Written by Kate Hollowood
Experiencing a miscarriage can feel like an enormous loss. While everyone who loses a pregnancy may deal with it differently, many will go through a period of grief. Those feelings can become more complicated if you learn that the cause of the miscarriage is that there was never a baby there to begin with.
Sometimes referred to as a “blighted ovum,” an anembryonic pregnancy occurs when a fertilized egg attaches itself to the uterus but doesn’t develop into an embryo or stops developing and resorbs. Eventually, it will result in a natural miscarriage.
The term “blighted ovum” is now deemed outdated, so health professionals tend to say “anembryonic pregnancy” instead, as it’s considered more accurate, gentler, and less blaming. After all, an anembryonic pregnancy is a random occurrence and never anyone’s fault. It’s also fairly common and is believed to be the single leading cause of miscarriage.
Vicki, now 33, experienced an anembryonic pregnancy last year. She explains the emotional impact and how it was very difficult to deal with: “I didn’t feel entitled to grieve, because there wasn’t a baby there. It took a long time for me to accept that it was okay for me to be upset. That it was okay to grieve.”
Unsurprisingly, Vicki had started to imagine her future family. “As soon as you find out you’re pregnant, you start to plan a life, and you have dates that you work towards,” she says. “We were looking forward to the fact that the baby would be with us by Christmas.”
If, like Vicki, you’ve recently experienced an anembryonic pregnancy, it can be helpful to find out more about what’s happened and hear from others who have faced the same situation. Below, you’ll find answers to some of the most common anembryonic pregnancy questions, along with information on support services.
It can be especially shocking and difficult to hear you’ve had an anembryonic pregnancy because it often produces the same symptoms as a viable pregnancy. Detailing the science behind this, Cynthia DeTata, MD, physician and clinical assistant professor at Stanford University School of Medicine, explains: “The cells destined to become the placenta and amniotic sac continue to develop. These structures make hormones that support the development of an embryo into a baby, without realizing the embryo is missing.”
“It took a long time for me to accept that it was okay to grieve”
These hormones, including human chorionic gonadotropin (hCG), are the same ones that cause early pregnancy symptoms, including breast tenderness, abdominal bloating, nausea and vomiting, dizziness, headaches, fatigue, taste and smell aversions, and many others.
Dr. DeTata continues: “If someone is pregnant with an anembryonic pregnancy, they would still feel pregnant and not have the bleeding and cramping that would signify an impending loss.”
Rebecca, 37, experienced that exactly. She was so bloated in the early days of what she thought was a viable pregnancy, it looked like she was developing a bump.
She recalls the heartbreaking silence from the monitor during her first scan and the moment her sonographer told her she had an anembryonic pregnancy. “I didn’t know what any of it meant,” she says. “It’s not something that anyone has ever talked about.”
Anembryonic pregnancies are detected in the first trimester, either when a person notices dwindling pregnancy symptoms or during an ultrasound scan when no fetal heart sounds are found (usually at 10 to 11 weeks). An anembryonic pregnancy will always be confirmed with a second scan, usually a few days after the first. At that point, a health care professional will explain that there are three treatment options.
The first is to let nature take its course and wait for the body to naturally miscarry on its own. Often, this will be within one to two weeks; however it may not always happen. Another option is to speed up the time it takes to progress to miscarriage by taking medication. Or, you can opt to have the sac surgically removed.
There’s no right answer as to which approach you take. It’s a hugely personal decision, and the best option will vary from person to person. For Rebecca, taking the medication, which can come as pills that can be taken orally or inserted into the vagina, was the best choice. “I just felt I didn’t want to be pregnant any longer, knowing that there was no baby,” she says. “I was almost angry at my body. And I couldn’t bear all this going on any longer than it had to.”
While feelings of self-blame or failure after any miscarriage are understandable, remember that an anembryonic pregnancy is nobody’s fault.
“Many women wonder if they did something wrong when they find out they have an early pregnancy loss,” says Jennifer Boyle, MD, clinical instructor at Harvard Medical School and OB-GYN at Massachusetts General Hospital. “We value having a sense of control. These feelings are completely normal, but there is never anything anyone could have done to make their pregnancy not develop normally.”
Dr. DeTata echoes these thoughts: “Please remember this is not your fault! Most of the causes of anembryonic pregnancies are spontaneous chromosomal abnormalities that have a low risk of happening again.”
In fact, many people who experience an anembryonic pregnancy go on to have children later. After her miscarriage, Rebecca got pregnant again after around eight months of trying.
To offer some peace of mind after what she’d been through, Rebecca’s health care provider scheduled her for an earlier scan at six weeks. Happily, the ultrasound revealed that there was a fetal pole (the first direct image you can see of a fetus). “I can’t even tell you, the sense of relief!” she says. Rebecca went on to have a healthy baby girl, who is now five.
And after trying for nine months, Vicki has become pregnant again, too. Along with the excitement, she’s understandably nervous about her pregnancy. “I cried all morning before my first scan,” she says. “Even though there's a heartbeat, I don’t think the anxiety is ever going to completely go away. You just have to try and keep taking it day by day.”
But even on Vicki’s anxious days, it’s nothing compared to what she went through last year. “It felt like a black hole,” she says. “I thought, how can you go from being so happy and excited to such a dark place? But it really does get better. Even before I found out I was pregnant, I was in a much better place.”
Through organizations like the Miscarriage Association, Vicki was able to talk to others who had been in the same situation. “Hearing other women talking about their own experiences [with anembryonic pregnancy] made me feel a lot less isolated,” she says.
If you’ve experienced an anembryonic pregnancy, getting the right support could make all the difference. Whether through a nonprofit organization or support group, help is out there all over the world. We’ve listed some support services you can reach out to below if you need someone to talk to:
- Share Pregnancy and Infant Loss Support (US)
- The Miscarriage Association (UK)
- The Pink Elephants Support Network (AU)
Remember, it’s completely natural to experience feelings of grief, failure, or self-blame. Lean on your support network and allow yourself to process your feelings with self-compassion, awareness, and patience.