Don't Ignore the Signs

                                                             

In preparation for Resolve's theme for National Infertility Awareness Week coming up in April, the topic of not ignoring infertility continues...

Don't ignore the signs.  I do not proclaim to be an expert and I am not a doctor but here is what I have learned through my own experiences about the warning signs that you may be miscarrying or that you may have an underlying issue resulting in recurrent miscarriages.  One first trimester miscarriage is very common and not usually a cause for concern.  Most women who have an early miscarriage go on to have perfectly normal pregnancies the next time.  Two consecutive miscarriages is less common, still could be a fluke, but also a little more likely that there is an underlying problem.  If this is you the choice to seek testing and advice from a specialist is really up to you.  I did after my second one, but I'm pretty proactive about these things.  Three consecutive miscarriages is absolutely something that should be looked into further by your obgyn or a specialist.  You should now qualify for testing to see what is going on.  I know it is hard to face that there may be a problem.  You want to believe it is just a fluke.  You may blame yourself and be sure it was something you did.  But the sooner you find answers, the sooner you can get treatment and the sooner you will be holding your sweet baby.  Three consecutive miscarriages is not a fluke.  It's not your fault.  It's a health concern that needs to be addressed. 

Other obvious warning signs of a miscarriage include bleeding and cramping.  If you call your doctor and say you are bleeding and cramping you will (if your doctor is worth anything at all) get a first class ticket straight into your doctor's office for an appointment to check it out.  But here are a few more subtle signs that a doctor may overlook and you may have to push harder to have it checked out. 

A faint line on a pregnancy test.  If your period is several days or a week late and you are sure of when you ovulated then you really should get a dark line on a pregnancy test.  I don't want to scare a bunch of women into freaking out over how dark a line is.  There are too many variables that effect that.  But I can tell you this.  If you know for certain it has been 12 - 14 days since you ovulated, you are purchasing high quality (the expensive ones) pregnancy tests and you are testing with first morning urine then you should get an unmistakable positive on a pregnancy test if you are indeed pregnant.  If you meet all the above requirements and your line is still faint, something might be up.  My period was a week and half late with my first pregnancy and I still could not get a positive pregnancy test.  I even tested negative with a blood pregnancy test from my doctor's office.  I didn't finally get a positive until my period was two weeks late.  And I miscarried that baby a few weeks later.  I have had other pregnancies where I was 5 weeks pregnant and the line was still faint.  I miscarried those.  When I was pregnant with Riley, I tested a day before my period was even due and got an extremely clear, dark line immediately.  This is nothing to completely freak out over, but if you are recurrently miscarrying, this is definitely a sign I would pay attention to.  Your doctor can run blood tests to tell you for sure if your HCG is rising or falling.  It should double every two to three days in those early weeks.  If it is, that is a good sign.  If it's not, it is a sign you may miscarry.  

A low heart rate or absence of a fetal heart beat.  The first baby I ever conceived was seen on ultrasound at 6 weeks with a heart beat...a dangerously low one.  My doctor never mentioned a word to me about it.  She never gave me any indication that it was low or that there could be any problem.  When I went in again at 11 weeks my doctor could not find a heart beat with the doppler on my stomach.  She told me it was fine.  The baby was just in a weird position and she sent me home.  Two days later I started bleeding at home and was terrified.  If you go in for an appointment and you are 10 weeks or more and the doctor cannot detect a fetal heart beat by doppler, you should demand an ultra sound.  I didn't.  I didn't know any better.  There is some conflicting info on this, but generally your baby's heart beat should be between 120 and 180 BPM.  I left my first doctor after her mismanagement of that pregnancy.  When I first saw my new and current obgyn she reviewed my records and when she saw what my baby's heart beat was on that 6 week ultra sound, 102, she said, "That's too low.  If you had been my patient you would have been on bed rest and we would have been doing an ultra sound every week to follow up."  I just didn't know any better. 

Any loss, even your first one, after 12 weeks should be evaluated.  A loss after the first trimester is much more rare and in my opinion is an indicator that something is wrong.  It doesn't necessarily mean you will miscarry again, but it is certainly a big enough warning sign to at least take some steps to make sure nothing more serious is going on.  You would be surprised that many doctors will not test a miscarriage for chromosomal errors, especially if it is your first one.  But if you lose a baby after 12 weeks I would advise you to have the baby tested.  Knowing whether or not your baby had any chromosomal errors is huge.  If the baby had a chromosome issue, then it could just be a fluke but if the baby was healthy and you still miscarried, it is more likely there is some other issue that is causing you to miscarry.

Bottom line is this, I know many women who have miscarried once.  I know a few who have miscarried two or three times.  I know no one who has miscarried as many times as me.  No one.  It is a lonely place to be.  If you miscarry two or three times, that is your warning sign.  Something is going on.  Find out what it is.  You will never regret getting testing done.  If the tests all come back normal then you will have that peace of mind with your next pregnancy.  If you discover there is a problem, you will never regret seeking treatment and giving your next baby every chance possible to be carried safely to term.  Don't ignore the signs.