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Expectant parents share journey when unexpected miscarriage occurs
Derrick and Katie Sova were thrilled when they learned they were pregnant with their third child. The Littleton couple had been trying for so long, they were considering giving up. An early blood test at 10 weeks revealed the sex: They were having a little girl. As Katie’s belly began to round, they shared the news with friends and family, including the chosen name: Brooke Madeleine. Then, at a 16-week prenatal checkup, everything changed. After a nurse struggled to find the baby’s heartbeat, the couple was whisked into an ultrasound room where the dreaded silence confirmed the worst: Katie Sova had miscarried.
The harsh reality is that miscarriage happens in about 15 percent of all pregnancies, increasing in frequency with age, according to the American College of Obstetricians and Gynecologists. At age 45, a woman has a 50-percent chance of miscarrying. Defined as the loss of a pregnancy before 20 weeks gestation, miscarriage most often happens in the first trimester, although a small number do occur between 13 and 19 weeks, as in Sova’s case.
Whether a miscarriage happens at six weeks or 16 weeks, it can be emotionally difficult. “When we found out that we’d lost her, we felt numb,” says Katie Sova, 38, adding that the grief process takes time.
“Many women are immediately guilt-ridden,” says Dr. Lynn Barta, an OB/GYN hospitalist and vice chair of the department of Obstetrics and Gynecology at Rose Medical Center. “They rack their brains for the choices they may have made that led to their pregnancy loss.” But, she says, it is important for parents to know there is no one to blame.
At least half of all miscarriages are caused by a chromosomal abnormality, which is something that occurs at fertilization and is out of anyone’s control, says Dr. Steven Grover, an OB/GYN with Sky Ridge Medical Center. He adds that a low level of progesterone, the pregnancy hormone, can also initiate miscarriage, as can cervical issues, such as the cervix dilating too soon. Uterine abnormalities, the presence of scar tissue, or more rarely, maternal infections can also cause miscarriage, says Dr. Daniel Jacobson, an OB/GYN with both Sky Ridge and Rose medical centers. However, despite the many wonders of modern medicine, Jacobson says: “Many miscarriages are simply unexplained.”
When a miscarriage occurs, the first signs are often cramping and bleeding, although there may not be any physical signs initially, as in Sova’s case. “Things were going fine, and I felt great, which is why it was such a shock,” she says. In either instance, parents must decide how best to proceed. As long as the mother’s health is good, she may allow the miscarriage to occur naturally. In this case, she will start to cramp more severely and bleed more heavily. This process typically occurs safely and without complications, although the timing can be unpredictable. If a miscarriage has been diagnosed, but bleeding hasn’t begun, a physician can prescribe medication to expedite the process.
Other times, an outpatient surgical procedure called a dilation and curettage, or D&C, is the best choice, which requires anesthesia. Normally after a D&C, women recover fairly easily with mild cramping and bleeding for a few days. In the rarer second-trimester miscarriages, parents have other surgical options, or they can choose induction and labor in the hospital, as the Sovas chose. “We felt lucky that we made a choice that was right for us and were able to spend a little time with Brooke at the end,” Derrick Sova says.
A reason to grieve
A miscarriage is a loss, and it can be emotionally difficult to process for many parents, Barta says. Adds Jacobson: “Some people may need to go through a mourning process that others may not understand, but they should not feel pressured to move on until they are ready.” There are resources for parents dealing with this grief, such as the Assistance With Grief peer support group at Swedish Medical Center, which the Sovas joined. “The group was really helpful because, in it, we found other people who had gone through something similar,” Katie Sova says.
The group offers people who have experienced a miscarriage or pregnancy loss a safe environment to express emotion with others who can relate, says Natalie Wurzer, an AWG facilitator. “The group format helps people see that they are not crazy, and they are not alone,” Wurzer says.
“Everyone handles grief differently and needs to allow themselves the space to go through the stages,” says Kristi Sagrillo, also an AWG facilitator, referring to the five stages of grief: denial, anger, bargaining, depression and acceptance. The bottom line is, it takes time to heal, Sagrillo says. Seek out books and online communities to benefit from sharing with others in the same situation; journaling can also help, she says.
Holding onto hope
The good news is that a miscarriage does not impact a woman’s future chances of getting pregnant. As long as parents are emotionally ready, they can start trying to get pregnant again once the woman resumes her normal menstrual cycle. Many women do get pregnant fairly soon after a miscarriage, which can sometimes help with grief, Barta says. “Most will have successful pregnancies, and that — along with time — heals the wounds.”
Katie Sova doesn’t know whether Barta is right, but she should soon find out. She recently learned she was pregnant again. “Our hopes for the future are to continue on as a family (Brooke included), enjoy each day with one another, and hopefully have another child,” she says. “I am very nervous, but hopeful.”
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