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Michelle's riding the roller coaster. She had an ultrasound this week because of spotting, thinking she was around nine weeks pregnant. The technician gave her sad news. There was a sac (amniotic membrane) but nothing in it. Michelle and her husband were obviously upset until an obstetrician told her the reason the sac was empty was because she was only six weeks along—not nine. Her blood hormone levels were adequate and appropriate for a six-week pregnancy. Sometimes we can see a beating heart on a six-week ultrasound but not always. It's only been beating for a few days at that point and it's not very big. By nine weeks, it's pretty clear but most women don't get that first look-see at their baby until around 12 weeks when there's plenty to see.
That news made Michelle and her husband happy but she's still spotting. She's still worried. Oh honey, how frustrating, scary, disappointing, optimistic, delighted, excited and ambivalent you must feel. That's a whole lot of feelings. I've written before about spotting in the first trimester; about how sometimes it's nothing to worry about and sometimes it's a miscarriage waiting to happen. Time will tell. No doubt you're scheduled for another ultrasound soon and I'm hoping that one will show a full sac and a healthy beating heart.
I'll answer the "why am I spotting?" question again briefly. Approximately 20-30% of women have some amount of spotting in the first trimester. From there, it's a 50-50 split between those that miscarry and those that go on to deliver a healthy baby. Spotting can be caused by leftover blood that wasn't squeezed out with your last period; a fragile placenta or in really scary and dangerous cases, an ectopic pregnancy. Sometimes your cervix is irritated or extra-hormone sensitive and it bleeds a little. Since your doctor saw a sac on the uterus and not in the fallopian tube, we can rule out ectopic pregnancy. We can't, however, always say for sure what the bleeding is caused by. Your doctor will check for infections and other causes of cervical irritation and your next ultrasound might be able to give you more information about your placenta. Or not. You might never know that the bleeding was about. Mother Nature's little secret. Sorry, I know it's frustrating not to have answers.
While you're waiting this out—don't have sex, don't wear a tampon, don't exercise vigorously and don't stick anything up your vagina. Just leave everything alone and hope for the best. Millions of women have been in the same spot as you. It might help to talk to your Mom, Grandma or other supportive woman. You'll be surprised how many of them have been there. Right there. Some of them miscarried and some didn't.
At the risk of being a downer, let's talk a little about what it means to lose a baby. I was reading an "olden days" book (A New Dawn on Rocky Ridge—how's that for a metaphor on pregnancy and miscarriage) to my 8-year-old daughter last night and a character had a baby who died a week after birth. The baby had been "sickly" since delivery and wouldn't eat. They couldn't afford the five dollars "cash money" it cost to have the baby checked by a doctor so they had the "granny woman" come out. The "granny woman" went house to house when needed as sort of a midwife, doula, grandmother ,jack-of-all-trades to help deliver and care for new moms and babies. She got paid a dollar or with a basket of eggs; whatever the family could afford. When little baby Earl died, she was the one who dispensed the wisdom: Sometimes babies die and we have to accept it and move on. The rest of the chapter was about how this triggered grief reactions in other women who'd suffered a loss. The chapter was called "A Mother Never Forgets."
Fortunately, very few women in this day and age will suffer the loss of a newborn but plenty will have miscarriages. We rarely get to know why. It's just a fact of nature. Sometimes babies die and we have to accept it and move on. Is it sad? You bet—the saddest. Will you grieve? Yep—no doubt about it. Will you go on to have another baby? More than likely. Will you remember this loss forever? Yes. A mother never forgets, no matter how young her baby was when she lost it. Michelle, I hope you'll be writing back soon with another good question and I hope it will be because your pregnancy is strong and progressing well. If that doesn't happen, I'm truly sorry, honey. I've been there and I know. You'll never forget.
Got a question for Jeanne? E-mail it to firstname.lastname@example.org and it may be answered in a future blog post.
This Fit Pregnancy blog is intended for educational purposes only. It is not intended to replace medical advice from your physician. Before initiating any exercise program, diet or treatment provided by Fit Pregnancy, you should seek medical advice from your primary caregiver.