Miscarriage: understanding and support

What miscarriage is and how common it is

A miscarriage is the loss of a pregnancy before 24 weeks, and most happen in the first 12 weeks, known as early miscarriage. It is very common: around one in five, and by some estimates more, of pregnancies that a woman knows about end this way, and many more losses happen so early that they are never noticed. Despite how common it is, miscarriage is often not discussed openly, which can leave people feeling isolated and as though they are the only one. Understanding that it happens to many people, and that it is not a rare failure, can be a small but genuine comfort at a very difficult time. It is a loss that deserves acknowledgement and support.

Why miscarriage happens

Most early miscarriages happen because the baby was not developing as it should, very often due to a chance problem with the chromosomes that occurred as the pregnancy formed. This is not something the parents caused or could have prevented. It is important to be clear about what does not cause miscarriage: normal everyday activities, working, exercise, sex, lifting, stress from ordinary life, or a fright do not cause it. Certain factors can raise the risk, such as older age, some health conditions and smoking, but for most individual miscarriages no specific cause is found. This uncertainty is hard, but it also means there is usually nothing a woman did, or failed to do, that led to the loss.

Signs and getting assessed

The most common sign of miscarriage is vaginal bleeding, which may come with cramping tummy pain. However, light bleeding in early pregnancy is common and does not always mean a miscarriage is happening, so bleeding should be assessed rather than assumed to be the end of the pregnancy. If you have bleeding or pain in pregnancy, contact your GP, midwife or an early pregnancy unit. It is important to remember that severe one-sided pain, shoulder-tip pain, dizziness or collapse can signal an ectopic pregnancy, which is an emergency needing 999. When miscarriage is suspected, an ultrasound scan and sometimes blood tests are used to find out what is happening, though the answer is not always immediate.

Care and choices after a miscarriage

If a miscarriage is confirmed, there are usually a few options, and where it is safe, the choice can be yours. Many women wait for the pregnancy to pass naturally, which can take days to a couple of weeks. Others prefer medicine to help the process along, or a minor procedure to remove the pregnancy tissue from the womb, particularly if there is heavy bleeding or the natural approach is not working. Each option has pros and cons that your care team can talk through with you. Afterwards, some bleeding is normal for a while. Signs of infection, such as fever, offensive-smelling discharge or worsening pain, or very heavy bleeding, should be checked urgently. Physical recovery is often quicker than emotional recovery.

Emotional support and looking ahead

Grief after miscarriage is real and valid, whatever the stage of pregnancy, and there is no right or wrong way to feel — sadness, numbness, guilt, anger or relief can all come, sometimes together. Partners grieve too. It can help to talk to people you trust, and support is available from your GP, midwife and dedicated charities such as the Miscarriage Association and Tommy's. If low mood or anxiety persists or feels overwhelming, please seek help, as counselling and other support can make a difference. Most women who have a miscarriage go on to have a healthy pregnancy next time. Recurrent miscarriage — usually three or more in a row — can prompt investigations, though often a cause is still not found.