When Katie Long (not her real name) settled down in the chair at her doctor's office for her ultrasound at 18 weeks, all she could think about was keeping her baby's gender a surprise. Miscarriage was the last thing on her mind.
"We don't want to know the sex!" she eagerly told the technician.
Instead of responding, the ultrasound tech paused, the wand left lingering in a sea of warm jelly.
"Is everything okay?" she asked, fighting back a hefty dose of panic. She felt her husband squeeze her hand, but she couldn't bring herself to look at him.
"I'm just going to go grab the doctor. I'll be right back," the tech said, backing out of the room and closing the door quietly.
Instead of morning sickness or a craving for ice cream, miscarriage -- loss before the 20-week mark -- is actually the most common event during pregnancy. About 30 percent of pregnancies are lost before a woman even knows she is pregnant; it is estimated that around 15 percent of confirmed pregnancies end in miscarriage.
Ingrid Rodi, M.D., of The Fertility Center in Santa Monica, California, advises pregnant women to know the risk factors and symptoms of miscarriage so they can know if they are at risk and recognize signals that they may be miscarrying.
She cites risk factors such as advanced maternal age, being underweight or overweight, diabetes, high blood pressure, smoking, and excessive drinking. If you are noticing any miscarriage signs call your health care provider immediately, and take care to avoid any strenuous activity or activities that involve vaginal penetration, as those activities could make your symptoms worse. Signs of miscarriage include:
Bleeding. Bleeding is typically the first sign of a miscarriage, but it may be misleading. "About 30 percent of women will have bleeding during their pregnancies," Dr. Rodi says, "but not all of them will miscarry." Contact your doctor at the first sign of bleeding so she can check your health and your baby's.
Pain. Pain, especially associated with other symptoms like bleeding, is the other leading symptom of a miscarriage. The pain may be located in the abdomen, pelvic area, or lower back, and can range from dull and aching to period-like cramping. It may be difficult to distinguish if the pain is normal, since round ligament pain and even cramps can be common during early pregnancy as your body expands for the growing uterus.
Decreased activity of the baby. The majority of miscarriages occur during the first trimester, but signs of a loss later on in the pregnancy may be different. One of the primary ways to determine your baby's health is staying attentive to her activity. If you notice a sudden or drastic decrease in her activity, be sure to let your doctor know so he can determine if further testing is necessary.
Change in pregnancy symptoms. Less common but still noticeable symptoms of a miscarriage could include a decrease in pregnancy-related symptoms such as nausea and vomiting or breast tenderness, according to Dr. Rodi. "If there's an abrupt change before the second trimester, it may be due to a decrease in pregnancy hormones," she explains. A blood test to measure the levels of pregnancy hormones can be done to determine if the pregnancy is still viable.
Unfortunately, there is no one proven indicator of a miscarriage, so be sure to speak to your pregnancy health care provider if you're experiencing any of these symptoms or have concerns about your own risk of a miscarriage.