Health Conditions / Sexual and Reproductive Health / Miscarriage

As anyone who menstruates knows, getting your period isn’t always fun. At 28, having had plenty of experience with cramps, mood swings, and bloating, I thought I’d learned about most of the unpleasant things that can happen to the body during the menstrual cycle—but a TikTok recently taught me about one I’d never heard of before.In the viral video, Madi Swegle, an Iowa-based nurse, described a recent period that started off normal, but quickly turned nightmarish. “My cramps suddenly got very, very intense,” Swegle, who did not respond to a request for comment made via Instagram, said. She added that she made her way to the toilet out of instinct. “I had a heating pad; I had a bucket in front of me because I felt nauseous from the pain. It was a consistent, severe cramp.” The pain was so bad, Swegle said in the video, that she and her partner talked about going to the emergency room. “I thought it was just an awful period,” Swegle explained. “Then, an hour later, after this consistent, never-ending, extremely painful cramp, something came out of me.”Swegle said she passed something that was roughly the size of her palm and shaped like her uterus—which prompted her to take a picture of what she was looking at in the toilet and send it to her ob-gyn. “It was terrifying to see it come out of my body… because what the heck is this thing?” Swegle said. As it turns out, she said, it was a decidual cast, which is medically known as a membranous dysmenorrhoea, Alyssa Dweck, MD, FACOG, a New York-based gynecologist, tells SELF.A decidual cast develops when, instead of gradually shedding tissue, blood, and mucus as you would during a typical period, your body ejects the entire membrane lining of your uterine cavity—called the endometrium—in one fell swoop, Dr. Dweck says. “Possibly, it has something to do with mucus formation, but nobody seems to understand why this happens,” though people who use hormonal birth control methods may be slightly more likely to pass a decidual cast, she says.The pain Swegle was talking about can be extreme, Dr. Dweck adds: “The cervix will dilate a little bit,” she explains, “and because you have to pass this through a very small opening, it’s going to cause quite a bit of pain.” As Swegle noted in her experience, it’s going to look similar to a uterus. “It looks like a triangle, because that’s the shape of the uterine cavity,” Dr. Dweck says. Swegle’s first thought was that she’d passed a large blood clot, but Dr. Dweck says decidual casts won’t be as flimsy as clots. “Tissue, if you hold it in your hand, is spongy and looks like liver or meat. It wouldn’t just tear apart easily, while a blood clot would disintegrate a little bit easier,” she explains.The good news is, you don’t typically need treatment if this happens to you—once the decidual cast passes through, relief will set in. “People miraculously just feel so much better,” Dr. Dweck says, adding that the pain and cramping should subside quickly.

There are countless devastating effects that can and will result from the fall of Roe v. Wade, but one emergent and chilling consequence of the Supreme Court’s decision is how abortion bans may influence the crucial treatment of miscarriages.By definition, a miscarriage—known as a spontaneous abortion—is a nonviable pregnancy that occurs before the week 20 of gestation; after that, it’s considered a stillbirth. The treatment options are very similar to those of abortion—there is no way to stop or prevent a miscarriage that has already been diagnosed. That means providers in states with total or near-total bans, such as Texas, now face a legally murky landscape when it comes to care.As Luu Ireland, MD, an ob-gyn in Massachusetts and fellow with Physicians for Reproductive Health, tells SELF, a miscarriage is a pregnancy that cannot be safely carried to term. “There is no chance of it going on to be a normal pregnancy,” Dr. Ireland says. While the research varies, it’s estimated that between 10 to 20% of pregnancies end in miscarriage, per the Mayo Clinic, but experts believe that figure could be much higher.Sometimes a miscarriage could mean that the embryo is not having cardiac activity at the expected time, that the gestational sac (a fluid-filled structure that protects the embryo) is growing but the fetus isn’t, or that someone is actively bleeding in the process of passing a pregnancy. It’s difficult for a doctor to know what has caused a particular miscarriage, but as Planned Parenthood notes, it’s almost never something the pregnant person has done. And Dr. Ireland is clear: “What clinches a diagnosis is what the outcome would be, which is, this is not a viable pregnancy, and it will never be a normal pregnancy.”Meera Shah, MD, chief medical officer at Planned Parenthood Hudson Peconic, tells SELF that there are a couple of treatment options for a miscarriage: One involves administering the exact same two drugs that are used in a medication abortion (mifepristone and misoprostol), and another involves performing a dilation and curettage, or a D&C, which is a surgical procedure that is done to remove tissue from inside the uterus. “Regardless of the status of the pregnancy, whether it’s a viable pregnancy or a miscarriage, the treatment options are exactly the same,” Dr. Ireland says.How might abortion bans affect crucial miscarriage treatment?Similar to the way that abortion bans can potentially affect the lifesaving treatment needed for an ectopic pregnancy, treating a miscarriage may become unnecessarily complicated and could lead to dangerous delays in care in states where legal abortion is illegal or criminalized, according to Dr. Ireland.“Because it’s the same medication used in abortions, we are seeing a lot of pushback from pharmacists,” Dr. Ireland says. “Patients aren’t getting the medication they need because the pharmacist is worried about legal repercussions. Instead of providing appropriate medical care, pharmacists are having to think about what they need to do to keep themselves safe. As a result, they are denying care to patients undergoing the very difficult process of having a miscarriage.”

In addition to seeing her own therapist, Sumpter and James go to couples therapy every week as well. “I have the best fiancé, and not just on Mother’s Day or my birthday,” she says. “He just keeps loving me, even if I push him away or I’m upset. I really feel like that’s a gift when somebody can love you no matter what—even when you judge yourself.”As one half of SugaBerry, an audio-based media company for and by Black women, Sumpter realizes how important it is for women to own their narrative, confront difficult emotions, and embrace vulnerability. “At SugaBerry, we always say, ‘We don’t sip tea, we share suga,’ so in order for other people to be vulnerable with me on The Suga (SugarBerry’s parenting podcast), I started uncovering so many things about myself,” she says. “We’re in the age of vulnerability where people want to know more about who you are. I always feel like the more I share, the more people will feel validated in their own lives; that they’re not the only ones going through something.”For Sumpter, this means getting honest about her struggles and evolution as a mother to five-year-old Ella-Loren, for one. “As mothers, we’re often so tough on ourselves in every single way—on top of having to wade through the water in our jobs and being judged all the time,” she says. “Motherhood is another backpack. We love it, and we’re happy to have it, but a lot of the time Black women especially will carry everybody on their back, plus extra bricks, and not complain.”“I’ve accepted that it’s OK if you’re not at every moment of your child’s life; you’re not going to be at every game,” Sumpter continues. “We want to be there all the time, but I focus on the times I have been there as a mom. And I’ve also been at work, which means a lot to me, too. So does being with my friends.”That delicate dance between motherhood and ambition is a topic Sumpter and her business partner, Thai Randolph, discuss frequently on The Suga. The podcast was also the inspiration for Sumpter to share candidly about her miscarriage.“Sometimes you need to keep stuff for yourself until you’re ready, and now I’m ready,” she says. “Ready to say, ‘I see you, and this is a piece of me that I’m giving to you so you know you’re not the only one. You’re validated in your feelings, and I’m a sister who loves you.’”And it’s that sharing with others—versus suffering in silence—that can be so fundamental to healing, no matter what you’re struggling with, says Nelson. “Reach out to your support systems—find a trusted friend you can confide in, talk with a therapist, or find a community of support. Don’t hesitate to ask for what you need,” she suggests. “And you may also want to ask yourself, ‘How do I feel my pain and use it to be in service to others?’” Uplifting other people who are dealing with similar circumstances can give you a sense of purpose and be mutually beneficial for well-being, Nelson says. Sumpter agrees: “Even if telling my story just helps one person, it’s worth it—you don’t know what someone else is going through.”For anyone else who has experienced pregnancy loss, Sumpter offers a reminder that you’re not alone: “There are so many women who have gone through this silently. I have some type of privilege in this world, and I still didn’t tell anybody,” she shares. “Take a moment of silence for yourself. It’s a grieving process. Take a moment to breathe.”Related:

Jessie J’s recent response to body-shamers is just another reminder that it is never appropriate to comment on another person’s weight or body in general—regardless of your intentions. “Stop commenting on people’s weight, anyone. Just stop. Or telling someone they look pregnant,” the British singer wrote on her Instagram story on Thursday. “I see it so much on socials and I know it happens in real life.” Jessie revealed that she had been motivated to speak out after someone asked if she was pregnant because she supposedly “looked” it. She went on to explain that she had gained some weight since the end of last year, which didn’t seem to concern her. “As long as I feel good, I’m healthy,” she wrote.Unfortunately, the same person who asked if she was pregnant also went on to offer her unsolicited opinions and advice on something very personal she experienced late last year. “They also knew of what I went through last year and told me their thoughts on that, and how I should’ve handled it,” Jessie wrote. The 34-year-old is referring to her miscarriage. In November 2021, she revealed on Instagram that, sadly, no heartbeat was detected during her third sonogram. She also touched on her decision to parent solo and how she was so excited about the possibility of becoming a mother. “I decided to have a baby on my own. Because it’s all I’ve ever wanted and life is short. To get pregnant was a miracle in itself and an experience I will never forget and I know I will have again. I’m still in shock, the sadness is overwhelming. But I know I am strong, and I know I will be OK,” she wrote in a since-deleted Instagram post.Jessie has been candid about her health struggles. In 2019, she revealed in an interview with the BBC that she had been diagnosed with adenomyosis some five years earlier. According to the Cleveland Clinic, adenomyosis is a rare condition in which the endometrial tissue that lines the inside of the uterus grows into the myometrium, which are the outer muscular walls of the uterus. This can lead to the uterus expanding in size, and “abnormal” uterine bleeding and painful, heavy periods can ensue as a result. The condition can also lead to fertility challenges.Jessie ended her message to body-shamers with some final words of wisdom: “Just no. It’s a no. Not cool to just say or comment on anyone’s body. Unless they/I tell you or ask your opinion it’s not one that’s needed or helpful. Wild that some people don’t know that. Phew.”Related

A year and a half after losing her son Jack at 20 weeks due to pregnancy complications, Chrissy Teigen has announced she is in the middle of another in vitro fertilization (IVF) cycle. In a candid Instagram post on Sunday, the model and cookbook author shared a picture of herself stretching with the caption: “I wanted to let you guys know I’m balls deep in another IVF cycle to save as many eggos as I possibly can and hopefully make some strong, healthy embryos. I honestly don’t mind the shots…they make me feel like a doctor/chemist…but the bloating is a bitch.” Aside from announcing that she was undergoing IVF, Teigen made a plea to those reading: “I humbly beg you to stop asking if I’m pregnant because while I know it’s said with excited, good intentions, it just kind of sucks to hear because I am the opposite of pregnant! But also like please stop asking people, anyone, if they’re pregnant,” she wrote in the caption. “I said this in the comments and got yelled at because the internet is wild but I’d rather be the one to tell you and not some poor woman who will look you in the eyes through tears and that’s how you finally learn.”Instagram contentThis content can also be viewed on the site it originates from.Teigen has been open about her fertility struggles, often using her social media to document her experiences with other rounds of IVF treatment and her grief after Jack’s death. The 36-year-old is mom to daughter Luna, 5, and son Miles, 3, with her husband, John Legend, 43. Both children were conceived through IVF. In September 2020, the couple sadly lost Jack at 20 weeks due to a pregnancy complication. “I didn’t get to take care of you but you came and went to get me to love myself and take care of myself because our bodies are precious and life is a miracle. they told me it would get easier but yeah, that hasn’t started yet. mom and dad love you forever,” Teigen captioned heartbreaking photos of herself and her husband in the hospital shortly after Jack’s death. Anywhere from 10 to 15% of couples in the U.S. are experiencing infertility, according to the Mayo Clinic. The technical definition of infertility is not being able to get pregnant after at least a year of unprotected sex, the Centers for Disease Control and Prevention (CDC) explains, although depending on a person’s age, it can be recommended to see a doctor before reaching that point. (For instance, the general guideline is to see a doctor if you’re a person with a vagina who’s 35 or older and hasn’t gotten pregnant after six months of unprotected sex.) 

James Van Der Beek is a proud dad again. On Monday, the Dawson’s Creek actor celebrated welcoming his sixth child with his wife, Kimberly, by posting a gallery of photos and videos on Instagram. “Humbled and overjoyed to announce the safe, happy arrival of Jeremiah Van Der Beek,” he wrote.But it hasn’t been an easy road for the parents. James, 44, shared that Kimberly, 38, experienced two late-term miscarriages before the birth of Jeremiah.“After experiencing late-term #pregnancyloss twice in a row (both at 17+ weeks), we kept this one quiet. Truthfully, I was terrified when I found out,” he wrote.Kimberly told The Make Down podcast that these experiences were, understandably, both emotionally and physically hard on her. “I understand that I am very blessed to be able to birth five children. I’ve also had five miscarriages, two of which were really hard experiences,” she said. “The last two miscarriages, they’ve been really extreme. The one in November, it was losing a ton of blood, losing consciousness over and over again and feeling like, ‘Am I going to die?'”In James’s post, he shared what was different this time around. “We found a doctor here in Texas who diagnosed the last two as having been caused by an ‘incompetent cervix.’” If that term makes your skin crawl, James is with you: “I asked him what kind of misogynistic old dude invented that term and he laughed—which made me like him even more.” As James notes, this complication has other names as well, like having a “weak cervix.” (“Cervical insufficiency” is another term for it, but “incompetent cervix” is still very much in use.)The cervix is the lower part of the uterus that opens into the vagina. In a healthy pregnancy, the cervix remains closed and firm until you approach your due date, when it begins to soften, get shorter, and open. In the case of cervical insufficiency, it begins to open too soon, potentially leading to premature birth or pregnancy loss, according to the Mayo Clinic.

As you probably know from living life with a vagina, having your period looks nothing like how it does in most tampon commercials. For one, period clots can happen during that lovely time of the month, and the jelly-like glob doesn’t usually come out in a tidy little splash. While it’s expected to have some blood clots during your period, especially if you’re prone to heavy menstrual bleeding, there are certain times when they might be a sign that something is off in your body. Here’s how to tell the difference between what’s normal and what’s not.What causes period blood clots during your cycle?First, a mini-primer on blood clots in general. When you think about clots of blood, you might imagine the kind that come together when you have a cut. Your body springs into action, combining enough platelets (blood cells that adhere to each other) and proteins from plasma (the liquid part of your blood) to plug the injured blood vessel1. This is how clots help to stop bleeding.Blood can also clot in your veins, especially if you have risk factors like being pregnant, which causes hormone changes that increase your blood clot risk, or recently having surgery, because moving less also contributes to this health hazard. These clots can dissipate without harm, but sometimes they can be life-threatening.The blood clots that can emerge from your vagina during your period are a bit different than these other types, though. Menstrual blood clots are comprised of the endometrial lining that builds up in your uterus in preparation for pregnancy, then sloughs off during your period when you don’t conceive.“Clots are normal, but they typically happen when a [person] has a heavy flow,” G. Thomas Ruiz, M.D.2, lead ob-gyn at MemorialCare Orange Coast Medical Center in Fountain Valley, California, tells SELF.This is in part because a gushing period prompts your body to form clots so you don’t lose more blood than you should (around two to three tablespoons over the course of your entire period). Also, the opening of your cervix (the narrow passage at the lower end of your uterus) is pretty small. If you have a substantial flow, that allows the blood to build up in your uterus, Dr. Ruiz explains, giving components like platelets and plasma proteins time to congeal.Back to top.How big should period clots be?For the most part, period clots are a completely normal part of menstruation, Mary Jane Minkin, M.D.3, a clinical professor of obstetrics and gynecology and reproductive sciences at Yale Medical School, tells SELF.But if you’re seeing clots the size of a quarter or larger, you should visit your doctor, according to the Centers for Disease Control and Prevention (CDC)4.“If someone is passing quarter-size clots, that tells me that there could be something wrong [in] the uterus that needs further investigation,” Dr. Ruiz says. You can even take a picture of what you’re seeing so that your doctor can look during your visit. “It helps show me the magnitude of what’s been going on,” Dr. Ruiz says.Back to top.When should I be concerned about blood clots during my period?Period clots the size of a quarter or larger actually indicate that you’re officially in heavy bleeding territory, also known as menorrhagia. According to the CDC, other menorrhagia symptoms include:You’re soaking through one or more tampons or pads every hour for multiple hours in a row.You need to use two pads at a time.You have to change your pad or tampon during the night.You bleed for more than seven days.Your flow is so heavy that it sometimes prevents you from living your normal life.You regularly experience pelvic pain (especially in your lower abdomen) during your period.You’re constantly fatigued.The reason why all of this matters (other than making your life borderline hell during your period): Having heavy, drawn-out bleeding can lead to anemia, a blood issue that can leave you feeling tired or weak, the CDC says. It can also be a sign of an underlying health condition that requires treatment (but more on that in a sec).Back to top.OK, are large blood clots ever normal during your period?It’s important to remember that “normal” is a relative term for everyone, Christine Greves, M.D.5, a board-certified ob-gyn at the Winnie Palmer Hospital for Women and Babies, tells SELF. If your usual is to pass occasional larger clots, then that may simply be your usual, as long as you are not anemic and your quality of life is not affected, she explains.Meaning, if you’ve always had one period clot that you’re tempted to take a photo of or pester your best friend about every month, but you otherwise feel OK and aren’t soaking through tampons or pads like it’s your job, it’s probably nothing to be too stressed about. Still, Dr. Greves says, it’s not a bad idea to bring it up during your next check-up with your ob-gyn, just to get their take. And, remember, if you’re bleeding heavily, are in pain, or have any other symptoms of menorrhagia, you should get it addressed sooner rather than later.