Is a Chemical Pregnancy a Miscarriage?

Is a Chemical Pregnancy a Miscarriage?

After a blighted ovum miscarriage about 6 months ago, I was cautiously optimistic that I would go on to have a successful pregnancy. I was comforted by sources like Mayo Clinic, stating that only about 1% of women have repeated miscarriages. Fast forward a few months, and I have since had 2 chemical pregnancies.

According to WebMD, “A chemical pregnancy is a very early miscarriage”. So with this in mind, I initially assumed that I was part of that unlucky 1% who have multiple miscarriages. I have since learned though, that chemical pregnancies are not always included in a count when it comes to “recurrent miscarriage”.

It seems that it really depends on who you ask. So it’s not very clear to me anymore, whether or not I am a part of that 1% statistic. Confusing, I know. 

You can skip ahead to Is a Chemical Pregnancy a Miscarriage to get some of the varying viewpoints on the topic. I also share my doctor’s answer to the question, is a chemical pregnancy a miscarriage.

My First Chemical Pregnancy

A few months after my blighted ovum miscarriage (you can read about that experience in my post on What is a Miscarriage Like), my husband and I decided it was time to try and get pregnant again.

So when the time came, I was excited to take a home pregnancy test. And it came out positive! So I took another to confirm, and it too was positive! While I was happy about this news, I also felt fearful. My previous experience of miscarriage was truly unpleasant, and I certainly did not feel immune to the possibility of another.

And about a week and a half after those positive tests, I felt what only feels like a period starting. And that was that. The bleeding lasted for about 5 days, and was a bit heavier and more uncomfortable than my normal period. Had I not been tracking my cycle days and taken those positive pregnancy tests though, I might have just assumed I was just having a late and heavy period.

Once this pseudo period was over, I took another pregnancy test to see if my hCG levels (pregnancy hormone) had dropped, and sure enough the test was negative. There’s something that’s just so sad about peeing on a pregnancy test, knowing that you are definitely not pregnant. So I felt disappointed and off kilter for a couple of weeks. And when I say off kilter, I mean I was raging around the house and feeling like an alien had taken over my mind and body. I don’t know if it was all the shifting hormones or the disappointment of it all, but I suspect it was a combination of the two.  

A Second Chemical Pregnancy

Before I knew it, my cycle resumed and I again found myself anxiously awaiting to take a pregnancy test. The first one I took was a faint positive. So I continued to take them every morning, waiting to see if the line that detects hCG would get darker. Even though I knew I should have been waiting at least a few days in between tests, I couldn’t help myself. 

But I just kept getting faint positives day after day. I started spending way too much time googling all the reasons a person might get ongoing faint positives. And even though I really wanted to believe that everything was just fine, I think I knew another chemical pregnancy was underway.   

And then again, about a week later, the physical confirmation of what looked like a heavy period arrived.

As a disclaimer, I should note that I did not have my chemical pregnancies confirmed by a doctor. While I usually avoid self-diagnosis and know that such matters are best left to the professionals, I took enough pregnancy tests to pretty confidently say that my body was preparing for pregnancy. And that then it stopped.

And I ultimately did not feel I needed to go to the doctor, as sites like WebMD explain that there is usually no treatment required for a chemical pregnancy. This is not to be confused with later miscarriages though, where treatment may be needed. 

Please note that I am only speaking of my own personal situation, and anyone with questions and concerns regarding their health (mental and/or physical) should go see a doctor. 

What is a Chemical Pregnancy?

Cleveland Clinic defines a chemical pregnancy as “a very early miscarriage that happens within the first 5 weeks of pregnancy”An egg is fertilized and the body begins producing the pregnancy hormone hCG, but an embryo does not continue to develop after implantation.

Since the pregnancy stops progressing so early, many women who have not taken a sensitive pregnancy test or who have not visited their doctor may not even realize they were ever pregnant.

The signs pointing to chemical pregnancies in my case were as follows;

  • Multiple early positive pregnancy tests (with faint lines that never progressed)
  • Mild early pregnancy symptoms that only lasted for a couple of days and then disappeared
  • Heavy period like bleeding accompanied by low back pain about a week and a half after my expected period dates (I have never had late periods) 

Is a Chemical Pregnancy a Miscarriage? 

As I started sifting through information online and trying to figure out what my miscarriage and consecutive chemical pregnancies might mean for my future pregnancy prospects, I found myself a bit confused. After doing some online digging, I realized that while a “chemical pregnancy” is often referred to as an “early miscarriage”, it is not technically a “miscarriage”, according to some. 

Perspective 1

For example, as noted earlier, Cleveland Clinic states that a chemical pregnancy is an early miscarriage that happens within the first 5 weeks of pregnancy. An egg is fertilized, however the embryo does not continue to develop after implantation and this results in miscarriage. 

Perspective 2

Baby Center on the other hand, states that a “chemical pregnancy” is not really a “miscarriage” medically speaking, because a woman has never been “clinically pregnant”. Baby Center defines “clinically pregnant” as being able to see a gestational sac on an ultrasound or hear a heartbeat. So while conception has occurred with a chemical pregnancy and the body starts producing the pregnancy hormone hCG, the pregnancy never progresses to the point that further evidence of a growing embryo is detected. 

My Doctor’s Perspective

To further confirm that different sources have varying opinions on what counts as a miscarriage or not, I recently visited my doctor. She considered my chemical pregnancies as miscarriages, and also seemed to disagree with the idea that a woman is not truly pregnant if she has a chemical pregnancy.

In various online forums though, I read comments from women who said their doctors essentially dismissed their chemical pregnancies and did not regard them as miscarriages. So even among the professionals there seems to be a lack of consensus. I am inclined to adopt the perspective of my doctor, as I trust her and think she is an excellent doctor. 

My Perspective

So as I reflect on these different perspectives, I’m left feeling uncertain. Conception did in fact occur, but I was never technically pregnant? Or I was just a little bit pregnant? And if I didn’t have an actual miscarriage, why do I feel like something was lost? Or maybe I was truly pregnant and did in fact have a total of 3 miscarriages?  

Dealing with early pregnancy loss and all the hormonal shifts and disappointment is such a horrible drag, can’t we at least all agree on some common language to talk about it? When I literally don’t know what words to use to categorize my experience, how am I supposed to talk about it with anyone or process it even by myself?  

My conclusion is that I can speak about my chemical pregnancies in whatever feels right for me. But nothing about the whole experience really feels right, so maybe it is fitting that it is hard and confusing to know what words to use. Maybe no words are needed, and early pregnancy loss is just a thing to feel. In all its discomfort and disappointment. And other than that, taking care of oneself and talking with a trusted doctor is really all one can do.   

Alternatively, some women may not even know they have had a chemical pregnancy or they may not have strong feelings about it. There’s really no one way to say what the experience of a chemical pregnancy should or should not be, just as apparently there is more than one way to classify it. 

My Doctor’s Perspective

To further confirm that different sources have varying opinions on what counts as a miscarriage or not, I recently visited my doctor. She considered my chemical pregnancies as miscarriages, and also seemed to disagree with the idea that a woman is not truly pregnant if she has a chemical pregnancy.

In various online forums though, I read comments from women who said their doctors essentially dismissed their chemical pregnancies and did not regard them as miscarriages. So even among the professionals there seems to be a lack of consensus. I am inclined to adopt the perspective of my doctor, as I trust her and think she is an excellent doctor. 

Do Repeated Chemical Pregnancies Count as “Recurrent Miscarriage”?

As I continued to try and learn more about chemical pregnancies, and specifically consecutive chemical pregnancies, I came across websites like Tommy’s stating that a woman should seek testing or treatment after “recurrent miscarriage” (3 or more consecutive miscarriages).

So initially, since so many sites refer to chemical pregnancies as “early miscarriages”, I figured that chemical pregnancies were included in the count that make up the term “recurrent miscarriage”.

After further investigation though, I realized that when it comes to the term “recurrent miscarriage”, chemical pregnancies are usually not included. USC Fertility explains that it is unclear whether chemical pregnancies should be counted in a “recurrent miscarriage” count. So, another example of confusing and inconsistent language. 

UCLA Health clearly defines “recurrent miscarriage” though, as the loss of “clinically recognized” pregnancies. So as mentioned earlier, this would exclude chemical pregnancies, because they are not “clinical pregnancies” (that is, there is no evidence of pregnancy on ultrasound or a fetal heartbeat).

Many sites are not clear about whether or not they include “chemical pregnancies” in their definitions of “recurrent miscarriage” though, so it can be confusing and misleading.

Update: Initially, I thought that I would not be a candidate for any sort of testing, since chemical pregnancies may not always be included in a “recurrent miscarriage” count. So I wasn’t going to make a doctor’s appointment after my second chemical. After talking to some friends who also had chemicals though, I decided checking in with my doctor would actually be a good idea. And interestingly, she does consider chemical pregnancies as miscarriages. So she said that because I have had 3, we could start some testing. So just one scenario of which I’m sure there are many that play out differently depending on the doctor. 

How Common are Chemical Pregnancies?

I found it difficult to find statistics (at least ones that site their sources) on chemical pregnancies, but I will share a few I did find;

Obstetrics & Gynecology Science (a peer reviewed journal) states, “the incidence of biochemical pregnancy is between 8% and 33% of all pregnancies”. That seems like quite a large range, which indicates to me that there are a lot of unknowns when it comes to rates of chemical pregnancies.

Another stat from UCLA Health states that “it is estimated that at least 30-60% of all conceptions will end within the first 12 weeks of gestation. Up to 50% of the time, the woman doesn’t even realize that she was ever pregnant”. Again, that seems like a big range. This makes sense though, if half the time, women don’t even know they are pregnant. These women would obviously then not be able to report their pregnancies. 

Another stat from Copperstate OB/GYN  states that “chemical pregnancies account for 70% of all conceptions.” That’s a pretty large and interesting percentage; however, they do not site their source. So I’m not sure how reliable this statistic is. 

Overall though, the above makes me think that chemical pregnancies are probably much more common than most realize. And in my case, this at least provides me with a little bit of comfort as I process my own early failed pregnancies. 

What I ultimately spent some time doing and that I found more useful than trying to rely on sourceless statistics on the web, was reading through online forums of women sharing their experiences with chemical pregnancies and miscarriage. When I did this, I realized that there really are a lot of women who go through chemical pregnancies, and that my experience is not unique.

Living with Uncertainty, Hoping for the Best

Many women experience chemical pregnancies and some experience multiple chemical pregnancies. Some of these women ultimately are able to stay pregnant later on, and some have an undetermined future when it comes to pregnancy. Many sites claim that most women will go on to have healthy pregnancies after miscarriage or a chemical pregnancy. There are a lot of women also though, who have no idea why they have repeated miscarriages or chemical pregnancies.

Pillarisetty & Mahdy (2022) state that “up to 50 percent of patients with RPL (repeated pregnancy loss) have no clearly defined etiology”. So I am learning to live with uncertainty, while hoping that I will be able to have another child one day. I also know though, that I may not and may never know why. 

While I may not have many answers, I do hope that I brought some awareness to the oftentimes confusing issue around terms like “miscarriage”, “recurrent miscarriage” and “chemical pregnancy”. 

I offer space in the comments below for anyone to share thoughts, feeling and/or experiences of early pregnancy loss.

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