Early- and late-stage pregnancy loss

Some studies show that smoking or consuming alcohol can raise your chances of early pregnancy loss. Other studies suggest that consuming caffeine can also raise your chances. 

These studies also say that consuming 200 milligrams of caffeine a day or less, doesn't seem to raise your chances of early pregnancy loss. 

It’s important to remember that in most cases, a woman cannot cause early pregnancy loss. Working, exercising, having sex and/or taking birth control pills before getting pregnant do not have a direct link to early pregnancy loss. 

Some women who have suffered from a recent fall or impact will connect their pregnancy loss to the event, but in most cases, this isn't true.

The two most common signs for early pregnancy loss are bleeding and cramping. In small amounts, these can be completely normal symptoms. They often stop on their own and the pregnancy can usually go on normally. 

In some cases, bleeding and cramping can be signs of loss or other pregnancy problems like ectopic pregnancy. If you have either of these symptoms, please contact your doctor right away. 

After you’ve told your doctor about your symptoms, you’ll visit the office for a physical exam. You'll also answer a series of questions, such as:

• When did your bleeding start?
• How much bleeding do you have?
• Do you have pain or cramping?

This is why it's important to track your symptoms throughout your pregnancy. 

After the physical exam, your doctor may do an ultrasound to check for a heartbeat and to see if the embryo is in the uterus (womb). 

Your doctor may also test the level of human chorionic gonadotropin (HCG) in your blood, which makes up the placenta. If your levels of HCG are low, it may mean a pregnancy loss. The combination of these tests can confirm pregnancy loss. 

When you suffer from pregnancy loss, some tissue may stay in the uterus. It's necessary to remove this tissue. If it's not an emergency, your doctor will talk about your care plan. 

To treat early pregnancy loss, there are care plans with surgery and some that don't involve surgery. Non-surgical care plans take up to two weeks and include: 

• Waiting and letting the tissue pass naturally 
• Taking medication to help pass the tissue 

Surgical care plans include: 

• Vacuum aspiration: under local anesthesia, your doctor attaches a small tube to a suction device and inserts it into your uterus to remove the tissue
• Dilation and Curettage (D&C): while under general or regional anesthesia, your doctor opens your cervix (lower part of the uterus) and uses a tool to remove the tissue

After early pregnancy loss, don't put anything into the vagina for one to two weeks to help prevent an infection. This includes tampons and sexual activity.  

In some cases, women have some or all of the following symptoms:

• Fever
• Chills
• Severe pain 
• Heavy bleeding (soaking through two or more pads per hour for more than two hours in a row) 

It’s important to know that you cannot cause a miscarriage and most don't have a specific cause or link. 

But there are factors medical professionals can trace it back to, including:

• Age
• Weight
• Diabetes
• Infection 
• Weak cervix 
• Preeclampsia
• Thyroid conditions
• Genetic conditions 
• Multiple miscarriages
• Unusually shaped uterus
• Long-term medical conditions
• Lupus or other immune disorders 
• Hypertension (high blood pressure)
• Use of alcohol, tobacco, or illegal drugs

Learn more about high-risk pregnancy. High-risk pregnancy means a pregnancy that has a greater chance of having problems that could affect both the mother and the baby.

Signs and symptoms can include: 

• Unexplained fluid or tissue
• Vaginal bleeding or spotting
• You can't feel the baby moving 
• Cramping or pain in your back or abdomen

You'll still need to deliver your baby, which can overwhelming. Your doctor will induce labor and give you medicine to soften your cervix. This can take a few hours. 

Once your doctor determines you are ready to begin labor, they will ask you to push until you deliver the baby. 

Your doctor will ask if you want to see or hold your baby. Be sure to prepare yourself for this decision. You may want to talk about the decision with your family or partner ahead of time.

A stillbirth means the baby dies in the uterus after 20 weeks. The reason for most stillbirths is unknown. 

Potential causes include: 

• Infection 
• Medical problems 
• Problems with the umbilical cord  
• Birth defects or genetic disorders
• Use of alcohol, tobacco, or illegal drugs
• Complications during labor and delivery, although less likely if labor is monitored closely
• The baby is not growing properly due to problems with the placenta, the mother’s circulation (blood flow) or overall health

Signs and symptoms can include: 

• You can't feel the baby moving
• The ultrasound technician cannot find the baby’s heartbeat during an ultrasound

When a stillbirth happens in the second trimester, your doctor will do a D&C. While under general or regional anesthesia, your doctor will open up your cervix and use a tool to remove the tissue. 

When a stillbirth happens late in the second trimester and third trimester, your doctor may choose to induce labor to deliver the stillborn baby. This decision depends on your health and your current stage of pregnancy. 

In most cases, no one is at fault. The best way to lower the chances of infant death is by providing proper care and attention. Always contact your health care team if you have a concern about your baby.

Signs and symptoms a baby displays that indicate neonatal and infant death can include:  

• Fever 
• Fit or convulsions
• Difficulty breathing
• Skin feels unusually cold 
• Reduced activity or movement 

If your baby has any of these symptoms, call 911 or seek help right away. 

Early pregnancy loss occurs in approximately 10% of known pregnancies. 

If you feel overwhelmed by the loss, be sure to talk about it with your care team. Many families find it helpful to talk to a counselor or join a support group.

Your care team at USMD is here for you. If you’re struggling, share your feelings with your care team so that they can get you the resources you need. 

In most cases, women are able to have successful pregnancies after a first-trimester pregnancy loss. 

If you’ve had several pregnancy losses and are concerned about getting pregnant, talk with your doctor about tests and evaluations to help find the cause of pregnancy loss. 

After losing a pregnancy, you may begin ovulating as soon as two weeks. If you are still coping with the loss and don't wish to become pregnant, be sure to use a contraceptive. 

If you have a late pregnancy loss, some hospitals offer to arrange for cremation and burials. It’s important to talk with your doctor about this beforehand, so you know what to expect and can make the best decision for you.

If your hospital doesn't offer this service, you may want to make your own arrangements.