A Determined Look into Non-Viable Pregnancy: Heartbreak and The Way Forward

I won’t lie to you, mama. This topic is HARD. Non-viable pregnancy is sometimes a blessing but ALWAYS a tragedy.

Growing a little one is such a special thing, and you don’t need me to tell you: losing a pregnancy is one of the hardest things in the world to handle.

It’s my belief that knowing all there is to know in advance, or at least having the information from a source that gets you and feels for you, will help you to work through the worries or heartbreak that accompanies such a tough thing.

Get more support from the @mommy.labornurse Instagram community! Join over 520k mamas for tips and solidarity on all things pregnancy, birth, and postpartum!

Our Objective Regarding Non-Viable Pregnancy

As a labor and delivery nurse, you can guess that I’ve seen every shade 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.

But I’m with you, lady. As are millions of women before and beside you.

Your medical staff, the people you pass on the street, those somber-eyed ladies in black and white photos–we are all touched by this unique form of tragedy in one way or another at some point in our lives, even if we never know it.

So let’s take some time to review it all; it’s not 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 acceptance and RECOVERY.

What Should You Do With This Information?

If you are NOT working through a non-viable pregnancy at this time and are simply hoping to be well-informed, it’s my hope that I give you everything you need to feel good about your options–all without increasing your FEAR. Life’s too short for that, mama.

That said, be sure to ask about the pregnancy viability milestones your provider uses, as their information and how they relate that to you is going to more important than any other resource.

If, on the other hand, you are currently experiencing or are in danger of having a non-viable or at-risk pregnancy, my heart goes out to you–as does my hand.

I’ll be taking you through the definitions, causes, and treatment options necessary to cover ALL YOUR BASES.

I hope we’ll be able to examine non-viable pregnancy treatments together to ensure you have everything you need to make the best choices in what is easily a crucible for the best of us.

What is a Non-Viable Pregnancy?

There’s a little push and pull when it comes to the definition of a non-viable pregnancy.

The reason for this is that there are legal implications if a radiologist or a practitioner uses a term like “non-viable pregnancy” or “non-viable fetus” outside of a very specific range of time.

It’s typically safer for medical staff to refer to it as a failed pregnancy.

This makes for pretty stale reading, but suffice it to say that we’re talking about a fetus that cannot be carried to term

Because it’s simpler for our needs, we’ll stick to non-viable, but remember that your OB or radiologist might go a different way, mama.

If it becomes important to know the difference, your care provider will help you understand.

What Does Viability Mean Regarding Pregnancy?

If non-viable means the baby can’t be carried to term, it follows that viability is the consideration of whether or not that little seed can actually grow into a plant.

Viability is determined by a lot of things, including:

  • How and where the zygote (little baby bubble) 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.

The Differences Between a Viable and a Non-Viable Pregnancy

The viability of a pregnancy looks a little different depending on what term you’re in. As you can imagine, a lot goes into losing viability as a zygote.

That little seed pod needs very different conditions than a fully formed and growing embryo; even further still are the requirements for a legit fetus or an actual baby.

You can probably guess, but it’s a much more dangerous world for a tiny little zygote or an embryo than it is for a fetus or a baby.

The result is that you’re much more likely to have a failed pregnancy in the first trimester (the first 0-13 weeks of pregnancy).

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, mama. They overlap a lot, actually.

The reason for this is that miscarriage falls under the UMBRELLA of what we consider non-viable pregnancy.

But 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 low or null chance to survive beyond the womb.

Can You Have a Non-Viable Pregnancy Without Miscarriage

Yes, you CAN absolutely have a non-viable pregnancy but no miscarriage. The products of conception may have to be removed surgically if the pregnancy is non-viable.

Related: Everything You Need to Know About Pelvic Pain During Pregnancy (Right Now!)

Determining Viability in Pregnancy

As you can imagine, mama, a lot goes into determining whether or not a zygote, embryo, or fetus presents a viable pregnancy.

Because of the drastic nature of a non-viable pregnancy, it is very important for your health care provider to be as certain as possible before declaring the pregnancy non-viable.

Symptoms of a Non-Viable Pregnancy: What to Look For

If you have excessive bleeding and cramping, it’s always a good idea to see your care provider as soon as possible.

Severe abdominal pain can be a strong indicator that something is wrong.

Also watch out for severe headaches (particularly with blurred vision), convulsions of any kind, a fever accompanied by extreme weakness or fast/labored breathing–they can all be indicators that something is wrong with your pregnancy

You can read more details about when to call your doctor during pregnancy which might help!

Determining Whether or Not Your Pregnancy May Be Non-Viable

As with testing for the pregnancy itself, measurements of hCG (human chorionic gonadotropin) along with an early ultrasound can help in diagnosing the potential for complications.

Keep in mind that these methods aren’t 100% conclusive, though–this is important to note because a failed diagnosis could be catastrophic.

For this reason, and I hope your practitioner agrees, the investigation of viability should come to a screeching halt when the practitioner asks themselves “Is there a chance of viability”.

Diagnostic criteria for a non-viable pregnancy in the first trimester are imperfect enough that your doc should always be erring on the side of caution.

Ultimately, the consequences of your doctor giving you a false positive result (saying the pregnancy is non-viable when it’s not) blow the consequences of a false negative WAY out of the water.

Believing a pregnancy IS viable when it’s actually NOT may result in a slight delay in the correct treatment (and possibly a little more disappointment, if that’s possible), while the opposite can lead to birth defects and even CAUSING a non-viable pregnancy when a bit of waiting might have put your worries to bed for good.

Can hCG Levels Tell If a Pregnancy is Non-Viable?

Ultimately, there is no silver bullet amount of hCG that can tell us whether or not a pregnancy is non-viable.

There’s a lot of overlap between different conditions and the amount of hCG present in the body at any given time.

Can a Non-Viable Pregnancy be Misdiagnosed

We’ve covered it a bit here, but there is EVERY POSSIBILITY that a doctor may misdiagnose a non-viable pregnancy.

Technology has progressed a lot with the advent of things like the transvaginal probe, but we are still limited to what we can test for in the chemistry.

The Causes of a Non-Viable Pregnancy

The various causes of a non-viable pregnancy range from significant defects preventing there from ever being a fetus to infections that erode the environment in which the fetus grows.

Some of these are pretty small potatoes, mama. But some of them can be really serious if left untreated.

Anembryonic Gestation / Blighted Ovum

Anembryonic Gestation is a condition where the gestational sac forms but no embryo grows within it. They used to call this a blighted ovum, but the term isn’t as widely used today. Some believe that it can be due to chromosomal abnormalities.

Chemical Pregnancy

A chemical pregnancy is when an egg gets fertilized but never attaches to the uterus. Chances are that you’ll never know you had one of these, honey, so don’t lose sleep over it.

Ectopic Pregnancy

An ectopic pregnancy is when a fertilized egg implants inside of a fallopian tube or some other cavity, rather than inside the uterus. This one can actually be really dangerous if left untreated too long.

Molar Pregnancy

A molar pregnancy occurs when an already non-viable egg attaches to the uterine wall. Because the egg already can’t become a fetus for one reason or another, it grows into a non-cancerous mass instead.

Septic Abortion

A septic abortion occurs when an infection takes hold in the placenta. This septic infection can transfer to the uterus and pelvis, potentially damaging organs nearby and even further away if left untreated.

Genetic / Congenital Defects

A genetic or congenital defect is an error in the DNA (or “code”) that comprises the substance of mommy or daddy.

These defects may be specific to a single specimen of sperm or ovum, or they can be substantial defects that affect all or most of a potential parent’s stuff.

Extremely Premature Labor

This one is what it is, mama. Premature labor short of about 24 weeks will be considered non-viable, as the fetus is insufficiently developed for survival outside of mom.

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.

As always, the best recommendations are going to come directly from your care provider.

Hopefully, though, you can walk into that conversation armed to the teeth with the information necessary to ask the right questions and walk away fully satisfied by the outcome. Or at least as satisfied as can be under such circumstances.

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.

If you suspect your pregnancy is not viable, be sure to walk in with hope but be prepared for the possibility of the worst news.

Management Options for a Non-Viable Pregnancy

Your doctor will have a very strong 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 for us 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.

Beyond that, there are medical treatments with medicine that can ensure your non-viable pregnancy will come to an end without much more effort and agony on your part.

In the worst case, a doctor may sometimes recommend surgical evacuation of the products of your non-viable pregnancy. It’s hard and drawn-out by comparison, but your doctor will know best if this is necessary.

Making It Through a Non-Viable Pregnancy

Obviously, mama, this is the last place any of us want to be.

Losing a pregnancy, even early on, can be incredibly difficult for the strongest of us.

The most important thing you can do for yourself is trust in the science, trust in the people, and trust in the fact that these things happen for a reason–biologically speaking.

With the rare exception of something like an infection, you can basically assume that if your pregnancy becomes non-viable, that fetus would likely not have had much of a life given the complications that feed into most or all of these situations.

That’s small consolation if you’ve been there. Trust me, I get it. Your medical staff feels it too. We never get into the business to deal with the non-viable ones–but it’s worth all the tears in the world to be there for mamas like you in such a tough time.

As with anything, be sure to seek solace in the arms of loved ones and know that you have support.

With the right social interaction and a proper mindset, you stand a great chance of working through a non-viable pregnancy.

With a heavy heart, happy future-making, mama.

You might also like…

Liesel Teen, BSN-RN
Founder, Mommy Labor Nurse

Meet Liesel Teen

Hi there. I’m Liesel!

As a labor and delivery nurse, I’ve spent countless hours with women who felt anxious — even fearful — about giving birth. I want you to know it doesn’t have to be that way for you!

When you know what to expect and have the tools to navigate the experience, you’ll feel confident and in control.

I believe you deserve a better birth — no matter how you deliver.