Miscarriage

It is the most common type of pregnancy loss.

It affects around one in four pregnancies.

In the UK, a miscarriage is when a baby dies in the uterus up to 23 weeks and 6 days. Any loss from 24 weeks onwards is a stillbirth.

If your baby was born alive before 23 weeks and 6 days but died not long after that is still considered a live birth and a neonatal death, not a miscarriage.

However, miscarriages most often occur in the first trimester (first 12 weeks), but this is not always the case.

These are just legal timelines and definitions.

IT IS NEVER YOUR FAULT - always remember this! 💜

WHY?

There is still alot we do not know about why they happen. Most people never find out the actual cause of their loss, even when it has been investigated.

It can make it harder to cope with when you don't know why. Sometimes knowing what caused it does help as you can understand better and you can plan how that affects your future pregnancies. However, this is not something most people get. Not knowing can lead to more questions and more stress. Its important to know it is never your fault.

Symptoms you may have experienced

You may not have any of these symptoms, or you may have had them all. These symptoms can be traumatic to experience and may have led to your diagnosis of a miscarriage.

Vaginal bleeding
- The most common symptom, and may even be painless
Mild to severe back pain or stomach cramping
Passing pregnancy tissue (can look like blood clots)

Treatments you may have received

Not all miscarriages require treatment. Some early miscarriages may require no treatment at all, whereas later on in pregnancy, there are more likely to be some treatments required.

Expectant management
- Wait to let the miscarriage happen on its own.
- You will be checked in on often during this time to make sure you are ok.
Medical management
- Medicines are given to help the pregnancy tissues pass.
- You may have received a medication called misoprostol, which makes the uterus contract to push out the pregnancy tissues.
Surgical management
- May be needed to remove the fetus and other tissues.
- It can be referred to as surgical evacuation of the uterus, or dilation and curettage (D&C).
- You would have been put under general anaesthesia so you are comfortable through the procedure.

Any pregnancy tissues may be sent to the lab for investigation if required or requested.

If there is the possibility of an infection, you might have been given antibiotics.

Potential causes

These are thought to be the main causes of miscarriage. Just because these might have caused a miscarriage for you, it does not mean that you cannot go on to have a successful pregnancy.

- Genetics:
  - This is when the baby does not develop properly from the start of the pregnancy, which means it cannot survive. This is believed to be the cause of more than half of all early miscarriages (before 14 weeks).
- Hormones:
  - People with irregular periods may find it harder to get pregnant and are more likely to miscarry.
  - This could be due to low levels of progesterone or thyroid problems
- Blood-clotting problems:
  - Problems with the blood supply to the placenta can lead to miscarriage, especially if the blood clots more than normal.
- Infections:
  - Minor infections such as common colds or coughs are not harmful. Instead, very high fevers, certain illnesses such as measles, cytomegalovirus, chlamydia and toxoplasma can lead to miscarriage.
  - Autoimmune diseases, such as lupus, are conditions in which the body attacks its own tissues.
- Anatomy:
  - If the cervix is weak or damaged, then it may start to open as the uterus gets heavier with the pregnancy, which can lead to a miscarriage
  - If the uterus is irregularly shaped, it might mean that the space in the uterus is smaller than usual, and this can make a pregnancy difficult
  - Large fibroids (harmless growths inside the uterus) can also cause a miscarriage

Terms you may have heard used to refer to your miscarriage

Some of these terms may have been difficult to hear, especially when you don't know what they actually mean.

Threatened

Spotting or bleeding during the first 12 weeks of pregnancy.

Complete

The embryo, fetus, placenta, and other tissues (products of conception) are passed with bleeding.

Incomplete

Only part of the tissues passes; some stay in the uterus, which can cause heavy vaginal bleeding.

Missed

The embryo or fetus dies but does not pass out of the uterus. Some dark brown spotting could occur.

Septic

The miscarriage becomes infected. It can occur after the miscarriage has happened if not all tissues have been passed.
If it is septic, then you will likely have a fever, some bleeding, discharge with a bad smell and stomach pain. This is a serious problem that needs immediate treatment.

Reccurrent

When you've had 3 or more miscarriages.

(Miscarriage Association 2022; Miscarriage Association 2023; Nationwide Children's Hospital 2024)

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