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Miscarriage

Miscarriage is when somebody loses a pregnancy naturally in the first 23 weeks of pregnancy. 

It’s different to stillbirth which is when a baby is born after the 23rd week of pregnancy with no signs of life or abortion, which is when someone  decides to end a pregnancy through medical means.

Miscarriage is common and about one in every five pregnancies ends naturally. Most miscarriages happen in the first 12 weeks of pregnancy. Sometimes people miscarry when they didn’t even know they were pregnant.

If you or someone you know has miscarried you may have a range of feelings about it. If you want to talk in confidence find your nearest Brook service

What causes miscarriage?

It can be difficult to know what has caused a miscarriage, but it is very unlikely that it has happened because of anything you have done or not done. Pregnancies can be lost for a range of medical reasons, such as problems with chromosomes, which are a bit like sets of genetic instructions and building blocks that shape the development of the baby. If the right building blocks are not in place, a baby won’t develop normally, and a miscarriage usually happens.

There are some things which might mean someone has a higher risk of miscarrying. These include previous miscarriages, being very overweight (not just a stone or two), using some drugs or a lot of alcohol, and smoking during pregnancy. Again, these things don’t mean that you will have a miscarriage, but stopping (or reducing) smoking, drinking and drug use during pregnancy will help you to have a healthier pregnancy. 

There are lots of myths around what causes miscarriage. It’s really important to know that having sex during pregnancy, exercising, having an argument or carrying on working does not increase your chance of having a miscarriage. If you want to know if something is safe to do while pregnant, speak to your doctor. 

​How common is miscarriage?

Miscarriage is more common than many people think – around one in five pregnancies. In lots of cases, miscarriages happen really early – so early, that the person involved didn’t even realise she was pregnant. Most miscarriages happen before 12 weeks of pregnancy. However, they can happen later in a pregnancy too, although this is more rare – only about 2 in 100 miscarriages happen after 14 weeks.

​How does miscarrying affect future pregnancies?

Miscarrying does not mean that you can’t have a baby. In fact, the majority of people who have a miscarriage will go on to have a baby in a later pregnancy. Most miscarriages are thought to be caused by problems with the development of the baby (also called an embryo or foetus).

If someone has more than two miscarriages in a row they will usually be offered some tests to try to find out the cause. In lots of cases, though, there is no obvious cause found.  It can be quite frustrating not to know why you’ve lost a pregnancy, and it can make you feel anxious about trying again or when you are pregnant again. In most cases, though, you are more likely to have a healthy pregnancy next time than another miscarriage. 

What is the difference between miscarriage and stillbirth?

If a miscarriage happens after 24 weeks of pregnancy, it is classified as a stillbirth. One in every 200 births ends in a stillbirth, and they are often caused by problems with the placenta (the organ which nourishes the baby in the womb). You can find out more about stillbirth on NHS Choices, and if you want support after having a stillbirth, see the useful links section at the bottom of this page.

Ectopic pregnancy

Ectopic pregnancy is not a type of miscarriage but has been included here because it is a cause of pregnancy loss. The word 'ectopic' means 'out of place'. An ectopic pregnancy is one where the pregnancy starts to develop outside the womb, usually in one of the Fallopian tubes. A pregnancy cannot continue to grow outside of the womb, and it can be dangerous. Ectopic pregnancies happen in between 1 and 2 of every 100 pregnancies. 

Sometimes, an ectopic pregnancy will be reabsorbed by the body, with no need for further medical treatment. In other cases, you will need medical treatment. 
If you have any of these symptoms, go and see a doctor:

  • Irregular bleeding from your vagina
  • Pain low down in your abdomen (stomach)
  • Pain where your shoulder and your arm meets
  • Problems when going to the toilet, like diarrhoea, or pain when weeing or doing a poo
  • Collapsing, feeling faint, a fast heartbeat, feeling very unwell or sick.

Some people who have an ectopic pregnancy don’t have any symptoms at all, so it’s really important to go to all of your pregnancy scans and appointments, so that doctors and nurses can check how you are.

For more information have a look at this leaflet on ectopic pregnancy from The Miscarriage Association.   

Molar pregnancy

Molar pregnancy is not a type of miscarriage but has been included here because it is a cause of pregnancy loss. It is rare and only happens in about 1 in every 600 pregnancies. This is when cells do not develop properly, instead becoming something like a tumour. A molar pregnancy means that the pregnancy cannot continue.

Symptoms of a molar pregnancy include:

  • Bleeding, or losing brown-red liquid from the vagina
  • Being sick much more than in a normal pregnancy

However, sometimes people who have a molar pregnancy don’t have any symptoms – again, it’s vital to go to all of your appointments to check up on how your pregnancy is doing. 

A molar pregnancy is usually removed by a surgical operation, using suction to remove the contents of the womb. Everyone who has a molar pregnancy needs to be followed up afterwards to make sure that the molar cells have all gone. They also need to wait till then before getting pregnant again. A small number of people will need more treatment.

Get further information on molar pregnancy from The Miscarriage Association and NHS Choices.

How do you know if you are having a miscarriage?

The most common sign of miscarriage is bleeding from the vagina. However, some light bleeding or spotting early in pregnancy is quite common, so it doesn’t necessarily mean you are having a miscarriage.

Other signs of miscarriage include cramping (like period pains) and back pain. If you do experience any of these signs it’s a good idea to contact your GP.  If the bleeding is very heavy or the pain is unbearable, it’s best to go to the accident and emergency (A&E) department of your local hospital. They will be able to check and see what’s happening. 

If you have strong pain in your abdomen or your shoulder, or feel very faint or dizzy during pregnancy, that could be a sign of ectopic pregnancy, which can be dangerous. If you do get these symptoms, go to A&E or if you can’t get there, ring 999 and ask for an ambulance.

Some people don’t have any symptoms and won’t know their baby has died until they have a pregnancy scan.

What happens when you have a miscarriage?

If you have a lot of bleeding and pain, you may have a complete natural miscarriage. If you go to hospital, you might have a pregnancy scan, and perhaps blood tests to confirm if you’ve had a miscarriage.

If you only find out that the baby has died when you have a scan, that means that the tissue (the remains of the pregnancy) is still in the womb. You may have to decide whether to: 

  • Wait for the tissue to pass out of the body naturally, which can take several weeks - this is called expectant management 
  • Be given pills that causes the tissue to pass out of the body – this is called medical management
  • Have a simple procedure that removes the tissue – this is called surgical management

Expectant management:  Some people choose this option because they want nature to take its course. It might take a while before it starts but once it does, you will probably experience pain and bleeding. This might go on for up to two or three weeks, but it should gradually tail off.  If the miscarriage doesn’t start naturally, you might want to go back to the hospital to be checked. If the symptoms carry on after three weeks, or get worse, you should get advice and a scan at the hospital. After the scan, depending on what is happening, you may choose to continue to wait for the miscarriage to finish naturally, or you may want to take pills or have surgery (see below). 

If the pain is really bad or the bleeding is really heavy, or if you feel feverish (that is, you have a high temperature, and/or you feel faint and dizzy), or if the bleeding or discharge looks or smells really bad, you need to get checked out at the hospital as soon as you can.

 Medical management: If you decide you don’t want to wait for a miscarriage to finish in its own time, you can choose to end it using medication. You will be given pills which cause the cervix (the entrance to the womb) to open and the bleeding to start. 

Once it starts, the bleeding is likely to be very heavy, with clots, and it can be very painful so you will need painkillers. You might stay in hospital after having the pills, or go home and manage the miscarriage there. But if you are worried by lots of bleeding, or if the pain becomes too much, call the hospital straight away. 

You’ll be told to take a pregnancy test a few weeks later to make sure that the miscarriage has finished safely. If the result of the test says you are still pregnant, you might need more treatment. 

Surgical management: This means having a small operation in hospital to remove the pregnancy tissue from your womb. If you’ve experienced heavy bleeding that doesn’t stop, if the doctors think the remains of the pregnancy have become infected, or if you’ve waited for the tissue to pass naturally but it hasn’t happened, you will probably be offered a surgical operation. It might also be the method you would rather have.

During the operation, a small tube will be used to open your cervix, and the contents of your womb will be removed by suction. You might be offered a local anaesthetic (so you stay awake), or a general anaesthetic (where you are asleep). After a general anaesthetic, you’ll probably have to stay in hospital for a few hours, or maybe overnight. 

There is more information about these methods of finishing the miscarriage in this Miscarriage Association leaflet.

How do you feel after a miscarriage?

It depends on the individual. Many people who are trying to have a baby feel very upset, guilty or frustrated when they miscarry. People who weren’t trying to get pregnant may feel some relief, sadness, or confusion – because they feel sad, but don’t think that they have a ‘right’ to feel sad. Some people experience grief after the miscarriage but feel better again soon, others need much longer to move on. However you feel is fine.

Sometimes it can be really hard to talk about a miscarriage. If you hadn’t told anyone you were pregnant, you might feel like you don’t want to tell them about your miscarriage. And if you had let people know you were pregnant, it can be hard to tell people what happened. To add to that, people often find it difficult to know what to say to someone who has had a miscarriage. If people don’t know what to say, it can sometimes feel like they don’t care what happened, or want you to forget about it. This isn’t usually true, but it can feel like it unless people are able to be open with each other. 

If you feel like you need support, don’t be afraid to reach out to your partner, or to family and friends. You can also talk to a counsellor, and your doctor. There are lots of organisations out there who can help – see below for information.

If you have other children, you can talk to them about their baby sister or brother. If you feel you can, it is good to talk to them about what happened, to explain how you feel, and to let them know that they can ask you any questions they have.  

If you are the partner of someone who has had a miscarriage, you might also feel really sad, and that is perfectly normal. Sometimes, the partner of someone who’s had a miscarriage feels like they have to be the strong one, as it was their partner who actually had the miscarriage. Please don’t try and bottle up all of your emotions – it’s great to be there for your partner, but it’s also really important that you get the emotional support you need. The Miscarriage Association has videos and leaflets for partners which you might find useful. 

For support with feelings after a miscarriage you can call The Miscarriage Association helpline on 01924 200 799 (Monday to Friday, 9am to 4pm) or email info@miscarriageassociation.org.uk.

You can watch a video of Holly-mae describing her own miscarriage experience

Remembering your baby

Just because your baby never had a chance to be born doesn’t mean that they didn’t exist. If you want to remember your baby, there are lots of ways you can do this. You can have a burial, or a memorial service, and mark your baby’s life with words, songs or poems that are meaningful to you. 

You don’t have to register your baby’s death if it happens before 24 weeks so you won’t get a death certificate. But if you’d like some kind of certificate, as a way to remember your baby, you can ask the hospital if they can provide one.

The anniversary of your baby’s passing might be a day for you to remember them, and to talk to other people about how you feel. You can give your baby a name, if you like, to mark that they were a real person, and they mattered to you.

Getting help and support

However you feel about having a miscarriage, you can go to specialist organisations for help, and you can ask your doctor to be referred to a counsellor. 

You can also get help any time during or after a miscarriage – even if it is years later. You don’t have to go through it alone, and you will probably find that talking about it to someone who understands helps you to feel better. 

However long it takes you to feel better is the right amount of time for you. Take your time, and if you can, be honest to other people – especially those who are close to you – about your emotions. Don’t feel like you have to put on a brave face to make them stop worrying. This is also true of people who are the partners of someone who has had a miscarriage.

Page last reviewed: July 2015
Next review due: July 2017