Having a miscarriage can be a devastating and emotional experience for expecting parents. A miscarriage is defined as the loss of a pregnancy before 20 weeks. At 5 weeks gestation, a miscarriage is considered an early pregnancy loss. Understanding what to expect physically and emotionally can help you cope during this difficult time.
What happens in the body during a 5 week miscarriage?
At 5 weeks gestation, the embryo is still very small, ranging from 2-4 mm in size. The gestational sac and yolk sac have formed, and the embryo may have a visible heartbeat on ultrasound. When a miscarriage occurs this early, the process happens quickly.
Signs of a miscarriage at 5 weeks often include:
- Heavy bleeding, often with clots
- Cramping in the lower abdomen
- Loss of pregnancy symptoms like nausea and breast tenderness
The heavy bleeding usually lasts around 2-7 days as the uterine lining is shed, although light spotting may continue for a few more days. The actual embryo comes out during this bleeding, often without being noticed. The cramping and bleeding is very similar to a heavy period at this stage.
What causes a 5 week miscarriage?
Most early miscarriages that occur before 10 weeks are caused by chromosomal abnormalities in the embryo. In a healthy pregnancy, the egg and sperm each contribute 23 chromosomes. Sometimes errors can occur when the chromosomes separate and divide, leading to too many or too few chromosomes in the embryo.
Having the wrong number of chromosomes means the embryo will not develop normally and the pregnancy can’t continue. This is known as a “blighted ovum” – where a gestational sac forms but the embryo does not develop or has stopped growing.
Other causes of early miscarriage include:
- Hormonal problems or luteal phase defect – this can cause improper implantation of the embryo
- Thyroid problems
- Infections
- Anatomical problems in the uterus
- Weakened cervix
- Advanced maternal age
- Smoking, alcohol, drug use
However, in most cases of very early loss, the cause remains unknown.
What to expect emotionally after a 5 week miscarriage
Emotionally, an early miscarriage can be just as difficult to deal with as a later loss, even though the miscarriage itself often happens quickly. Parents often feel grief, anger, sadness, guilt and anxiety after a miscarriage. Common feelings include:
- Devastation over the loss of a wanted pregnancy
- Emptiness after thinking about the baby that will not be
- Guilt about anything you may have done to contribute to the loss
- Anxiety about having another miscarriage
- Sadness and depression around the due date
- Anger at your body or health care providers
- Isolation
These feelings are normal, although the sadness and guilt tend to decrease in intensity over time for most women. Seeking emotional support can help – this may include talking to your partner, close friends, counseling, or joining a pregnancy loss support group.
Will I pass the tissue and is it recognizable?
At 5 weeks gestation, the embryo is microscopic in size. The embryo will come out during the bleeding, but it is usually not possible to identify it in the blood and clots. The heavy bleeding washes out the uterine lining along with the embryo.
Sometimes with very early miscarriages, an ultrasound will show the gestational sac with no visible embryo yet – this is known as a “blighted ovum”. The pregnancy tissue may take on a grayish color but there will be no distinguishable features.
The embryo itself would be too small to recognize without a microscope – most women do not actually see any pregnancy tissue. However, it’s possible you might notice some white-gray tissue. Large blood clots are also common.
When to see a doctor
If you have significant bleeding and think you might be having a miscarriage, contact your doctor right away. They can do an ultrasound to confirm if the pregnancy is still viable or if a miscarriage has begun.
You should go to the emergency room if you have:
- Heavy bleeding – soaking more than 2 pads per hour
- Severe pain
- Signs of lightheadedness or dizziness from blood loss
- Fever or chills
- Abdominal swelling
- Tissue remaining in the uterus after miscarriage (your doctor can check this)
These symptoms can indicate a possible complication like infection or hemorrhage that needs prompt treatment.
What happens after the miscarriage bleeding stops?
Once the heavy bleeding lets up after a week or so, the miscarriage is complete. The uterus continues contracting to get back to its normal size. You may have some light spotting or brown discharge for several days afterward as the cervix closes.
Your doctor will likely want to follow up with:
- Pelvic exam to check uterus and cervix
- Ultrasound to verify the miscarriage is complete and no tissue remains
- Blood tests to ensure hCG is going down
It’s recommended to wait 1-3 normal cycles before trying to conceive again so the body can recover. Use protection or abstain from sex during this time. Discuss with your doctor when you can start trying again.
Many women conceive again within a few months after an early miscarriage and go on to have a healthy pregnancy – there are good chances for a successful pregnancy in the future.
Recovering physically after a 5 week miscarriage
Physically, expect some bleeding, cramps, and other symptoms as the miscarriage runs its course. Self-care measures can help manage the symptoms:
- Get lots of rest
- Use a heating pad on your abdomen and back
- Take over-the-counter pain medication as recommended by your doctor
- Avoid sex, tampons, swimming until bleeding stops
- Drink plenty of fluids
- Eat a balanced diet
Your body passed the pregnancy tissue on its own, so there is no need for a D&C procedure to remove contents from the uterus after a 5 week loss. The bleeding should stop within 7-14 days. Call your doctor if it lasts longer than 2 weeks.
Give yourself time to heal physically and emotionally. With support, most women can get through this difficult experience and go on to have a healthy pregnancy.
What are the chances of miscarriage at 5 weeks?
Miscarriage is very common – around 10-20% of known pregnancies end in loss. The risk is highest very early on:
- Weeks 3-4: about 30% will miscarry
- Weeks 5-8: about 15% will miscarry
After a heartbeat is visible at 8 weeks, the risk drops to about 5%. Having an early ultrasound that shows a gestational sac, yolk sac, and fetal pole with heartbeat are all good signs for the pregnancy continuing successfully.
Having one miscarriage does not mean you will definitely have another. Most women will conceive and deliver a healthy baby after an early pregnancy loss.
Can a miscarriage at 5 weeks be prevented?
Unfortunately, most of the time early miscarriage cannot be prevented since it is caused by genetic abnormalities in the embryo. However, there are some things you can do to try to optimize your chances for a successful pregnancy:
- Take a prenatal vitamin with folate before conception
- Manage pre-existing health conditions like diabetes and thyroid disorders
- Reach a healthy BMI before becoming pregnant
- Avoid harmful exposures like smoking, drugs, alcohol
- Limit caffeine
- Reduce stress levels
Talk to your doctor about any concerns prior to pregnancy and to establish care early on. While most miscarriages can’t be prevented, good pre-conception health may improve your chances.
When is it safe to try again after miscarriage at 5 weeks?
Most doctors recommend waiting for at least 1 normal menstrual cycle after a loss before trying to conceive again. This allows some time for the body to recover from the miscarriage and return to normal hormonal cycles.
For a very early miscarriage, you can often start trying again after your first period, especially if you don’t have any risk factors. However, it’s a good idea to discuss the optimal timing with your doctor based on your individual situation.
Make sure any retained tissue has passed and hCG levels have dropped back to negative before another pregnancy. Getting pregnant again too soon raises the chances of another early miscarriage or preterm delivery.
Aim for at least 2-3 cycles between pregnancies. But waiting too long (more than 6 months) does not seem to improve outcomes. Take time to cope with the loss, and know your chances for a successful pregnancy are still very good moving forward.
Conclusion
Having a miscarriage, even at just 5 weeks, can be heartbreaking. Physical symptoms like heavy bleeding and cramping make it even more difficult. But it is fairly common and most women go on to have healthy pregnancies in the future.
Give yourself time and grace to heal, physically and emotionally. Reach out for support and comfort from loved ones or professionals during the grieving process. Discuss future pregnancy plans with your doctor to help ensure you are in optimal health.
While it may not feel like it now, there is hope ahead. Most couples conceive and deliver a healthy baby within the first year after an early pregnancy loss. Although the miscarriage itself cannot be reversed, the prognosis for future fertility and motherhood is very good.
