Pregnant women often experience bleeding at the beginning of their pregnancy. Bleeding may be related to changes associated with the start of pregnancy, i.e., the implantation of the embryo in the uterus. However, half of all women who bleed in early pregnancy have a miscarriage. In some cases, miscarriage can occur without any symptoms or bleeding.
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Women whose blood is Rh negative may need to receive immunoglobulin (WinRho®) if they have bleeding or a miscarriage. Your health professional will tell you if this is the case for you.
The abnormalities that cause miscarriage occur at random. They do not mean that a woman is infertile or has a health problem.
About one in six pregnancies ends in miscarriage. Most miscarriages occur in the first 12 weeks of pregnancy and are caused by major genetic abnormalities. The embryo doesn’t develop, or the baby’s heart stops beating. At this point, the uterus generally stops growing and will expel its contents.
However, the risk of miscarriage does increase with age. For women age 35 and over, one in four pregnancies end in a miscarriage. For women age 40 and over, it is one in two.
If you want to get pregnant again after a miscarriage, it’s best to wait until you have had at least one normal menstrual cycle. It may be helpful to consult with a health professional if you have had several miscarriages. Keep taking your folic acid supplement.
In rare cases, the embryo implants itself outside the uterus. This is called an ectopic or extra-uterine pregnancy. An ectopic pregnancy cannot continue to term. A medication or surgical abortion is usually necessary.
In very rare cases, a baby may die later during pregnancy, for reasons that cannot always be explained.
Grieving: when your pregnancy ends unexpectedly
After a miscarriage, you and your partner may feel sad and distressed, and even go through a period of mourning. You may also experience feelings of anger, denial, and confusion.
Miscarriage is not related to stress, fatigue, physical or sexual activity, diet, or lifting heavy loads.
Some women feel guilty about things they did or did not do early in the pregnancy because they think they caused the miscarriage.
If you have had an ectopic or extra-uterine pregnancy, it is also normal to grieve for a time and to perhaps need help. If you are concerned about your chances of getting pregnant again, feel free to bring it up with your health professional.
The grieving process
Even after a miscarriage, it is possible to have a healthy pregnancy in the future.
The loss of an unborn child is a deeply personal experience. The grief a person may feel is influenced by circumstances. Some people start establishing an emotional bond with their child from the moment they start planning the pregnancy. For others, the loss of the baby represents the loss of their identity as a parent or an end to their plans for a family.
Generally speaking, men and women don’t grieve the same way. In addition, individuals may go through the different stages of grieving at different times. Whatever your situation, give yourself time to grieve and work through your emotions at your own pace.
If you and your partner don’t know how to break the news to your children or family and friends, you can talk to someone who has been through the same situation or ask a health professional for help. Resources also exist to help your family and friends understand what you’re going through and provide support through this difficult time.
The death of an unborn baby can trigger grieving the same way as any human death. It should not be minimized.
If your baby dies after 19 weeks of pregnancy or after being born, you may also be entitled to maternity benefits under the Québec Parental Insurance Plan.
Québec Parental Insurance Plan
Here are a few resources to help you during your grieving process:
Telephone helpline for questions about pregnancy and termination of pregnancy
www.sosgrossesse.ca (in French only)
Info-Santé and Info-Social
Revenir les bras vides (CHU Sainte-Justine)
A series of free videos on perinatal grief (in French only).
www.chusj.org/fr/soins-services/C/complications-de-grossesse/Deuil-perinatal-mort-perinatale (in French only)
Ectopic or extra-uterine pregnancy: A pregnancy in which the embryo implants itself and develops outside the uterus (e.g., in a fallopian tube).
Embryo: Name given during the first full 10 weeks of pregnancy to the human being developing in the mother’s abdomen.
Genetic abnormalities: Error in the genes. Genes are located on the chromosomes of human cells. They pass along the traits of parents to their children.
Miscarriage: A spontaneous abortion, which can have a variety of causes (e.g., a deformity or disease).
Rhesus factor (Rh factor): One of the characteristics of blood. You are either Rh positive or Rh negative.