Signs of a Miscarriage and Support for Recovery
This article provides an overview of miscarriage, including its causes and risk factors. It also discusses the emotional effects of miscarriage and how to find support.
The medical name for a miscarriage is a spontaneous abortion. In this context, the word “abortion” simply means that the pregnancy is ending before reaching full term. It is different from a pregnancy termination, the medical name for which is an induced abortion.
Doctors use a range of terms to describe different states of pregnancy loss. These states include:
- threatened miscarriage, which is when vaginal bleeding occurs but the cervix remains closed, and an ultrasound scan shows a viable fetus
- inevitable miscarriage, which is when there is vaginal bleeding and the cervix is open, indicating that fetal tissue is likely to pass
- complete miscarriage, which is when there is bleeding and passage of fetal tissue, and an ultrasound scan shows no remaining fetal tissue inside the uterus
- incomplete miscarriage, which is when bleeding occurs with some passage of fetal tissue, and an ultrasound scan shows some remaining fetal tissue inside the uterus
- missed miscarriage, which is when the fetus has stopped developing but no symptoms of miscarriage occur
Bleeding and cramping in the abdomen and pelvis are the most common symptoms of miscarriage.
It is common to experience light bleeding, or spotting, during the first trimester of pregnancy. However, heavier bleeding can be a symptom of a possible miscarriage. Contact your obstetrician-gynecologist (OB-GYN) or midwife if you have concerns about vaginal bleeding during your pregnancy.
Common symptoms of a miscarriage
Symptoms of a miscarriage include:
- vaginal bleeding
- abdominal or pelvic pain, which may radiate to the lower back, buttocks, or vulva
- heavy cramping accompanied by bleeding or discharge
Symptoms of a miscarriage infection
In cases of incomplete miscarriage, there is a risk of infection of the fetal tissue that remains in the uterus. Septic miscarriage is a potentially life threatening condition that can occur as a result of an infection in the uterus.
Seek immediate medical care (call 911) if you are pregnant or suspect that you may be pregnant and have symptoms including:
- fever (101ºF or 38ºC)
- moderate to severe vaginal bleeding that saturates more than one pad per hour
- heavy vaginal discharge
- a slowed heart rate
- difficulty breathing
- blurred vision
Contact your OB-GYN or midwife if you are pregnant or may be pregnant and you experience any nonemergency symptoms that cause you concern.
What does not cause miscarriage?
Many misconceptions exist about activities or habits that cause miscarriage. However, the American College of Obstetricians and Gynecologists (ACOG) explains that miscarriage occurs randomly and is not the fault of the pregnant person.
Things that do not cause miscarriage include:
- vaginal intercourse
- past use of oral birth control pills
- morning sickness
- a recent fall or bump, in most cases
The ACOG also notes that only a few medications can increase the risk of miscarriage. Talk with your OB-GYN about any medications you are taking and whether or not they are safe to continue during pregnancy.
Researchers have identified several risk factors for miscarriage. However, not everyone with risk factors will experience a miscarriage, and not everyone who experiences a miscarriage has these risk factors.
The risk of miscarriage increases with the age of the pregnant person. The risk of miscarriage at ages 20–30 years is 8.9%. The risk increases to 74.7% past the age of 40 years.
Experiencing a previous miscarriage increases the risk of miscarriage in subsequent pregnancies.
|Medical history||Risk of miscarriage in a future pregnancy|
|2 consecutive miscarriages||28%|
|3 or more consecutive miscarriages||43%|
Although previous miscarriage is a key risk factor, the ACOG notes that repeat miscarriages are rare.
Other risk factors
Additional risk factors for miscarriage include:
- chronic diseases, including celiac disease, diabetes, and certain autoimmune conditions
- infections, including vaginitis, HIV, malaria, and syphilis
- conceiving again immediately after delivery
- exposure to chemicals or other environmental hazards, including lead and arsenic
- anatomical issues in the uterus or cervix
If you are pregnant or planning to become pregnant, talk with your OB-GYN or midwife about your individual risk factors and steps you can take to lower your risk.
If you are pregnant or could be pregnant and you experience symptoms of a miscarriage, contact your OB-GYN or midwife right away. They will perform a pelvic examination and check your cervix for dilation and lost fetal tissue. If you have been bleeding, they may ask you to keep and bring in a sample to confirm that a miscarriage has occurred.
If there are no signs of an infection, you may choose to allow fetal tissue to pass naturally from the uterus. This process may take up to 2 weeks. Your doctor may also prescribe medications that induce contractions to expel any remaining tissue.
In cases when some fetal tissue remains inside the uterus, doctors will perform a dilation and curettage (D and C). In this procedure, they will use a speculum to dilate the cervix, and then they will use a small tool called a curette to remove tissue from the uterus.
A miscarriage can cause a wide range of emotions, including sadness, anger, and grief. A 2013 survey conducted by researchers asked people who had experienced a miscarriage about their feelings afterward.
Nearly half (47%) of respondents reported feeling guilt, and 41% said that they felt they had done something wrong. More than one-third (37%) said that they felt they had lost a child.
The Office on Women’s Health offers guidance for coping with a pregnancy loss, including these steps:
- If you have a partner, talk with them about the pregnancy loss and how it is affecting each of you.
- Reach out to friends and family members for help when you need it.
- Find ways to express remembrance, such as holding a memorial event or planting a tree.
- Join a support group, either online or in person, to connect with other people who share your experience.
- Speak with a grief counselor or another therapist, particularly if intense feelings of grief persist.
The short answer is yes. The ACOG explains that most people who experience a miscarriage go on to have healthy, full-term pregnancies.
The ACOG also reports that it is safe to try conceiving again as early as 2 weeks after a miscarriage. However, you may need time to recover both physically and emotionally. Talk with your OB-GYN or midwife about your personal experience and the right time to start trying again.
These are some additional questions that people ask about miscarriage. They have been answered by Dr. Valinda Riggins Nwadike, M.D., M.P.H.
How do I know if I had a miscarriage?
Although it is not uncommon to miscarry before you are aware you are pregnant, you can tell if you have miscarried if there is bleeding, cramping, and passage of tissue after a positive pregnancy test. Your OB-GYN may also detect an absence of cardiac activity on an ultrasound or Doppler in the office.
What does miscarriage look like?
You may experience bright red bleeding, blood clots, or passage of tissue. The tissue may appear brown, pink, or bright red.
How long does miscarriage bleeding last?
Bleeding can be heavy at first and last anywhere from a few hours to 2 weeks.
Is miscarriage common?
One-half to one-third of early pregnancies can end in miscarriage before a person is aware that they are pregnant. Of those who are aware that they are pregnant, 10–20% experience a miscarriage.
Miscarriage can occur in up to 20% of clinically recognized pregnancies. If you experience a pregnancy loss, you may notice vaginal bleeding, abdominal cramping, and passage of pink, brown, or red tissue.
It is important to allow yourself time to grieve and recover after a miscarriage. If you feel comfortable doing so, it can help to talk about your emotions with trusted friends and family members. Reaching out to a therapist or support group can also be useful.