A miscarriage is the loss of a baby before the 24th week of pregnancy.

Miscarriage is the most common kind of pregnancy loss, affecting around one in four pregnancies.

In the UK, the miscarriage definition applies to pregnancies up to 23 weeks and 6 days, and any loss from 24 weeks is called a stillbirth.

The death of a baby at any stage of pregnancy is a deeply personal experience. Everyone is affected differently and it can be a very distressing time for parents.

What is an early miscarriage?

Most miscarriages are early miscarriages - those that happen during the first 3 months of pregnancy, also known as the first trimester. These can happen before the woman knows that she's pregnant and some miscarriages go unreported and unnoticed.

The most common cause is thought to be a genetic problem within the developing baby, but a poorly formed placenta can also cause problems. In most cases though, the cause of an early miscarriage is unknown, which can be difficult to cope with.

It’s important to know that your miscarriage is very unlikely to have happened because of anything you did or didn’t do.

What is a late miscarriage?

A late miscarriage is one that happens after the first 3 months but before 24 weeks of pregnancy.

It can be very hard to understand why a very late loss is called a miscarriage rather than a stillbirth. This is because, from a legal point of view, a baby is thought to have a good chance of surviving if they are born alive at 24 weeks. 

This distinction can be upsetting for some women who have a late miscarriage because they may also give birth to their baby and, understandably, feel that it should be called a stillbirth.

Late miscarriages are not as common as early miscarriages and happen in 1-2% of pregnancies.

What are the signs and symptoms of miscarriage?

The most common symptom of miscarriage is vaginal bleeding, but there are other symptoms to be aware of. Sometimes there are no obvious signs at all.

Vaginal Bleeding

This varies from light spotting or brown discharge, to a heavy bleed that may be heavier than a normal period. You may pass clots or “stringy bits”.  You may also have spotting, which you notice on your underwear or when you wipe yourself.

Light bleeding before 12 weeks of pregnancy can be quite common and is not always a sign of miscarriage. Bleeding after 12 weeks is not common. But you should always contact your midwife, maternity unit or GP straight away if you have any bleeding, with or without pain, at any point in your pregnancy.

If you are bleeding, use a clean sanitary pad. Don't use tampons, they can increase the risk of infection.

Abdominal Pain

Pain and cramping, like bleeding, can vary. Some pain and very light cramps in the stomach area in early pregnancy is not unusual. Mild stomach pain in early pregnancy is usually caused by your womb expanding, the ligaments stretching as your bump grows, hormones, constipation or trapped wind.

However, cramping and pain in your lower tummy may be caused by a miscarriage. If you have any concerns about any pains you’re having, or even if you just feel like something is wrong, contact your GP or midwife.

Lack or loss of pregnancy symptoms

This can also sometimes be a sign of miscarriage but, like pain and bleeding, that doesn’t necessarily mean there is a problem.  Some women have very little in the way of pregnancy symptoms, and many feel differently in different pregnancies.

But if you have strong pregnancy symptoms which suddenly reduce or stop well before 12 weeks of pregnancy, that might mean that hormone levels are dropping.  You may want to do another pregnancy test and/or talk to your GP about perhaps having a scan.

In some cases there are no signs at all that anything is wrong and miscarriage is diagnosed only during a routine scan. 

How is a miscarriage diagnosed?

Miscarriage is usually diagnosed or confirmed with an ultrasound. The person doing the scan needs to be absolutely certain that the baby has died or not developed and they may need more than one scan to confirm.

Having to wait can be very upsetting but it means that there is no risk of damaging an ongoing pregnancy.

In some cases, especially in later (second trimester) pregnancy, there may be no need for the miscarriage to be confirmed by scan. 

Can miscarriage be prevented?

As it's not known why the majority of miscarriages happen, most miscarriages can't be prevented. It's important to remember that there's nothing you can do that will guarantee that you won’t have a miscarriage too. However, we do know that there are some things that increase your risk of miscarriage and these changes can help.

• not smoking
• eating a healthy, balanced diet 
• losing weight before pregnancy if you are overweight or obese
• managing your weight gain if you are overweight or obese in pregnancy
• trying to avoid certain infections during pregnancy, including rubella
• avoiding certain foods in pregnancy
• not drinking alcohol or using illegal drugs in pregnancy
• staying active
• limiting your caffeine intake before and during pregnancy.
  

It’s also important to go to all your antenatal appointments and any other medical appointments you are offered during pregnancy.

Where can I get more information and support?

The Miscarriage Association offers support and information to anyone affected by the loss of a baby in early pregnancy.  They also raise awareness of miscarriage and promote good practice in medical care. They provide a network of support groups and telephone contacts throughout the UK.

Helpline: 01924 200799 (Monday–Friday, from 9.00am – 4.00pm)

Email: [email protected]

Website: https://www.miscarriageassociation.org.uk/