Missed abortion in the second trimester

Verified by

Maria Midstam

Midwife

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    Missed abortion in the second trimester

    Verified by

    Maria Midstam

    Midwife

    Going through a missed abortion in the second trimester is a very tough experience for most people. In this article, we try to summarize what happens and what common feelings may arise.

    When the pregnancy stops before 22+0 weeks, it is called a missed abortion. It is usually detected during a scheduled ultrasound or because the pregnant woman seeks medical attention for various reasons. Missed abortion is uncommon, but it is more common for a missed abortion occurs in the first trimester. In a few cases, however, the pregnancy can stop during the second trimester and when it does, it is a terrible thing to go through both mentally and physically. 

    Pregnancy termination can be caused by abnormalities in the fetus, such as chromosomal abnormalities or organ damage. It can also be due to an underlying disease in the pregnant woman that prevents the pregnancy from developing and growing, because something in the circulation in or from the placenta to the fetus has not been normal. It can also be due to some kind of abnormality or anatomical effect on the uterus. 

    Missed abortion in the second trimester - how it works 

    If the news of a stalled pregnancy comes during a planned ultrasound scan, it is likely to come as a shock and may feel both unreal and nightmarish. The midwife or doctor carrying out the scan will ensure that the pregnant woman is given information about further care and treatment. A referral is then sent from the ultrasound clinic to a gynecologist or abortion clinic in a hospital. In this department, a further ultrasound scan is performed to confirm that the pregnancy has stopped. If this is the case, a plan is made for how and when the treatment will take place. 

    Once the pregnancy has passed week 13, medical treatment is carried out in the same way as an abortion. This means that tablets are given to make the uterus contract and for everything to come out. When a missed abortion occurs between weeks 13 and 22, the pregnant woman stays in the clinic or ward at the hospital longer than if it is a missed abortion in earlier weeks of pregnancy. This is because the longer the pregnancy has continued, the more similar it is to childbirth, and both support and follow-up are needed. 

    How it feels to go through

    The contractions that occur when everything comes out are like severe period pains and are usually localized in the lower abdomen, lower back and radiate down to the groin and legs. There may be a feeling of pressure against the lower abdomen or buttocks, which can be uncomfortable. You will be in the hospital when you go through this and the staff will guide you and be there for any questions you may have. You will then stay in the hospital until everything has come out and an examination is done to make sure there is no residue left. If there is any residue left, an additional scraping can be done. 

    The pain associated with the contractions can come in intervals with breaks in between, but it can also be a constant feeling of the uterus contracting. This is usually likened to a severe period pain. There are different types of pain relief available, such as heat, tens, tablets or injections, and some hospitals also offer other pain relief methods. Before starting the treatment, a counselor or psychologist is offered and this support is also available afterwards.

    Common thoughts and feelings

    Reactions and feelings can come immediately but also afterwards. To get support that suits you, it is usually recommended that you talk to the person(s) you feel comfortable with and trust. This could be a friend, a family member, a midwife at a midwifery clinic or a contact at a health center. The important thing is that support that suits you is provided and that you make sure you get the support you need. 

    Common emotions that tend to emerge are anger, sadness, guilt, shame and jealousy of others who get to continue their pregnancy and the journey to becoming parents. It is both reasonable and normal to react in different ways to a missed abortion - both because of the news but also because of having to go through the treatment. Guilt and shame do not change anything, but they are hard to bear. So if you have these feelings: talk to the person(s) you trust. You will need to recover both physically and emotionally afterwards, so you also need to talk to the doctor in charge before you go home from the hospital about the possibility of taking sick leave. 

    After a missed abortion

    Bleeding usually continues for one to two weeks after treatment. If an infection is suspected, such as high fever and abdominal pain or bleeding that smells different than before, you should contact a gynecological emergency room or abortion clinic. 

    When the bleeding stops, you can ovulate again and, unless otherwise stated during the treatment, your body is ready to get pregnant again. But! You decide when you feel comfortable getting pregnant again. There is no right time, it is when your body and mind are both ready.

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