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The process

The first thing many women notice is the disappearance of pregnancy symptoms. Your breasts are no longer sore, the nausea is gone, and you are less reactive to unpleasant smells. In practice, we often hear women tell us that they have a feeling that something isn’t right. If you have this feeling, you can always discuss it with us.

There is a difference in the process of a miscarriage that occurs early in the pregnancy and one that occurs later. That’s why we describe them separately.

A miscarriage that occurs between the 4th and 10th week

Call us if you have bleeding. A miscarriage between the 4th and 10th week is accompanied by bleeding and abdominal pain.

It’s helpful to keep a kind of logbook with times when things happen. You can always call us for advice and support.
Tip: Try to collect the clots and put them in a container with water, then put it in the refrigerator. This way, we can assess if you have lost everything.

What to expect:

Bleeding
Most women experience heavy bright red bleeding, ranging from a normal period to a very heavy period. It is best to use sanitary pads instead of tampons as the latter increases the risk of infection. As the pregnancy progresses, you will experience more blood and clots. Clots are bright red gelatin-like lumps of blood that can be as large as a fist/tennis ball. You may notice that the bleeding becomes heavier as you experience more abdominal pain. Often, the bleeding and abdominal pain will decrease together. Once the uterus is empty, the bleeding will decrease and the abdominal pain will turn into a nagging pain. On average, bleeding may continue for another 5-10 days. Like during a menstrual period, the bleeding will become less and darker in color.

Call!
If you feel like a tap has been turned on or your pad is soaked within half an hour, this is considered excessive bleeding and we urge you to call us!

Your baby
Be aware that you may see your baby. At around 5 weeks of pregnancy, your baby is about the size of a poppy seed, but at 8 weeks, it will be the size of a pea. You may already see small arms and legs. It is also possible that you only lose blood clots and do not recognize the baby. Place a sieve in the toilet and urinate through the sieve. You may lose your baby while urinating and in a reflex, flush the toilet. The sieve will catch the blood clots and possibly your baby. If you want to show the baby to us, please contact us and try to collect the embryo in a container and put it in (ice) water in the refrigerator.

Abdominal pain
The abdominal pain is similar to severe menstrual pain. The pain often comes in waves and lasts for several minutes. Usually, the pain subsides when blood or clots are released from the uterus. Your uterus contracts to expel the blood loss and clots. The pain may last a few minutes, hours, or may subside and return later.

Pain relief
Feel free to take pain relievers. Paracetamol is allowed, take 1000 mg at once. You can take it 3 to 4 times a day. Avoid aspirin as it thins the blood. A hot water bottle or shower can provide some relief.

How do you know if you have lost everything?
If you have had a lot of bleeding and you notice that it is decreasing and the abdominal pain is slowly subsiding, you have most likely lost everything. However, do contact us so we can discuss this with you and evaluate with an ultrasound whether your uterus is truly empty.

What should you do if you are not sure if you have lost everything?
It is possible that you experience some bleeding that sometimes subsides. You may have nagging abdominal pain that persists. Sometimes, it may seem as though the pain is gone for a few hours, but then it returns with full force. It may also happen that bleeding does not stop or suddenly returns heavily. In such cases, please call us.

A miscarriage occurring between the 10th and 16th week.

In the case of a miscarriage occurring between the 10th and 16th week, we advise you to always contact us. This type of miscarriage presents itself as a very heavy menstrual period, with significant blood loss, passing of clots, and abdominal pain.

Try to keep a journal, write down what happens, and note the times. Call us if you have any questions or if you would like us to come and confirm whether it is indeed a miscarriage and if you have lost everything. Collect what you lose and put it in a container or jar with water in the refrigerator.

Tip: Place a strainer in the toilet so that you can catch any clots or tissue and prevent accidentally flushing them away. Be aware that you will actually see the fetus, which can be quite shocking.

What to expect

Bleeding
Often, bright red bleeding (heavy) increases as the miscarriage progresses. You may lose more blood than during a period. To be able to manage this bleeding properly, you will need large sanitary pads. Some women even use incontinence pads. It is good to be prepared for this. It can also be useful to protect your mattress by lying on a disposable underpad. These can be purchased at a drugstore. Do not be alarmed by the amount of bleeding, as this is normal. Especially when you have been lying down for a while and then get up, it may run down your legs. You may also pass blood clots.

Blood clots are bright red gelatinous lumps of blood that can be as large as a fist/tennis ball. This is still normal.

Call!
If you lose several blood clots the size of a tennis ball in a short period of time or feel like the bleeding is continuous, like a tap that won’t stop, please contact us immediately.

Abdominal pain
The abdominal pain is often similar to very intense menstrual cramps. The pain comes in waves, lasts for several minutes, and then subsides. Usually, the pain decreases when blood or clots have been passed from the uterus. The pain may last for several minutes to hours, until the uterus is empty.

Your baby
At this stage, you can clearly recognize a baby. The fetus will be between 4 and 12 cm in size. The afterbirth, the placenta, is also more recognizable. It looks like a hamburger, with a diameter of 8-12 cm. Sometimes, the pregnancy is completely delivered. You see a red colored balloon that is filled with water when you move it back and forth. If you open the balloon, sometimes you only see water, and sometimes you can see a small baby. This can be very confronting. If you would like to show us the baby, please contact us and try to collect the fetus in a container and put it in (ice) water in the fridge. Between the 10th and 16th week, it is not so common for the pregnancy to be completely delivered. Therefore, it is always wise to contact us so that we can assess with an ultrasound whether the uterus is empty.

Pain relief
Take pain relief if you need it. Paracetamol is fine, take 1000 mg at a time. This can be taken 3-4 times a day. If you have your own pain reliever that works better, feel free to take it. We only recommend avoiding aspirin because it thins your blood, which can cause you to lose more blood than necessary. Heat can provide relief, such as a warm water bottle or a warm shower. We do not recommend a warm bath because it increases the risk of a uterine infection.

How do you know if you have lost everything?
If you clearly lose the baby and the afterbirth, you can be sure that your uterus is empty. You will notice that the bleeding decreases and the abdominal pain slowly subsides. However, please contact us so that we can discuss this with you and assess with an ultrasound whether your uterus is truly empty.

What should you do if you are not sure you have lost everything?
It is possible to only lose blood clots and not recognize anything from your pregnancy. The abdominal pain does not go away. Sometimes it seems to be gone for a few hours, but then it returns with full force. You may also experience prolonged and heavy bleeding or sudden heavy bleeding. In this case, please call us.

Practical info

The office can be reached 24 hours a day on telephone number: 074-2421910. For delivery and other urgent matters, calls can be made at any time. For questions or to make an appointment, our assistants are available Monday through Thursday from 8:30 AM to 2:30 PM and Friday 12:00 PM. So for non-urgent matters it is most appreciated to call within these times. If we cannot be reached, we can always be called through the hospital in case of emergencies, telephone number: 088-708 78 78. We do consultations on alternating days and have an evening consultation every week in Delden, Boekelo, Beckum, Bentelo and Deurningen.

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