What Happens When You Miscarry?

You're probably aware of the general details of a miscarriage. It's a pregnancy that ends in the loss of a baby before the 20th week. But the actual process of a miscarriage (as well as its physical, mental, and emotional side effects) is still shrouded in shame and silence. Miscarriage continues to be a taboo topic, and thus a hidden trauma. It's rarely spoken about publicly, and as a result, the ins and outs of the miscarrying body aren't widely known. But it's a mistake to think that concealment will help with miscarriage recovery or prevention. If you or someone close to you ever has (or ever does) miscarry, being able to identify what happens to your body may allow you some understanding amidst the trauma and pain of the experience.

You might already know this, but different miscarriages vary widely in their symptoms and effects. This really shouldn't be surprising — after all, no female body is the same, and neither is any pregnancy. That said, there's such a lack of awareness about miscarriage that you can't really blame anyone who assumes they're all mostly similar. Leaving aside such rare conditions as ectopic pregnancies (wherein fetuses develop outside the womb), "average" miscarriages can be wildly different from woman to woman — and not just because of how far along they are in their pregnancy when it occurs.

Given how common miscarriages are (22 to 75 percent of all pregnancies end in miscarriage in the first six weeks), we should know far more about them than we do. If you're interested in learning more about what happens to the female body during miscarriage, read on. But be warned — this will be graphic and potentially upsetting.

1. Early Symptoms Include Bleeding And Back Pain

The first sign of a miscarriage in most situations is "spotting," or light bleeding. However, that's not a guarantee; up to one in four women experience bleeding at some point in their pregnancy. If it's light and clears up within a few days, it's not likely a sign of a miscarriage, but you should still see a doctor.

In a miscarriage, blood flow increases instead of eventually going away, and it's sometimes accompanied by the beginnings of cramps in your lower back or abdominal area. Other symptoms include a sudden appearance of whitish-pink mucus in the vagina and the sudden absence of pregnancy symptoms, such as morning sickness or sore breasts.

2. The Cervix Will Soften So That The Baby Can Exit

Cervical softening is a natural part of birth, but the process of expelling a non-viable fetus needs its involvement, too. During miscarriage, cervixes often "soften" to let the material from the womb pass through — but sometimes they don't. When this happens, medical professionals have to step in. Incidentally, this is why it's recommended that people don't have sex until about two weeks after a miscarriage. Until the cervix closes up again, penetrative sex raises your risk of an internal infection.

3. The Body May Have Contractions

In some women, the process of miscarriage actually stimulates the body to start producing contractions similar to those that would help out with birth. In this case, though, the body's trying to rid itself of the products of the pregnancy, including the fetus, placenta, and other tissue. These tend to feel like cramps from hell, and may result in the expulsion of blood clots or bits of tissue. Additionally, they can happen either suddenly or over a period of days.

4. A Woman May Pass The Gestational Sac Or Fetal Tissue

This is one of the hardest parts about miscarriage to discuss. But it's an unfortunate truth: Women who miscarry toward the end of the first trimester, (when the fetus is more fully developed) may find that they actually pass the gestational sac in which the embryo has been growing. Others pass gray-colored "fetal tissue" or parts of the placenta.

This is obviously a very traumatic experience, and it's OK to be extremely upset about it. It's a different story for everybody, though. Some women have reported that they never saw anything recognizable — just lots of tissue and blood.

5. Sometimes, The Body Won't Remove All The Tissue By Itself

Miscarriages aren't all about waiting for the bleeding to stop. There are actually three different ways to "manage" miscarriage: expectant (the mother waits for the miscarriage to finish naturally), medical (she's given medicine to help the process), and surgical (any leftover tissue is taken out by doctors). It depends on whether the body struggles to remove all of the remnants of a pregnancy by itself. The medical option either uses oral drugs or vaginal pessaries. The surgical options include a minor outpatient procedure called dilation and curettage, or D&C, which uses a vacuum to "clean" out things that might be hurting the woman.

6. Pregnancy Hormones Will Take A While To Readjust

This is particularly unfortunate, but hCG, the hormone associated with pregnancy in women (which is what's detected in urine-based pregnancy tests) may take a while to return to its normal (basically undetectable) levels in the body after a miscarriage. How long this takes depends on when in the pregnancy the miscarriage occurred. If it happens between the eighth and tenth week, hCG will take longer to disappear.

These hormones may also stick around if you still have fetal or placental tissue inside you. What's worse is that until the hCG levels go back to normal, you may still have positive pregnancy tests.

7. The First Period After A Miscarriage Will Be Different

An evocative personal essay over at xoJane points out something that isn't often mentioned as an aftereffect of miscarriage: Your periods will likely be all over the place. Some will be heavier, as they attempt to eject the thickened lining that the body had prepared for pregnancy, and others will simply be all over the place due to the radical hormonal changes that have altered your body's menstrual clock. Either way, "snapping back," mentally or physically, doesn't easily happen.

8. A Chemical Pregnancy Has Different Loss Symptoms

Some exceptionally early miscarriages (those before the sixth week) are called "chemical pregnancies" because the body starts sending out hormonal signals of pregnancy before the fertilized egg actually gets fully implanted in the uterus. If the implantation doesn't succeed, the egg won't develop — so even if you have a positive pregnancy test, your first ultrasound may show no sign of a pregnancy. Chemical miscarriages can sometimes go completely undetected, and happen in 50 to 60 percent of first pregnancies.

9. Some Miscarriages Show No Symptoms At All

This is the crucial thing to remember. Not all miscarriages are the same, and some of the most traumatic miscarriages are the ones without any signs. These are called "missed" or "silent miscarriages," and they're the ones that happen without any signals whatsoever — some even occur without bleeding. They may result from problems with the embryo or the gestational sac, an infection, or some other reason. The one thing they have in common is that they generally only become clear when you go in for a scan.

If you've ever miscarried, just remember that you're not alone, and you're not a failure or a freak. If you're pregnant or ever become pregnant, visit a doctor immediately if you start to see any of the above signs. It may be nothing, but it will definitely be worth your time (and your peace of mind) to get it checked out.

Images: Jerry Lai/Flickr, Volkan Olmez, Alex Jones, Tertia Van Rensburg, Jake Hills, Brian Mann/Unsplash