I won’t lie to you, mama, this topic is tough. Losing a pregnancy, no matter how early, can be a devastating experience. It’s often the loss of a dream and a loss that usually goes unacknowledged by the world around you. Whether it’s a miscarriage, a blighted ovum, an ectopic pregnancy, or a molar pregnancy, the grief is real, and the path forward can feel heavy and uncertain.
As a labor and delivery nurse I’ve held the hands of countless women through these difficult moments. I’ve seen the tears, heard the whispers of “why me?”, and felt the weight of their sadness. And while I can’t take away their pain, I can offer support, guidance, and a glimmer of hope for the future.
- Understanding Non-Viable Pregnancy
- What Does Viability Mean Regarding Pregnancy?
- Differences between a Non-Viable Pregnancy and a Miscarriage
- Symptoms of a Non-Viable Pregnancy: what to look for
- How to Diagnose a Non-Viable Pregnancy
- Causes of a Non-Viable Pregnancy
- Non-Viable Pregnancy Options
- Finding Support and Healing
- The Way Forward: Trying Again
Follow @mommy.labornurse on Instagram to join our community of over 650k for education, tips, and solidarity on all things pregnancy, birth, and postpartum!
Understanding Non-Viable Pregnancy
A non-viable pregnancy is one that cannot result in the birth of a living child. This can happen for a variety of reasons, including:
- Miscarriage: The most common type of non-viable pregnancy, usually occurring within the first trimester due to chromosomal abnormalities
- Blighted Ovum: When a fertilized egg implants in the uterus but doesn’t develop into an embryo
- Ectopic Pregnancy: When a fertilized egg implants outside of the uterus, usually in the fallopian tubes
- Molar Pregnancy: A rare condition where abnormal tissue grows inside the uterus instead of a baby
As a labor and delivery nurse, you can guess that I’ve seen every kind of non-viable pregnancy. I’m here to tell you, they are all hard. If you experience or have experienced a non-viable pregnancy, it can feel like no one understands.
Let’s take some time to review it all. It isn’t always something to fear or something to dwell on, but knowledge and understanding can sometimes be our greatest hope. I firmly believe that context always provides a wider platform for recovery.
What Does Viability Mean Regarding Pregnancy?
There’s a little push and pull when it comes to the definition of a non-viable pregnancy.
Viability is determined by a lot of things, including:
- How and where the zygote attaches to the uterine wall
- What kind of conditions exist in the womb
- What kind of data mom and dad put into the sperm and egg that connected
In broader terms, “viable” means “capable of working successfully” or “feasible”. In biological terms, it’s more about being capable of surviving or living successfully, particularly in specific environmental conditions.
Differences between a Non-Viable Pregnancy and a Miscarriage
A miscarriage is defined as the spontaneous loss of a fetus BEFORE 20 weeks of development. Loss of the fetus after that would be considered a “stillbirth“.
There are a lot of similarities and correlations between a non-viable pregnancy and a miscarriage. The reason for this is that miscarriage falls under the umbrella of what we consider a non-viable pregnancy.
A non-viable pregnancy doesn’t have to be a miscarriage. Things like genetic issues may leave the zygote or fetus alive but with a very small chance to survive beyond the womb.
Symptoms of a Non-Viable Pregnancy: what to look for
If you have excessive bleeding and/or cramping, it’s always a good idea to see your OB provider as soon as possible. Severe abdominal pain and vaginal bleeding aren’t always a cause for concern but can be a strong indicator that something is wrong, especially if they are happening together.
Those are the big things to keep an eye on but other symptoms might include:
- Lower back pain
- Passing tissue or clot-like material
- Spotting
You can read more details about when to call your doctor during pregnancy which might help!
How to Diagnose a Non-Viable Pregnancy
According to ACOG, “There is no definite diagnosis of viability and no test that can definitively determine whether a fetus could survive outside of the uterus, so determining whether a pregnancy is viable beyond the first trimester is often based on clinical judgment. Clinicians will use ultrasound results and pregnancy hormone levels in early pregnancy to determine whether a pregnancy is developing normally and is thus viable. However, a determination of viability at this stage doesn’t mean that the fetus could survive if delivered later in pregnancy.”
Causes of a Non-Viable Pregnancy
A non-viable pregnancy, often resulting in miscarriage, is most commonly caused by chromosomal abnormalities in the fetus. These can occur due to random genetic errors during fertilization, and other factors like advanced maternal age, hormonal imbalances, structural uterine abnormalities, severe infections, trauma, and sometimes even lifestyle factors like smoking or drug use.
Non-Viable Pregnancy Options
What options a mama has when the fetus is determined non-viable vary significantly depending on why the pregnancy is non-viable and gestational age. As always, the best recommendations are going to come directly from your OB provider.
Hopefully, though, you can walk into that conversation armed with the necessary information to ask the right questions and walk away feeling heard and at peace.
First and foremost, you want to manage your expectations. If you know the little one is not viable, it’s important to frame your feelings and thoughts in a way that allows you to work through this difficult time.
Management Options for a Non-Viable Pregnancy
Your doctor will have a set of early pregnancy loss guidelines they follow. When in doubt, if they aren’t entirely sure the pregnancy is non-viable, they will typically offer expectant management, which is a fancy way of saying “let’s do nothing and see what happens”.
That might sound messy, and even risky in some of the scenarios we worked through earlier. What this recommendation does do is give a chance for a false positive to be determined false.
Because some of this is a bit like educated guesswork, there’s always a chance that the pregnancy may be viable when the circumstances suggest otherwise.
But what does that mean for YOU?
It’s a little bit of a waiting game. A really hard waiting game. Beyond that, there are medical treatments with medicine that can ensure your non-viable pregnancy will come to an end as safely as possible.
In the worst case, a provider might recommend surgical evacuation of the products of your non-viable pregnancy. This is not the preferred or the “go-to” method but it is an option if the wait and see and/or medication approaches are not effective.
Finding Support and Healing
Obviously, mama, this is the last place any of us want to be. Losing a pregnancy, no matter how far along you are, can be incredibly difficult.
There are many resources available to help you cope with the loss of a pregnancy. Here are a few:
- Your healthcare provider: They can provide medical information and emotional support
- Support groups: Connecting with others who have experienced similar losses can be incredibly helpful
- Therapy: A therapist can provide a safe space to process your emotions and develop coping mechanisms
- Online resources: There are many websites and online communities dedicated to supporting women who have experienced pregnancy loss
The Way Forward: Trying Again
After a non-viable pregnancy, you may be unsure about whether or not you want to try for another baby. There’s no right or wrong answer, and the decision is entirely personal.
If you do decide to try again, it’s important to give yourself time to heal both physically and emotionally. Talk to your doctor about when it’s safe to start trying again and what you can do, if anything, to increase your chances of a healthy pregnancy.
Remember, you’re not alone. Many women go on to have healthy pregnancies after experiencing a loss. With time, support, and self-care, you can find your way forward and embrace the hope of a new beginning.
With love,
Liesel 💗
