The term 'chemical pregnancy' is often misunderstood and we are often asked in clinic what it means. A chemical pregnancy is a proper conception and a proper pregnancy - just one that sadly ends in a very early miscarriage. It's not a false pregnancy or a false positive on a pregnancy test. And contrary to what you will read on some websites it doesn't mean that implantation did not take place. Implantation did take place because it is only after implantation that the pregnancy hormone HCG starts to be produced. It's a term that's there to distinguish between a pregnancy that has only been confirmed with a pregnancy test and one where a gestational sac or heartbeat has been seen on a scan - then doctors use the term clinical pregnancy.
Many women have asked me whether they were actually pregnant after being given the diagnosis "chemical pregnancy" and others only mention it as an afterthought when giving their history in appointments. There are important differences between a couple who have never conceived and one who have had several chemical pregnancies and we will plan their care in different ways so it's important to know.
Women tell me that they are often made to feel by medical and nursing staff that these very early losses are trivial mishaps and lesser somehow than miscarriages that happen at a later stage. There's a distinct whiff of impatience, even from staff in early pregnancy units - "well, a quarter of pregnancies will end this way so you just need to pull yourself together and get on with it" or "if you hadn't tested for pregnancy so early you'd probably never have known". We are where we are with super-sensitive pregnancy tests - we can't wind the clock back and get rid of them despite the fact that they may be responsible for making us consume more NHS resources or "upsetting ourselves" with knowledge we wouldn't have had 20 years ago.
And the thing is, for the woman who has only been trying to get pregnant for a few months a chemical pregnancy is bad enough. But for someone who has been trying to get pregnant for two years, who has seen the unwelcome streak of red, with her stomach swooping with crushing disappointment month after month after month, or who has been through the battlefied of infertility investigations and IVF treatment, then a chemical pregnancy is utterly devastating.
The Mumsnet campaign for better miscarriage care highlights the profound upset caused by "the 'official' language of miscarriage, which failed to distinguish between a miscarriage and a termination, or to acknowledge the loss of a baby with whom they already felt a profound emotional connection. Some felt that they were grieving for a whole set of hopes and plans for the future, but that the emotional impact of miscarriage was pushed to one side."
Maybe it's time to call time on 'chemical pregnancies' and refer only to early miscarriages instead.