Sarah is a Saffron & Cyrus reader who has asked to remain anonymous. Her name has been changed to protect her identity.
Losing her first pregnancy at 40
When Sarah contacted me to share her experience of miscarriage and a suspected partial molar pregnancy, I was struck by how little she had known about the condition before receiving an unexpected hospital letter. She wanted to tell her story because she hoped it might help another woman going through something similar.
At the beginning of January, aged 40, Sarah discovered she was pregnant with her first baby. She was over the moon, although understandably nervous about whether everything would go according to plan. Like many women expecting their first child later in life, she was conscious of her age and the additional risks that can come with pregnancy after 40.
During those early weeks, Sarah felt remarkably well. There was no severe morning sickness, no unusual pain and nothing to suggest anything was wrong. She asked her GP whether she could have her hCG levels checked for reassurance, but was advised that routine testing could cause unnecessary anxiety because hormone levels vary.
She accepted the advice and tried not to worry. At around six weeks pregnant, however, she began bleeding heavily at home. Oddly, there was very little pain, but she knew something wasn’t right and feared she was having a miscarriage.
At hospital, her fears were confirmed. She had lost the pregnancy. The tissue was sent away for examination, and she was told to take another pregnancy test in three weeks to make sure her hormone levels had returned to normal.
Sarah went home and tried to get on with things. There was the disappointment of losing a much-wanted baby, but physically she felt fine, and she took some comfort from knowing that she and her husband could think about trying again when they felt ready.
The hospital letter she wasn’t expecting
Three weeks later, Sarah took another pregnancy test as instructed. It was negative, which she understood to mean that her body had recovered from the miscarriage. She wasn’t experiencing any further symptoms, and she and her husband had started discussing another pregnancy.
They went away on holiday, something that probably did them both good after the previous few weeks. When they returned, however, there was a letter waiting from the hospital.
The laboratory examination of the pregnancy tissue had raised the possibility that Sarah had experienced a hydatidiform mole, more commonly known as a molar pregnancy. Doctors suspected a partial molar pregnancy.
She had never heard of it before and had absolutely no idea what it meant.
Having already dealt with the miscarriage, Sarah now found herself trying to understand why the hospital was writing to her about an abnormal pregnancy. She had done everything she was asked to do, her pregnancy test was negative and she felt perfectly well. As far as she was concerned, the physical side of the miscarriage was behind her.
Of course, she did what most of us would do and looked it up online. That was when she started to worry.
There were references to abnormal cells, further monitoring and, in some cases, treatment if those cells remained after the pregnancy had ended. She had gone from thinking about trying for another baby to wondering whether something might still be wrong with her.
What is a molar pregnancy?
A molar pregnancy is a rare complication that happens when something goes wrong during fertilisation. The cells that would normally develop into the placenta grow abnormally, and the pregnancy cannot develop into a healthy baby.
There are two types. A complete molar pregnancy occurs when abnormal placental tissue develops without a baby. In a partial molar pregnancy, some early fetal tissue may develop, but it cannot survive.
According to UK health information, molar pregnancy affects approximately one in 600 pregnancies. It is sometimes picked up during an early ultrasound scan, but not always. In some cases, women only discover they have had one after a miscarriage, when the pregnancy tissue is examined in a laboratory.
That was what had happened to Sarah. She had miscarried at six weeks, and there had been nothing particularly unusual about her symptoms to suggest she might have experienced something other than an early pregnancy loss.
One of the things that surprised her most was discovering that molar pregnancy doesn’t always cause obvious symptoms. She had assumed that something so unusual would have made her feel unwell, but that hadn’t been the case.
She felt fine, which made the diagnosis even harder to understand
By the time the letter arrived, Sarah’s pregnancy test was negative and her hCG levels had returned to normal. She hadn’t experienced severe sickness, her blood pressure was normal and a follow-up scan was reassuring. Her period had also returned.
She couldn’t understand how she could feel so well and yet be receiving a letter suggesting there had been a problem with the pregnancy.
The more Sarah read, the more concerned she became. Some of the information she found online mentioned persistent gestational trophoblastic disease, a condition in which abnormal cells remain after a molar pregnancy and continue to grow.
Although this happens in only a small proportion of cases, it was enough to frighten her. She began wondering whether she might need further treatment and whether the suspected molar pregnancy would affect her chances of having another baby.
She was also frustrated. She had been told to take a pregnancy test after three weeks, which she had done, and the result was negative. She thought that was the end of the medical follow-up. Now she was being asked to think about something she hadn’t even known was a possibility.
At 40, Sarah was understandably anxious about how long she might have to wait before trying to conceive again.
Why hCG monitoring matters after a molar pregnancy
Following a molar pregnancy, doctors monitor levels of human chorionic gonadotrophin, usually called hCG. This is the hormone detected by pregnancy tests, and it is also produced by molar tissue.
Once the pregnancy has ended, hCG levels should fall. Monitoring allows doctors to check that the abnormal cells have disappeared and that no further treatment is needed.
Most women recover without requiring additional treatment, but occasionally some molar cells remain and continue producing hCG. If levels stop falling or begin to rise again, further investigation and treatment may be necessary.
The risk is different depending on whether the pregnancy was a complete or partial mole. UK specialist information indicates that around 13–16% of women who experience a complete molar pregnancy require further treatment, compared with approximately 1% following a partial molar pregnancy.
The follow-up arrangements also differ. For a confirmed partial molar pregnancy, women generally need one further hCG sample four weeks after the first normal result. Monitoring following a complete molar pregnancy can continue for considerably longer.
Women are advised not to become pregnant again until their specialist team confirms that follow-up is complete. This is because a new pregnancy also causes hCG levels to rise, making it difficult to monitor whether any abnormal molar cells remain.
It was this last point that particularly concerned Sarah. She and her husband had already started thinking about trying again, and she now faced the possibility of having to wait.
Trying to make sense of what had happened
For Sarah, the hardest part was not knowing what the diagnosis meant or what would happen next. She had gone from being pregnant to miscarrying in a matter of weeks, and just as she was beginning to feel more like herself, she was receiving medical information that seemed to suggest the whole experience wasn’t quite over.
She also found it difficult to explain to other people. Most had heard of miscarriage, even if they hadn’t experienced it themselves, but a molar pregnancy was something entirely different. She was still trying to understand it herself, never mind explain it to friends or family.
The fact that she felt physically well made things more confusing. There was no pain or illness to remind her that something might be wrong, yet she was worrying about test results and whether she would need further monitoring.
Sarah contacted the Miscarriage Association and sought further medical advice. Speaking to people who understood the condition helped her put some of the information into perspective. Specialist nurses were able to explain what her results meant and why monitoring was important.
She found that much more reassuring than reading medical information online, where the most frightening possibilities can be difficult to separate from what is actually likely to happen.
It also helped to be able to ask questions without feeling silly. She wanted to know why she hadn’t experienced any unusual symptoms, whether the negative pregnancy test was a good sign and what the diagnosis might mean for another pregnancy.
Could she have known something was wrong?
One of the things Sarah kept coming back to was whether there had been any signs she should have noticed during those early weeks.
She hadn’t experienced the severe nausea or vomiting sometimes associated with molar pregnancy. Her blood pressure had been normal, and apart from the heavy bleeding that led to her miscarriage, she hadn’t noticed anything particularly unusual.
According to the NHS, symptoms of molar pregnancy can include vaginal bleeding, severe sickness and a uterus that is larger than expected for the stage of pregnancy. However, some women have few symptoms or none at all.
In fact, some cases are only discovered after a miscarriage, when the pregnancy tissue is examined.
For Sarah, knowing that was reassuring. She hadn’t ignored a collection of warning signs or failed to recognise something obvious. There simply hadn’t been anything that would have led her to suspect a molar pregnancy.
It’s easy to look back after something goes wrong and question every little detail, particularly during pregnancy, when women are already encouraged to pay such close attention to their bodies.
But sometimes there is nothing you could reasonably have noticed.
Getting answers and thinking about another pregnancy
Fortunately, Sarah’s follow-up findings were reassuring. Her hCG levels had returned to normal, her scan showed no concerning findings and her period had resumed.
That was good news, although it didn’t immediately take away the anxiety caused by receiving the letter. She still had questions about what had happened and wanted to be certain that she understood the implications before thinking seriously about another pregnancy.
She was also surprised by how little she had known about molar pregnancy. Until it was mentioned in her pathology report, it simply wasn’t something she had come across, despite having read plenty about pregnancy and miscarriage.
She wondered how many other women had received similar news and found themselves sitting at home searching for information, unsure what to make of it.
That was why Sarah decided to share her experience anonymously. She knew that not every woman with a molar pregnancy would have the same symptoms, results or recovery, but she hoped that somebody reading her story might recognise some of what she had been through.
Even knowing that another person has experienced something similar can help when you’re dealing with a diagnosis nobody around you seems to know much about.
A miscarriage is still a miscarriage
Something that shouldn’t get lost in all the medical explanations is that Sarah had also lost her first pregnancy.
Before the hospital letter arrived, she had already experienced the excitement of finding out she was expecting a baby and the disappointment of losing that pregnancy at six weeks. She and her husband had begun thinking about becoming parents, and those feelings didn’t simply disappear when doctors raised the possibility of a molar pregnancy.
The medical follow-up was necessary, but it also meant that she couldn’t quite put the experience behind her, even when she felt physically ready to do so.
At 40, Sarah was conscious that she didn’t want to wait too long before trying again. At the same time, she wanted to make sure that doing so was safe and that any monitoring recommended by her doctors had been completed.
It was a difficult position to be in, particularly when she had already spent several weeks coming to terms with the miscarriage.
There was also the emotional side of things. A negative pregnancy test might tell you that your hCG has fallen, but it doesn’t tell you very much about how you’re feeling. She was relieved that her results were reassuring, but she was still disappointed about losing the baby she had hoped to have.
What she wants other women to know
Looking back, Sarah wishes she’d known more about molar pregnancy before receiving the hospital letter. Not because she believes it would have changed what happened, but because understanding the condition might have made those first few days less frightening.
She also wants other women to know that it is possible to experience a molar pregnancy without having the symptoms commonly described online. Feeling well doesn’t necessarily rule it out, which is why pathology results and any recommended follow-up are important.
Her advice is to ask questions if you don’t understand your results and to speak to your healthcare team rather than trying to work everything out through internet searches. The Miscarriage Association was also a valuable source of support when she needed someone to talk to.
Most importantly, she hopes women who have experienced a molar pregnancy won’t feel alone or embarrassed about asking for help. It is an uncommon condition, and there is no reason they should be expected to understand all the medical terminology straight away.
At the beginning of January, Sarah had been looking forward to becoming a mother for the first time. Within weeks, she had experienced a miscarriage and was learning about a rare pregnancy complication she had never heard of.
Her follow-up results were reassuring, but the experience was upsetting and left her with plenty of questions. Sharing her story is her way of helping another woman who might one day open a similar hospital letter and wonder what on earth it all means.
Join the conversation
Have you experienced a molar pregnancy or received an unexpected diagnosis following a miscarriage? What do you wish someone had explained to you when you first heard the news?
If you went through hCG monitoring, how did you find the waiting, particularly if you were hoping to try for another baby?
I’d be interested to hear your experiences, although I completely understand that this is something not everyone feels comfortable discussing publicly.
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Disclaimer: This is a reader’s personal account of miscarriage and a suspected partial molar pregnancy. Sarah’s name has been changed to protect her identity. The article provides general information and is not a substitute for professional medical advice. Anyone concerned about their pregnancy or a molar pregnancy diagnosis should speak to their healthcare team. Medical figures and follow-up recommendations should be verified against current UK specialist guidance before publication.
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