A miscarriage can be both a physically & emotionally challenging experience. We’re here to help you understand miscarriage signs & symptoms & where to find support
We know that going through a miscarriage can be a really difficult and upsetting time for everyone involved. There’s no right or wrong way to feel in this situation and it’s something that will affect everyone differently.
However you’re feeling, know that you’re not alone. As well as being a time to lean on the people around you for support and spend time with loved ones, we’re here to help you through with answers to common questions about miscarriage along with information about where to access further help and advice.
What is a miscarriage?
In the UK, a miscarriage is when a baby (or a foetus or embryo) dies in the womb (uterus) during the first 23 weeks and six days of pregnancy. Any baby loss during pregnancy from 24 weeks onwards is considered a stillbirth.
If a baby is born alive and then dies, even before 24 weeks, that’s considered a live birth and a subsequent neonatal death.
These are the legal timelines and definitions for the UK, but it differs from country to country.
How common are miscarriages?
Sadly, miscarriages are one of the most common types of pregnancy loss. According to the NHS, it’s thought that around one in eight pregnancies will end in a miscarriage amongst people who know they’re pregnant. However, many miscarriages happen to people before they’re even aware they’re pregnant.
It’s rarer for people to experience recurrent miscarriages (three or more miscarriages in a row). This is estimated to affect one in 100 people.
What are the signs & symptoms of a miscarriage?
The most common sign of miscarriage is bleeding from the vagina. This could be continuous or on and off over several days.
Miscarriage bleeding could vary and include:
• Light spotting of blood
• Brownish discharge
• Heavy bleeding
• Bright red blood or clots
It may be helpful to use maternity towels if you’re experiencing vaginal bleeding.
It’s worth being aware that light vaginal bleeding is common during the first three months of pregnancy (first trimester) and may not mean you’re having a miscarriage. But you should contact your GP or maternity team as soon as possible if you’re experiencing vaginal bleeding.
Other miscarriage symptoms can include:
• Pain and cramping in your lower tummy
• Fluid discharge from your vagina
• Tissue discharge from your vagina
Sometimes, a lack or loss of signs of pregnancy (such as feeling sick and having tender breasts) may be an indicator of miscarriage. But some people don’t experience many of the signs of pregnancy, or these signs may change throughout the duration of their pregnancy, so this doesn’t necessarily mean you’re having a miscarriage.
What should you do if you think you’re having a miscarriage?
You should contact your GP or maternity team as soon as possible if you’re experiencing any of the above signs and symptoms of miscarriage or you’re worried about a lack or loss of signs of pregnancy.
You may be referred to a hospital for tests such as an ultrasound scan, which is the most common way to determine if you’re having a miscarriage. If you're less than six weeks pregnant, you may not be referred for tests straight away. This is because it's very hard to confirm a miscarriage this early on.
If a miscarriage is confirmed, your GP or midwife will help you manage the end of the pregnancy and support you with the loss of your baby. If the foetus, embryo or pregnancy tissue is still in your womb, it will often pass out naturally in one or two weeks, but sometimes medicine or surgery is required to help this.
When should you seek urgent medical help?
You should go to your nearest accident and emergency (A&E) department, or call 999 and ask for an ambulance if you’re unable to travel, if you’re experiencing any of the following symptoms:
• Persistent and severe tummy pain, which is usually on one side
• Vaginal bleeding or spotting, commonly after the tummy pain has begun
• A pain in your shoulder tip
• Diarrhoea and vomiting
• Feeling very faint and lightheaded, and possibly fainting
These symptoms could be a sign of an ectopic pregnancy (when a fertilised egg implants itself outside of the womb) which could create a serious risk of internal bleeding. Symptoms of an ectopic pregnancy usually appear between weeks five and 14 of the pregnancy.
What is a missed miscarriage?
Sometimes there may have been no signs and symptoms of a miscarriage (such as vaginal bleeding and pain) and the foetus, embryo or pregnancy tissue may not have physically passed out of your womb. However, your baby may have died or not developed. This is known as a missed, delayed or silent miscarriage.
It’s most often discovered during a routine scan, such as the 12-week or 20-week scan. In the case of a missed miscarriage, the scan will usually show a pregnancy sac with a foetus or embryo inside that’s a smaller size than it should be at this stage and that doesn’t have a heartbeat.
Pregnancy hormones may remain high even after the baby has died, so often missed miscarriages can happen and you may still feel pregnant. There’s usually no way to know a missed miscarriage has occurred unless you have a scan.
What causes a miscarriage?
Often, the exact cause of a miscarriage can’t be determined, which can make it difficult to understand why it’s happened, as well as creating worry around any future pregnancies. But it’s very unlikely to have happened because of anything you did or didn’t do.
There are a range of possible things that could cause a miscarriage or increase the risk of having a miscarriage. In general, the causes and risks differ between miscarriages that happen in the first trimester as opposed to the second trimester.
First trimester causes
Around three in every four miscarriages happen in the first trimester (first three months). These are often caused by problems with the foetus, including:
• Problems with the chromosomes (blocks of DNA)
• Problems with the placenta (the organ linking your blood supply to your baby's)
Several factors are linked to an increased risk of an early miscarriage in the first trimester, including:
• Increasing age (for example more than five in 10 pregnancies will end in miscarriage in people over the age of 45)
• Obesity
• Smoking
• Using drugs
• Drinking lots of caffeine
• Drinking alcohol
Second trimester causes
In the second trimester (weeks 13 to 28), miscarriages may be caused by anatomical reasons, including:
• An irregularly shaped womb
• Fibroids (non-cancerous growths) in the womb
• A weakened cervix (neck of the womb) which may cause the cervix to open too early during pregnancy, leading to a miscarriage
Several factors are linked to an increased risk of a miscarriage in the second trimester, including:
• Some long-term health conditions including high blood pressure, kidney disease, an under or overactive thyroid gland, diabetes or lupus, especially if they’re not treated or well-controlled
• Certain infections (such as malaria, sexually transmitted infections (STIs), HIV or bacterial vaginosis)
• Certain medicines (always check with your doctor, midwife or pharmacist before taking a medicine during pregnancy)
• Food poisoning (read more about foods to avoid eating in pregnancy)
• Polycystic ovary syndrome (PCOS), a hormonal condition where the ovaries are larger than normal
What does not cause a miscarriage?
There are many beliefs about what may cause a miscarriage. However, there’s no evidence to suggest any of the following are linked to an increased risk of miscarriage:
• Being stressed or depressed during pregnancy
• Experiencing a fright or a shock during pregnancy
• Exercising throughout pregnancy – though you should always discuss what kind and how much exercise may be suitable for you with your GP or midwife
• Lifting things or straining whilst pregnant
• Working whilst you’re pregnant, including work that involves sitting or standing for long periods of time
• Having sex whilst pregnant
• Travelling on an aeroplane whilst pregnant
• Eating spicy food whilst pregnant
Can miscarriages be prevented?
In many cases, the cause of a miscarriage cannot be identified and there’s often nothing you could have done to prevent it from happening.
However, there are ways to help lower the risk of having a miscarriage, including:
• Avoiding smoking – here are some tips to help you stop smoking (if you do smoke)
• Avoiding drinking alcohol
• Avoiding using illegal drugs
• Eating a healthy, varied and balanced diet, including your five-a-day
• Avoiding eating certain foods which could harm you or your baby during pregnancy
• Being a healthy weight and losing weight (if you’re overweight) before getting pregnant
Sometimes the cause of a miscarriage can be identified and it may be possible to treat these causes to lessen the risk of having another miscarriage in the future. These causes include:
• Antiphospholipid syndrome (APS) – a condition that causes blood clots which can be treated with medication
• A weakened cervix which can be treated with surgery
Where can I find support after a miscarriage?
A miscarriage can be a hugely emotional experience for you and others involved such as your partner, family and friends.
Everyone will be impacted differently by a miscarriage, but it’s common to go through a grieving period. Some people experience other emotions and difficulties including:
• Sadness
• Shock
• Anger
• Guilt
• Anxiety
• Relationship problems
No matter how you’re feeling, it’s important to know that there’s help and support available. For example, your GP may refer you to counselling or other talking therapies which are available on the NHS to support with mental health problems. Alternatively, if you’re experiencing symptoms of anxiety or depression and are over 18 and live in England, you can self-refer to an NHS talking therapies service.
For bereavement support, you could contact Cruse Bereavement Care, an organisation that helps people understand and cope with grief. Alternatively, there may be a bereavement support service in your local area.
There’s also plenty of help and advice available through The Miscarriage Association, a charity that supports people through baby loss.
Remembrance options
You may want to arrange a memorial service, burial or cremation for your baby after a miscarriage. Some hospitals can arrange a burial or cremation. You should check directly with them to find out what they can offer. Alternatively, you may prefer to arrange something privately.
Some hospitals can also provide a certificate for your baby to formally recognise them and mark what has happened. However, this isn’t currently a legal requirement, so you should check with them whether that’s possible.
How soon can you get pregnant after a miscarriage?
After a miscarriage, it’s advised not to start having sex again until after all of your miscarriage symptoms have gone. Your periods usually return within four to eight weeks after a miscarriage, but it can take several cycles for them to become regular. If you don’t want to get pregnant, you should use contraception immediately.
If you would like to get pregnant again, you may want to discuss it with your GP or hospital care team. Make sure you’re feeling physically and emotionally well before trying for another pregnancy. It can be helpful to wait until you’ve had at least one period before trying. This can make it easier to calculate when you conceived and when your due date may be, as opposed to if you conceived straight away.
In some cases, you may be advised to wait until trying to get pregnant, including:
• Following a molar pregnancy (a problem with a fertilised egg which means your baby and placenta don’t develop the way they should)
• Following an ectopic pregnancy
• If you have an illness, infection or you’re taking medicine that’s advised against in pregnancy
• If you’re having investigations into a previous miscarriage
You may prefer to talk to your GP before trying to conceive if you’ve had a late miscarriage in the second trimester or repeated miscarriages.
Some people prefer to try to get pregnant as soon as they can after a miscarriage, whereas others prefer to wait a while. There’s no right or wrong answer. Miscarriage affects everyone in different ways, so it’s important to do what feels right for you.
