Miscarriage and now I keep throwing up?!

Alice! I had a miscarriaged pregnancy 8 days ago. And for the past 6 days, I’ve been throwing up everything I eat. It's like morning sickness, but morning, noon, and night. And I can't get out of bed without feeling the need to throw up. What do I do? What is wrong?

Dear Reader, 

Although nausea is a typical symptom of miscarriage, it typically doesn’t last more than three days. In order to rule out any other health concerns that may be causing the nausea, it's best to contact your health care provider. You haven’t mentioned whether or not a health care provider has diagnosed your miscarriage; if you haven’t yet sought care for your miscarriage, it’s strongly advised to seek out medical care as soon as possible to rule out any potential infections or other conditions that may be causing the nausea and vomiting. The variety of factors that cause miscarriages may contribute to the length of your symptoms as could some of the miscarriage treatments, so working with a professional to determine what's going on may help you figure out why you’re still vomiting and feel better. 

Miscarriage is relatively common, with 15 to 20 percent of pregnancies estimated to end in miscarriage or a loss of the fetus before 20 weeks. One reason you may be feeling this way is that it’s possible the pregnancy hormones human chorionic gonadotropin (hCG) may still be in the body eight days after a miscarriage. These hormones may continue to be there from 12 to 16 days after a miscarriage, depending on how far along you were into your pregnancy. Your body may still be acting as though it's pregnant and continuing to induce morning sickness.

Many of the symptoms of a miscarriage are similar to those of an ectopic pregnancy. This type of pregnancy occurs when the fertilized egg implants into a Fallopian tube, rather than the uterus. Many people don’t realize they’re experiencing an ectopic pregnancy until 5 to 14 weeks after conception, which is when symptoms often appear. Those who have experienced an ectopic pregnancy are advised to seek immediate medical attention, as they may be experiencing internal bleeding. Symptoms include of an ectopic pregnancy: 

  • Typical pregnancy symptoms (nausea, breast tenderness, skipped periods)
  • Vaginal bleeding
  • Severe abdominal and pelvic pain
  • Shoulder pain
  • Light-headedness and fainting
  • Shock

List adapted from Mayo Clinic.

In many cases, miscarriage can be managed without additional treatment as it will complete on its own. Some people are able to pass the pregnancy without additional treatments, under the supervision of a medical provider. Depending on the situation, other treatments may be appropriate. These include a medication called misoprostol or a procedure called vacuum aspiration, where a small tube removes remaining pregnancy tissue. If you took misoprostol, nausea and vomiting is a common side effect, which may explain your symptoms. Side effects of all of these options include bleeding, cramps, and fever. Some people may also experience feelings of sadness and guilt. It may be more helpful to use sanitary pads rather than tampons, especially during extra heavy bleeding, to better monitor blood flow. 

During recovery, individuals are able to participate in non-strenuous daily activities such as driving, computer work, or other tasks they feel able to do. Before starting any strenuous activity, you may want to check with your health care provider to make sure your body has had time to adequately recover. Those who wish to have sex may be most comfortable doing so after one week, and those who are trying to become pregnant again don’t need to delay unless they have experienced two or more miscarriages in a row, as there may be underlying causes affecting fertility.

Overall, Reader, your symptoms aren’t unusual for those recovering from miscarriage, but the duration of the vomiting is longer than is typical. Seeking care from a health care provider will ensure that you're investigating whether any possible underlying conditions or causes other than the miscarriage itself may be contributing to what you’re experiencing right now. For more information about nausea, feel free to check out the Stomach & Other Gastrointestinal Grumblings category in the Go Ask Alice! General Health archives. 

Take care,

Originally published Feb 09, 2018

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