Risks of a Natural Miscarriage

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Miscarriage is a sad reality for many surrogates. The March of Dimes estimates that as many as 50% of all pregnancies will end in miscarriage. That statistic may be a bit misleading, as it assumes total number of all pregnancies, detected or not. Generally only 10-20% of pregnancies confirmed by either blood test or ultrasound are statistically likely to end in miscarriage. If an embryo transfer results in a miscarriage the first thing you should understand is that this is not your fault. Nothing that you did, didn’t do, or could have done differently is likely to have resulted in a different outcome. We understand this is an emotionally challenging time, but try not to blame yourself.

Following the diagnosis of a failed transfer or miscarriage you will need to make the choice between undergoing an outpatient procedure called a Dilation & Curettage (D&C) to remove tissue from the uterus or waiting for your body to experience a natural miscarriage, wherein the body would expel the tissue naturally. In some instances a natural miscarriage can be expedited through administration of an oral medication.

For many women, choosing a natural miscarriage can offer a more natural way to gain closure at the end of the transfer or pregnancy. While a natural miscarriage represents the body’s most natural way of cleaning out the uterus and preparing for a future pregnancy, it can also come with a few associated risks.

The most typical risk of a natural miscarriage comes in the form of an incomplete miscarriage. In this instance the body may expel some of the associated tissue, but not all. The end result may be that you will need to complete a D&C procedure in addition to the miscarriage. It is important to be certain that the entire uterus is clear of all tissue.

You may also experience excessive bleeding. Defined as any bleeding heavy enough to soak through a sanitary napkin in an hour or less, this amount of bleeding could represent hemorrhaging and should be taken seriously. You should also watch out for large clots or steady bleeding that lasts more than 3 days. In these cases a D&C procedure may be needed.

Other, rarer complications can include infection, or recurrent miscarriages as the result of scar tissue that can form after a D&C procedure or multiple miscarriages.

Dr. Kim Bergman

Kim Bergman, PhD, a licensed psychologist of 26 years, has specialized in the area of gay and lesbian parenting, parenting by choice and third party assisted reproduction for over two decades. Dr. Bergman has created a comprehensive psychological screening, support and monitoring process for Intended Parents, Surrogates and Donors. She is the co-owner of Fertility Counseling Services and Growing Generations and is a member of the American Society for Reproductive Medicine, the American Psychological Association, the Los Angeles County Psychological Association, the Lesbian and Gay Psychotherapy Association, and the Gay and Lesbian Medical Association. She is on the national Emeritus board of the Family Equality Council. Dr. Bergman writes, teaches and speaks extensively on parenting by choice. Along with co-authors, she published “Gay Men Who Become Fathers via Surrogacy: The Transition to Parenthood” (Journal of GLBT Family Studies, April 2010). Dr. Bergman’s is the author of the upcoming book, Your Future Family: The Essential Guide to Assisted Reproduction (Conari Press 2019). Dr. Bergman created her own family using third party assisted reproduction and she lives with her wife of 35 years. Her two daughters are in college.