What is a miscarriage? What clinical considerations exist?

When Dr. Emily Godfrey counsels a patient who has had a miscarriage, she stresses that the experience is common, and that it wasn't the patient's fault. Then Godfrey explains medical options. 

Recently the UW Medicine OB-GYN and family medicine physician helped produce a TED-Ed video that focuses on these messages while addressing misinformation and myths about miscarriage, which is the spontaneous loss of a fetus before the 20th week of pregnancy.

Godfrey said she was surprised that the video had accumulated almost 70,000 views within a few hours of being posted. Seven days later, it was up to 221,000 views and climbing. 

“I think patients are craving this information,” she said.  

Between 20% and 50% of pregnancies in the United States end in miscarriage, according to an estimate in the National Institute of Health's medical library.  The larger percentage accounts for miscarriages that occur before a woman even knows she’s pregnant. The 20% counts those who know they are pregnant. 

“Despite how common it is, miscarriage can still feel isolating and, for some, emotionally traumatizing,” Godfrey said. "The current political climate and draconian state laws can add an unnecessary element of fear on top, just as a patient may try to seek treatment.”

When a miscarriage begins, a woman has three approaches to consider: 

• Watch and wait 
• Take medications, mifepristone and misoprostol, which induce menstruation-like cramping and bleeding
• An outpatient procedure called uterine aspiration, which takes about five minutes

All three options are safe, Godfrey said, and should be available to women no matter where they live.

“What the video shows is that, when abortion is outlawed, the lifesaving treatments for miscarriage often go away, too,” she said. “So those who are miscarrying are systematically denied modern medicine options to choose from to treat their miscarriage.”

“Women shouldn’t have to wait until they are so sick that they need to be hospitalized to get care,” she added. 

The watch-and-wait approach can be appropriate in some circumstances. Waiting too long, however, can also result in life-threatening infection and bleeding if the two other options are not accessible, Godfrey said. 

Godfrey hopes the video will clarify what miscarriage is, and is not, so that everyone can understand the value of safe and timely treatment options. 

Download broadcast-ready soundbites and other multimedia of Godfrey discussing her TED-Ed project. 

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