Miscarriage (Early Pregnancy Loss)
Miscarriage, or early pregnancy loss, is defined as the spontaneous loss of a pregnancy before 24 weeks gestation (time since conception). After 24 weeks, this is known as a stillbirth. The majority of miscarriages – around 80% - occur before the 13th week of gestation and these are called early miscarriages. If a miscarriage happens during weeks 13 to 24 of pregnancy this is called a late miscarriage. Miscarriage is far more common than many people think with 20-25% of pregnancies ending in miscarriage.
A miscarriage is a very difficult and emotional experience, with physical, mental health, and social impacts linked to it. If you have had a miscarriage and are worried about it, we want you to be reassured that there isn’t anything you have done wrong, and there is nothing you could have done differently or better. A miscarriage or even multiple miscarriages does not mean that you are not going to be a parent. It is thought that most miscarriages are caused by faulty chromosomes in the developing baby, and this is nature’s way of stopping the pregnancy from continuing. Genetic problems can increase with increasing age and so miscarriage can be more common in older mothers as a result. Other risk factors include smoking and drinking alcohol during pregnancy, using recreational drugs, having poorly controlled diabetes or a history of fertility problems.
Recurrent miscarriages (more than three miscarriages in a row) happen in around 1% of women, and most women who miscarry go on to have a successful pregnancy the next time they try.
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What are the symptoms of miscarriage?
Common symptoms for miscarriage are cramping, lower abdominal pain, and vaginal bleeding with or without clots of blood – often like a heavy period. If you are pregnant and have any of these symptoms, they will need to be investigated as there are occasions when these symptoms can be caused by other things rather than a miscarriage.
What should I do if I suspect a miscarriage?
If you have symptoms of cramping lower abdominal pain and vaginal bleeding with or without clots of blood, you should always see your medical team such as your doctor, midwife, or nurse. You can call your doctor for urgent advice, or attend your local hospital which may have an early pregnancy unit (like an emergency department for pregnant women), or attend your local emergency department.
You should rest and keep hydrated and can take simple pain killers like paracetamol for pain. You should avoid sexual activity until you have been reviewed by your medical team.
What should I expect from my review?
The person reviewing you will want to ask about your symptoms and, if you are comfortable, examine you. This may include checking your pulse, feeling your tummy, and – with your consent - do a speculum examination to look at your cervix (the neck of your womb). Depending on the possible diagnosis, blood tests or imaging (ultrasound) could also be carried out, or you may be referred to a specialist department.
Should I just go straight to hospital?
In some cases, pain and bleeding with a positive pregnancy test can indicate an ectopic pregnancy (pregnancy outside of the womb) which should be viewed as a medical emergency. If you have any of the following symptoms, you should go straight to the hospital; new pain in one or both of your shoulder tips, dizziness or a feeling of a very fast heart rate, severe one-sided abdominal pain, heavy vaginal bleeding (changing your pad or tampon every hour).
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