your uterus.

Your doctor will examine you and ask questions to try to find out why it happened. Depending on how far along the pregnancy was, your doctor may examine the fetus, test for certain genetic or chromosome problems, or do blood tests for certain diseases. You might have an ultrasound or x-rays to see if there is a problem with your uterus. Even after examining and testing you, your doctor may not be able to tell what caused your pregnancy loss.

What can I expect after a pregnancy loss?

Your body will need to recover from the pregnancy. The amount of time this takes depends on how far along your pregnancy went. You may feel tired or have trouble sleeping. You may also have some bleeding and cramping. This can last for several weeks. Call your doctor right away if you have discharge that smells bad or if you get a fever.

After a later pregnancy loss, your breasts may produce milk. A good support bra can help you feel more comfortable. You can also take acetaminophen (one brand: Tylenol) to help you feel better.

What can I do to cope?

Losing a pregnancy can be very upsetting for you and your family. It is normal to have strong emotions afterward. You may feel like the loss was your fault. You may feel angry or bitter, or blame your partner. There is no right or wrong way to deal with these feelings. Some people find it hard to talk about their loss; others talk about it all the time. Some people express their grief by crying.

Talk with your doctor if you or your family are having trouble coping with the loss. He or she can help you find a counselor or support group that can help.

Will I still be able to have babies?

If you had a miscarriage, you still have a good chance of carrying another pregnancy to term. Even if you had a later pregnancy loss, it may be a one-time event that won't affect a future pregnancy. If a cause for your pregnancy loss is found, there may be some things you can do to help prevent another loss. Your doctor will tell you what your options are.