Pregnancy After Miscarriage

QUESTION

Dear Midwife,
I am 33 years old and had my first child when I was 19. It was completely normal, healthy, and full term pregnancy and delivery.

14 years later I found out I was 5-6 weeks pregnant. It was surprising but good news. My new husband and I had not been trying but also had not used birth control in over 2 years. I started bleeding lightly around 7-8 weeks for a couple of days and then it stopped.

My Doctor said it was probably just implantation bleeding. Then I started bleeding around 9 weeks and it became more and more like a period lasting for 2 weeks and ending in a miscarriage at 11 weeks.

We had ultrasound done at 8 weeks and everything looked normal and healthy. Also the Doctor heard the heartbeat in his office around 10 weeks. There was never a reason given as to why we had the miscarriage and after my physical exams no cause was found.

I waited a 2 months, had a normal period and then got pregnant again on our first real try in January. I am now 11 weeks and up until this week have not had any spotting or bleeding what so ever.

This past weekend I had light spotting when I wiped. Then the next morning when I was urinating I noticed a string substance (small) in the bottom of toilet. There was no blood and no pain. I had my miscarriage at home and I know how that goes. So I am assuming that stringy, fleshy looking material was not the fetus.

2 days later I have not had any more spotting. I am of course a bit paranoid about any type of spotting due to my recent miscarriage experience. Have you ever heard of this type of discharge? Any ideas of what it could mean? My first real Doctor's visit is a week away. Do you think I should go in now or just wait and let them know what happened when i go next week?

Thank you!

ANSWER

With your history, waiting so long for a first visit would not be my recommendation, but that's your choice. You might want to get your progesterone level checked, just to be sure. Sometimes late first-trimester miscarriages can be prevented with a supplement. I'm also assuming you had your thyroid level checked after your first miscarriage, but if not, that would be another easy thing to check. Chances are that these tests are not even necessary, because everything is ok. In about a week, your placenta should take over hormone production from the corpus luteum, and that reduces the miscarriage risk substantially. -- Cynthia, CNM. PhD.

Cynthia Flynn

Cynthia Flynn, CNM. PhD, is the General Director of the Family Health and Birth Center which provides prenatal, birth, postnatal, gynecological and primary health care to underserved women and their families in Washington, D.C. Recently Cynthia served as Associate Professor of Nursing at Seattle University. There she not only taught, but remained in full scope clinical midwifery practice at Valley Medical Center where she cared for pregnant and birthing women, and practices well-woman gynecology, family planning, and treatment of sexually transmitted diseases.

Cynthia founded Columbia Women's Clinic and Birth Center, where she took care of pregnant women and infants up to two weeks of age and attended both birth center and hospital births. Before Cynthia earned her CNM, she worked as a registered nurse in labor and delivery and postpartum and is a certified Doula and Doula trainer.