Miscarriage

Overview

A miscarriage is when a pregnancy ends on its own before the baby is developed enough to survive. Most miscarriages happen in the first 12 weeks of pregnancy. It is not caused by anything the mother did or did not do.

Yes. Miscarriage is very common. Many women experience it, often before they even know they are pregnant.

Miscarriage can happen to any woman of childbearing age. It is not linked to something you did or didn't do. It can happen in a first pregnancy or in pregnancies after a healthy baby.

Symptoms

Common symptoms

• Vaginal bleeding or spotting — this is the most common sign
• Cramping pain in your lower belly
• Passing fluid or tissue from your vagina
• A sudden loss of pregnancy symptoms like nausea or breast tenderness

Symptoms in children

• Not applicable — miscarriage happens only in pregnancy.

Symptoms in older adults

• Not applicable — miscarriage happens only in pregnancy.

Causes

Main causes

• Chromosomal problems in the embryo — these happen by chance and are not inherited
• Problems with the placenta
• Hormonal imbalances
• An infection that affects the pregnancy
• Conditions of the womb, such as fibroids
• An illness like diabetes, thyroid disease, or a blood clotting problem

Risk factors

• Being older than 35
• Smoking, drinking alcohol, or using recreational drugs during pregnancy
• Being very overweight or underweight
• Having had two or more miscarriages before
• Certain long-term health conditions, if not well controlled

When to see a doctor

See a doctor urgently if:

• If you have any vaginal bleeding while pregnant, contact your doctor, midwife, or early pregnancy clinic the same day.
• If the bleeding is heavy or you have severe pain, seek urgent medical care.

Book a routine appointment if:

• If you have had a previous miscarriage and are concerned in a new pregnancy, talk to your GP or midwife before you get pregnant.
• If you have repeated miscarriages (three or more in a row), ask for a referral to a specialist.

Diagnosis

A doctor will talk to you about your symptoms and do a physical exam. To find out if a miscarriage has happened, you will likely have an ultrasound scan and blood tests.

Tests that may be done

• An internal ultrasound scan — a small probe is placed in the vagina to look at the baby and womb
• Blood tests to check pregnancy hormone levels, usually done more than once
• Sometimes a pelvic exam to check the cervix
• Tests on any tissue that has been passed

What to expect at your appointment

It can take a few days to get a clear diagnosis, because doctors often repeat the tests. You may be asked to wait and have another scan or blood test. If the results are not clear, you will be offered follow-up care. It is okay to ask questions and ask for support during this time.

Treatment

If a miscarriage is confirmed, you will be given choices about how to manage it. You can take time to decide. Your doctor or nurse will explain the options and help you choose what is right for you. All options are safe, and you can change your mind.

Self-care at home

• Rest if you feel tired, but you do not need to stay in bed
• Use sanitary pads instead of tampons to reduce the risk of infection
• Ask your healthcare provider what pain relief is safe for you if you have cramps
• Avoid sexual intercourse until the bleeding has completely stopped
• Allow yourself time to grieve and ask for emotional support

Medical treatments

Medical management involves taking medicines that cause the womb to empty. These medicines are usually given at the hospital or clinic. They can cause bleeding and cramps for a few hours or days. This is an option if you prefer to avoid surgery and do not want to wait for the miscarriage to happen on its own.

When is surgery considered?

Surgery may be recommended if the bleeding is very heavy, if the miscarriage is not complete, or if medicines do not work. The procedure is called a surgical evacuation of the womb. It is usually done under general anaesthetic or with local numbing, and it is quick and safe. In some cases, surgery is the safest choice.

Living with this condition

Recovery takes time, both physically and emotionally. Your period usually returns within 4 to 6 weeks. You may bleed on and off for a week or two. It is normal to feel tired, sad, or angry. Give yourself permission to take things slowly and be kind to yourself.

Lifestyle tips

• Eat nutritious foods and stay hydrated
• Avoid alcohol, smoking, and recreational drugs
• Talk to your partner, friends, or family about how you feel
• Consider joining a support group when you feel ready
• Do gentle exercise like walking, if you feel up to it

Diet and exercise

You do not need a special diet after a miscarriage. Eat balanced meals and try to include foods with iron, such as leafy greens, beans, and lean meat, to help your body rebuild energy. Gentle movement can help your emotional wellbeing, but avoid heavy exercise until your bleeding has stopped.

Mental health and emotional wellbeing

Miscarriage can cause grief, sadness, anxiety, and even depression. These feelings are normal and can last for weeks or months. It is important to talk about them. If you are having thoughts of self-harm or feeling hopeless, reach out for help immediately.

Prevention

Most miscarriages cannot be prevented because they are due to chance and not anything you did. However, you can reduce some risks by taking care of your health before and during pregnancy.

Vaccines

Make sure your routine vaccinations — like measles, mumps, rubella (MMR) and flu — are up to date before getting pregnant. Talk to your doctor about which vaccines are safe during pregnancy.

Screening programmes

If you have health conditions like diabetes, thyroid problems, or high blood pressure, ask your doctor for a pre-pregnancy check-up. They can help you manage these conditions to reduce risks in pregnancy.

Complications

If left untreated

• Heavy bleeding that can make you anaemic (low in blood)
• Infection of the womb, which can cause fever and pain
• Incomplete miscarriage — when tissue remains in the womb, leading to ongoing bleeding

Long-term outlook

Most people who have a miscarriage go on to have a healthy pregnancy later. The emotional pain does fade with time, and there are treatments and support to help you along the way. You are not alone, and your chances of a future successful pregnancy are still very good.

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