Miscarriage

What is a miscarriage?

A miscarriage is a fairly common complication of early pregnancy, in which the developing embryo or fetus dies of natural causes in the womb. The term miscarriage is used to describe this process when it happens during the first 20 weeks of pregnancy.

A miscarriage which occurs in the first trimester (weeks 1-12 of pregnancy) is known as an early miscarriage. A miscarriage which occurs in the second trimester (during weeks 13-20 of the pregnancy) is known as a late miscarriage. Loss of the fetus which occurs after week 20 of pregnancy is known as a stillbirth.[1]

The symptoms of a miscarriage include vaginal bleeding, cramping and abdominal pain, but it is also possible to experience a miscarriage without symptoms being present, and many miscarriages are diagnosed during a routine ultrasound scan.

Many people experience intense emotional distress after having a miscarriage, particularly if it occurs during a planned pregnancy. Nearly 20 percent of women, who experience a miscarriage, develop symptoms of depression and anxiety, for which a range of therapeutic treatment options are available. For most people, distress associated with a miscarriage begins to lessen around four months after the miscarriage.[2]

Types of miscarriage

The kind of miscarriage a person has depends on:[3]

  • At what point within the timeline of a typical pregnancy the miscarriage occurs
  • Whether the miscarriage involves losing all or part of the pregnancy tissue, the protective sac, or lining, that forms around the developing fetus in the womb
  • How many times a person has been affected by miscarriage

The principal types of miscarriage are:

  • Early miscarriage, i.e. in the first trimester
  • Late miscarriage, i.e. in the second trimester
  • Recurrent miscarriage, i.e. more than three consecutive miscarriages Chemical pregnancy, i.e. in very early pregnancy, even before ultrasounds can detect - a fetus

A miscarriage can also be classified according to how much pregnancy tissue and fetal matter are lost:[4]

  • Complete miscarriage occurs when the fetus and all related pregnancy tissue are lost. No treatment is needed, but the previously pregnant person might benefit from psychotherapy to help process the experience.
  • Incomplete miscarriage occurs when only part of the fetal matter and pregnancy tissue exit the womb. Further medical treatment will be sometimes be needed to remove the remainder. Symptoms can be very subtle and can therefore go unnoticed.
  • Missed miscarriage occurs when the fetus dies within the first 20 weeks of pregnancy, but, in most cases, no fetal matter or tissue pass out of the womb. The physical miscarriage may have to be medically induced. Missed miscarriage is usually an incidental finding because there is rarely any indication that anything was wrong with the pregnancy.[5]

To find out about the range of possible treatment options for incomplete and missed miscarriages, see the Treatment section of this resource.

Early miscarriage

A miscarriage which takes place in the first trimester (during the first 12 weeks of pregnancy) is known as an early miscarriage. This is the most common type of miscarriage and is most commonly caused by chromosomal abnormalities (problems with the foetus’s DNA) or by problems affecting the placenta.

Late miscarriage

A miscarriage which takes place in the second trimester (during weeks 13-20 of pregnancy) is known as a late miscarriage. Late miscarriages are much less common than early miscarriages and are often caused by problems arising from uterine or cervical abnormalities, invasive fetal diagnostic procedures, rhesus isoimmunisation or long-term (chronic) health conditions affecting the pregnant person, such as polycystic ovarian syndrome (PCOS) or by the pregnant person contracting infections, which may be sexually transmitted (for example, chlamydia or from food poisoning (salmonella, toxoplasmosis and listeria).

See this resource on foods to avoid during pregnancy for more information about food poisoning and miscarriage.

Recurrent miscarriage

About 1 in 100 people experience recurrent miscarriages, three or more miscarriages in a row.[6] People who experience recurrent miscarriages can undergo tests to see if there is an underlying cause. Because a person’s chances of miscarrying increase with age, someone over 35 years of age will usually be offered these tests after two early miscarriages.

The underlying cause(s) of miscarriage will be treated where possible. However, a cause is not always found as a result of testing. Not finding a cause for recurrent miscarriage is not necessarily a negative outcome: many people who experience recurrent miscarriages for no apparent cause go on to have a healthy pregnancy when they next conceive, without needing further treatment.[7]

Chemical pregnancy

Many miscarriages occur very early in pregnancy, before a person is necessarily aware that they had become pregnant. This is called a chemical pregnancy, and occurs around week five of pregnancy – usually before pregnancy symptoms are present and always before the developing embryo would be visible on an ultrasound scan.

Some people, in particular, those who are trying to conceive, are aware of their chemical pregnancy, as it can be detected at this early stage on a pregnancy test. In a chemical pregnancy, the fertilized egg fails to survive in the uterus. After the miscarriage, future pregnancy tests related to this pregnancy will be negative.

It is possible for a person with a chemical pregnancy to be unaware of the pregnancy and of miscarrying, particularly if they were not trying to conceive, as symptoms like abdominal pain and/or blood loss may appear to be part of their next menstrual period.

Good to know: Many forms of birth control (contraception), such as the combined pill or progesterone-only (mini) pill work to thin the lining of the womb. These medications are usually taken intentionally to prevent pregnancy. One way in which they do this is by preventing the fertilized egg from implanting in the lining of the uterus. When a fertilized egg does not implant due to the effective use of birth control, this is not considered a chemical pregnancy.

Symptoms of a miscarriage

The potential symptoms of a miscarriage are broadly the same, whether it occurs in the first trimester (early miscarriage) or second trimester (late miscarriage). It is also possible to have a miscarriage without experiencing any symptoms, and some miscarriages are only detected during a routine scan.

When present, the most common symptoms of a miscarriage are:

  • Abdominal pain
  • Vaginal bleeding
  • Discharge of fluid or tissue from the vagina
  • Cramping
  • No longer experiencing the symptoms of pregnancy, such as nausea and breast tenderness

A person who is miscarrying may experience one or more of these symptoms, but their presence does not always indicate that a miscarriage is taking place: it is possible to experience these symptoms as part of a healthy pregnancy.

Other explanations for the presence of symptoms of miscarriage include:

  • Implantation bleeding This occurs in some pregnancies when the fertilized egg implants in the lining of the uterus.
  • A healthy pregnancy progressing normally: Pain, cramping, vaginal bleeding and discharge are normal features of early pregnancy. Vaginal bleeding in combination with abdominal pain or cramping is more likely to be indicative of a miscarriage than the presence of any of these symptoms on their own.
  • Ectopic pregnancy: Also known as a tube pregnancy, this occurs when the embryo attaches outside the uterus (womb). As with a miscarriage, abdominal pain and vaginal bleeding are two principal symptoms of ectopic pregnancy.
  • Molar pregnancy: This occurs when a lump of abnormal cells grows in the womb, instead of a healthy embryo. As with a miscarriage, vaginal bleeding is a principal symptom of molar pregnancy.

Many people become concerned that they are having a miscarriage if any of its possible symptoms occur ‒ particularly vaginal bleeding ‒ and it is advisable to seek medical attention promptly to check if there is a problem. One can undergo an early pregnancy ultrasound scan to establish whether one is in fact experiencing a miscarriage, and to detect any other problems with the pregnancy.

Causes

Most miscarriages occur in the first trimester and are a result of chromosomal abnormalities in the fetus or problems with the placenta. Miscarriages which occur in the second trimester are more likely to be caused by pregnancy complications related to long-term health conditions, diseases or infections.[8]

Age is a principal factor in the likelihood of a miscarriage, and increases the likelihood of miscarrying in both the first and the second trimester. In people under 30, only 1 in 10 pregnancies will end in miscarriage. In people over 45, more than half of all pregnancies will end in miscarriage.[9]

A 2015 survey of people across the U.S. who have experienced a miscarriage found that over 75 percent of people strongly wish to know the cause of their miscarriage.[10] To help identify any possible causes for miscarriage, it is usual for doctors to perform:

  • An autopsy on the pregnancy tissue
  • A placental exam

Common causes of first-trimester (early) miscarriages include:[11]

  • Chromosomal abnormalities: If an embryo has more or fewer than 23 pairs of chromosomes, this is a chromosomal abnormality, and it will be vulnerable to miscarriage, either during its embryo stage or when it develops into a fetus.[12] Chromosomal abnormalities are the most common cause of early miscarriage. They are detected in 50-85 percent of the pregnancy tissue specimens that are analyzed to determine the cause of miscarriage.[13]
  • Placental problems: The placenta is an organ which develops in the uterus during pregnancy to pass oxygen and nutrients to the foetus. It is pancake-shaped and should be positioned at the top of the uterus, as far away as possible from the cervix.[14] If the placenta does not form or function correctly, this is likely to negatively affect the development of the fetus, causing a miscarriage.

Common causes of second-trimester (late) miscarriages include:

  • Long-term health conditions: Certain long-term health conditions including diabetes, severe hypertension, coagulation disorder, lupus, polycystic ovarian syndrome (PCOS) and kidney disease can make a person more prone to miscarrying. If a long-term health condition is being poorly managed or managed in a way which is unsuitable for pregnant people, the risk of miscarriage increases further.
  • Medications: Some medications, including ibuprofen, certain vitamins and herbal supplements, are unsuitable for pregnant people, and using them can cause miscarriage or congenital abnormalities. Always consult a doctor before using any prescription or over-the-counter medication to ensure that it is suitable for use in pregnancy.
  • Diseases and infections: Diseases and infections commonly linked to miscarriage and pregnancy complications include chlamydia, Dengue fever, rubella, cytomegalovirus, malaria, brucellosis, influenza, vaginal infection with bacterial vaginosis and human immunodeficiency virus (HIV). Seek medical attention at the first sign of infection when pregnant and avoid activities and environments associated with increased risk.[15]
  • Food poisoning: The most common types of food poisoning associated with miscarriage are salmonella, toxoplasmosis and listeriosis. Avoid uncooked and unpasteurised meats and animal products, in particular when pregnant in order to minimise the risk of food poisoning, and visit a doctor if symptoms such as fever, diarrhea or vomiting occur. Antibiotics given to pregnant people for food poisoning may reduce the likelihood of miscarrying if taken promptly.
  • Environmental factors: Smoking tobacco and working in workplaces such as radiology departments, factories or farms are associated with an increased risk of miscarriage. It is strongly recommended that all people, who are trying to conceive or are pregnant, adapt their lifestyle and day-to-day routine in order to avoid factors such as pollution, pesticides and radiation to minimize the risk of miscarriage.
  • Womb or cervical dysfunction: Problems with the womb or cervix structure or function can increase the likelihood of miscarrying. Many womb or cervical dysfunctions make a miscarriage particularly likely to occur in the second trimester, as the developing fetus grows in size.

Other possible causes for miscarriage include:

  • Invasive fetal diagnostic procedures
  • Rhesus isoimmunisation

Risk factors for miscarriage

The following factors may not be the sole cause of a person experiencing a miscarriage, but they are linked to a heightened risk of miscarrying:

  • Being older than 35
  • Smoking tobacco
  • Drinking alcohol
  • Consuming more than 200mg of caffeine per day (one or two cups)
  • Drug misuse
  • Being obese
  • Having certain long-term health conditions such as diabetes or hyperthyroidism
  • Having certain bacterial and viral infections, such as chlamydia or salmonella

Although many resources falsely indicate that a restricted alcohol intake may be acceptable during pregnancy, according to the widely-accepted Dietary Guidelines 2015-2020, people who are or who may be pregnant should not drink any alcohol. As well as increasing the chances of miscarrying, alcohol consumption may result in negative behavioral or psychological consequences for the child.

Diagnosis

Miscarriages are most commonly diagnosed using a combination of tests, including:

  • Human chorionic gonadotropin (hCG) test
  • Pelvic exam
  • Ultrasound
  • Fetal heart scanning

It is important for the doctor(s) involved in diagnosing a miscarriage to be certain that the fetus has stopped living, which may involve some or all of these tests and/or waiting up to a week between the first and final scans, in order to complete the diagnosis.

This waiting time before a diagnosis is possible can be distressing. However, diagnostic testing is managed in this way to:

  • Reduce any possibility of a misdiagnosis
  • Ensure that any treatments would not be carried out at risk of damaging an ongoing pregnancy

In the second trimester (in a late miscarriage), there may be no need for tests to confirm the diagnosis. The miscarriage may be conclusively evidenced by symptoms including:

  • Abdominal pain
  • Bleeding
  • Passing a recognisable pregnancy sac or tissue
  • Delivering the fetus

In this instance, tests such as an autopsy on the pregnancy tissue or a placental exam may be performed to help determine the possible cause(s) of the miscarriage.

hCG test

Human chorionic gonadotropin (hCG) is a hormone produced by the placenta during pregnancy. This test can be:

  • Qualitative: To find out whether or not there is hCG in the blood, thereby proving the presence or absence of pregnancy. This is a urine test and is often how a person finds out they are pregnant initially.
  • Quantitative: To find out the precise amount of hCG in the blood. This is a blood test which is performed by a doctor to discover more information about a particular pregnancy. It might be repeated over a period of days or weeks in order to ascertain whether a person’s hCG levels are rising, decreasing or stabilizing.

In a healthy pregnancy, hCG levels will continue to double approximately within the blood throughout the first trimester, reaching their peak at around week 11 of the pregnancy and decreasing slightly during the second trimester. If hCG levels begin to decrease in the first trimester, this is likely to indicate a miscarriage.

Wherever possible, this test will be performed in conjunction with ultrasound, fetal heart scanning and a pelvic exam before a miscarriage is diagnosed. However, in cases where ultrasound equipment is unavailable, the hCG blood test may sometimes be the primary means of confirming a suspected diagnosis of miscarriage.[16]

Pelvic exam

A pelvic exam to diagnose miscarriage will be performed by an obstetrician, i.e. a doctor specializing in childbirth, and/or a gynecologist, a doctor specialising in the female reproductive system.

During a pelvic exam, a person will wear a loose hospital gown and lie on their back, with their feet in stirrups, so that the vagina and cervix can be easily examined. When diagnosing miscarriage, a doctor will check for the presence of two principal signs indicating miscarriage:

  • The presence of tissue/blood in the cervical/vaginal opening
  • The dilation (opening) of the cervix

Ultrasound

Ultrasound is an imaging technique which uses soundwaves to create an image of the developing fetus in the body. It is a painless and non-invasive procedure which can be performed by using the scanner in two different ways:[17]

  • Transvaginallyusually before week 11 of pregnancy, with a scanning probe inserted into the vagina
  • Transabdominally, usually from 11-12 weeks of pregnancy. Gel is spread on the skin of the lower abdomen, and the scanner is passed over the area

In diagnosing a miscarriage, doctors will look for various indicators in the ultrasound images. These can suggest how far advanced the miscarriage is and what kind of miscarriage is taking place. Indicators of miscarriage may include:

An empty pregnancy sac in the uterus Pregnancy tissue but no fetus in the uterus The fetus or embryo is smaller than it should be by this stage of pregnancy No fetal heartbeat, if the pregnancy is far enough advanced to detect it, usually after week seven of pregnancy

Fetal heart scanning

The absence of the fetal heart rate (the baby’s heartbeat) is a principal factor in diagnosing miscarriage.

The fetal heart scan is a specialized kind of ultrasound scan. The fetal heart can be scanned by means of ultrasound from around seven weeks into the pregnancy. At 13-14 weeks, the four chambers and great arteries can be clearly imaged, and many congenital heart abnormalities can be detected.[18]

As with a regular ultrasound scan, a fetal heart scan is a painless and non-invasive procedure, which can be performed transvaginally or transabdominally.[19]

Treatment

If a miscarriage is causing abdominal pain, suitable painkillers will be prescribed or recommended, and one’s doctor will advise on an appropriate dose. It is important not to take any medications, even painkillers, which have not been approved by a doctor at this stage.

Treatment depends on the type of miscarriage:[4]

  • Some miscarriages do not require any physical treatment, because no pregnancy tissue is left in the womb. This is called a complete miscarriage.
  • In an incomplete miscarriage, some pregnancy tissue comes out of the uterus, but some remains inside. Treatment may be needed to remove the remaining tissue.
  • In a missed miscarriage, there are usually no cramps or bleeding, and the dead fetus remains inside the uterus. Sometimes, pregnancy tissue leaves the uterus, but a form of treatment may be needed to remove the fetus.

In a complete miscarriage, without significant blood loss, no further medical or surgical treatment is needed. A person will be given simple aftercare instructions, including A person will be advised not to have sexual intercourse or any kind of vaginal penetration until the bleeding associated with the miscarriage has stopped (usually within two weeks after the process begins). Normal menstrual periods usually return 4-6 weeks after a miscarriage.

In an incomplete or missed miscarriage, a surgical or medical procedure may be prescribed in some instances in order to clear the uterus of all fetal and pregnancy tissue. Where possible, the course of treatment is left to the discretion of the person who is having the miscarriage. The American Family Physician finds that better mental health outcomes after miscarriage can be expected when a person’s treatment preferences are respected.

An incomplete or missed miscarriage can be managed expectantly, medically or surgically.

Expectant management

Also known as conservative or wait-and-see management, expectant management involves waiting for the tissue to pass out of the womb naturally, which can take up to three weeks. This is the course of action often chosen by people who do not wish to have a medical or surgical procedure.

Expectant management is suitable for a person having a missed or incomplete miscarriage who:

  • Prefers passing the pregnancy tissue related to the miscarriage in the privacy of their home
  • Considers the ongoing or intermittent pain levels acceptable - over-the-counter and/or prescription painkillers will be recommended
  • Has no additional health complications that render this option inadvisable

Experts on pregnancy loss advise that this course of action is ideal, where suitable, for people having a missed miscarriage who might wish to see, hold and perhaps memorialize their fetus with a burial or cremation, as it can be damaged by some of the more pragmatic miscarriage management procedures, such as dilation and extraction (D&E).

People who choose expectant management will need to return to hospital for a check-up on completion of the miscarriage, as there is an increased risk of infection. Medical or surgical intervention may be required if it does not complete as planned.[20]

Medical management

Medical management of miscarriage involves taking medication to cause the uterus to contract, so that the pregnancy tissue passes out of the womb. In most cases, the medication can be taken in the privacy of a person’s home. The medication used is called misoprostol. It can be taken in two forms:[21]

  • Orally as a tablet
  • Vaginally as a pessary, i.e. a tablet which can be inserted into the vagina with a special applicator

Misoprostol works by causing cramping and bleeding to empty the uterus. Bleeding usually starts around one hour after taking the medication, and it takes 4-5 hours in total for the full amount of pregnancy tissue to pass. Nausea and diarrhea are common during this period, but are not a cause for concern.

Cramping may last for 1-2 days, and associated bleeding and spotting may continue for 4-5 weeks. A doctor will advise on the appropriate timing of the dose(s) and recommend suitable painkillers.[22]

If the miscarriage does not occur in the expected timeframe or there are any problems, it is important to consult a doctor. Surgery may be necessary to complete the process of miscarriage.

The recovery time after a medically-induced miscarriage is usually around four weeks, with a medical check-up usually scheduled for 1-2 weeks after taking the medication. Avoiding sexual activity until one’s next menstrual period is recommended to reduce the risk of infection.

Surgical management

Procedures which may be recommended following a miscarriage include:

  • Manual vacuum aspiration
  • Dilation and curettage (D&C)
  • Dilation and extraction (D&E)

Manual vacuum aspiration

This procedure is usually recommended for first-trimester miscarriages or as a means of removing leftover pregnancy tissue when the fetus has already passed out of the womb. A device is inserted into the cervix to empty the womb of all pregnancy tissue and fetal matter, using gentle suction. This procedure can be carried out under local anesthetic and takes around 10-15 minutes.

Medications to help the cervix dilate are usually given before the procedure. Light cramping and period-like pain can be expected afterwards. This usually settles within seven days.[23]

Manual vacuum aspiration is used much more frequently as a treatment option than dilation and curettage or dilation and extraction (below).

Dilation and curettage (D&C)

This procedure is usually recommended for people having first-trimester miscarriages. D&C is usually performed under general anesthetic, but can also be carried out using local anesthetic via an intravenous therapy (IV) drip. The vagina is dilated using a device called a speculum, and the contents of the uterus are removed using an instrument called a curette, which scrapes the pregnancy tissue and fetal matter out of the uterine wall. Medications to help the cervix dilate are usually given before the procedure.

A person can undergo D&C as an outpatient procedure in most cases and return to normal activity around 24 hours afterwards. Light cramping and bleeding may last for up to two weeks, and appropriate painkillers, usually ibuprofen, will be recommended.[24]

Dilation and extraction (D&E)

This procedure is usually recommended for people having second-trimester miscarriages. D&E is almost always performed under general anesthetic, but can be carried out using local anesthetic via an IV drip. During the procedure, the vagina is dilated using a speculum, and forceps (a grasping instrument) is used to remove the foetus. Often, the fetus may need to be divided into parts before it can be removed. Medications to help the cervix dilate are usually given before the procedure.

After the fetus is removed, a curette is used to scrape any remaining pregnancy tissue from the uterine wall. A person can undergo D&E as an outpatient procedure in most cases and return to normal activity around 24 hours afterwards. Light cramping and bleeding may last for up to two weeks, and appropriate painkillers, usually ibuprofen, will be recommended.[25]

Post-miscarriage intervention

Post-miscarriage intervention is psychological treatment following a miscarriage which focuses on helping one to overcome the feelings of grief, self-blame and worry that are commonly associated with miscarrying. It is very common to feel distressed following a miscarriage, and for some people these emotions can develop into depression and anxiety if left untreated.

The Miscarriage Association suggests that feelings associated with miscarrying might affect a person in a variety of different ways, including:

  • Guilt: Even though it is very unlikely that any given miscarriage could have been prevented, it is normal for a person to feel guilt after miscarrying, particularly if they were subject to any risk factors, such as a long-term health condition or a history of smoking, which may render miscarriage more likely.
  • Anger and jealousy: It is normal to feel anger in a variety of ways, including anger towards one’s own situation, oneself and hospital staff, and jealousy towards others who have never experienced a miscarriage or on hearing others’ pregnancy announcements.
  • Sadness: It is normal to feel sad and tearful, either in relation to specific thoughts or with no obvious trigger.
  • Shock and confusion: These emotions are especially common if the pregnancy was progressing healthily prior to the miscarriage.
  • Physical emptiness: It is common for a person to feel acutely aware that they are no longer carrying a developing fetus, particularly if they had been acutely monitoring their sensations during pregnancy.
  • Panic: A miscarriage can be an intensely stressful experience and a sensation of loss of control is common in the weeks following it.
  • Numbness: Although a miscarriage can be distressing for many people, it is also possible for a person to feel an absence of intense feelings and to find this distressing in itself.
  • Loneliness: Many people, who have experienced a miscarriage, report the sensation that others do not understand how they are feeling. There are many organizations which can connect a person with others who have shared the experience of miscarriage. This can be an effective way to alleviate the feelings of loneliness that often accompany this impactful life event.

There are many different formats of post-miscarriage intervention available for people affected by a miscarriage, which can help a person to process the experience and avoid developing long-term depression and anxiety. These include:

  • One-on-one counseling
  • Group counseling, for both partners and/or other family members
  • Miscarriage support groups with other people who have experienced miscarriage

Healthcare providers will be able to direct people and families, who have experienced a miscarriage, towards available services and can provide advice on choosing the most appropriate kind of support for the affected person, couple or family.

Prevention

In most cases, it is not possible to prevent a miscarriage. However, it is possible to reduce the risk of miscarrying and to increase the potential of treating any complications of pregnancy that arise before they result in a miscarriage. This requires good antenatal care – a care plan devised with one’s doctor to increase the chances of a healthy pregnancy.

Antenatal care generally involves:

  • Having regular medical check-ups to ascertain the health of the pregnant person and developing fetus
  • Avoiding alcohol, tobacco, excess caffeine and other substances associated with an increased risk of miscarrying
  • Avoiding environments and situations which are associated with an increased risk of miscarrying
  • Eating a recommended pregnancy diet
  • Ensuring that any pre-existing medical conditions which may affect pregnancy are adequately managed prior to conception to reduce their potential impact on the pregnancy

Miscarriage FAQs

Q: What are the most common misconceptions about the causes of miscarriage? A: There are several widespread myths about certain factors being causes of miscarriage. Many pregnant people avoid air travel, eating spicy food and having sexual relations during pregnancy, but these activities are not medically linked to miscarrying. It is also common to avoid exercise during pregnancy with the aim of preventing a miscarriage. However, as long as an exercise programme has been approved by a doctor, it is safe for a pregnant person to carry out without risk to the developing fetus.[10]

Q: If a pregnant person experiences cramping, vaginal bleeding or discharge, does this mean they are having a miscarriage? A: Not necessarily. Vaginal bleeding is common in early pregnancy. Bleeding may occur due to the implantation of the fertilized egg in the uterus (implantation bleeding), and discharge can be caused by more blood than normal flowing to the pelvic area during pregnancy. However, bleeding and cramping may indicate a miscarriage, and a pregnant person should always consult their doctor if they experience vaginal bleeding in order to confirm the status of the developing fetus.

Q: How soon after a miscarriage can a person have sex and/or try to become pregnant again? A: For most people, the vaginal bleeding associated with a miscarriage lasts for under two weeks. During the period of vaginal bleeding, the uterus and cervix may remain dilated. This renders the vaginal area at increased risk of contracting bacterial infections. The risk of infection can be reduced by avoiding sexual activity involving the vagina until the bleeding has stopped.

Waiting until one’s next period before trying to conceive is recommended after a miscarriage. It is possible to become pregnant as soon as a new egg is released and fertilized by a sperm, which may happen as soon as a new reproductive cycle begins in the female body. Although it is therefore possible to become pregnant very soon after a miscarriage, waiting until one’s next period is recommended for two principal reasons: it increases one’s chances of accurately dating the new pregnancy, and it allows for the womb and cervix to return to their normal function following the miscarriage, helping to ensure hospitable conditions for the new developing fetus.

Q: Is a person who has had a miscarriage more likely than others to miscarry in future? A: Having a miscarriage is not an indication that a person will miscarry in the future. Many people experience one or more miscarriages before going on to have a healthy pregnancy. If a person experiences more than one miscarriage, they may wish to undergo tests to identify any underlying conditions which may be causing them to miscarry. However, it is possible to experience recurrent miscarriages without discerning an underlying cause and to then go on to have a healthy pregnancy.

Other names for miscarriage

  • spontaneous abortion

  1. Facts about stillbirth.” Centers for Disease Control and Prevention. 02 October 2017. Accessed: 24 January 2018.

  2. Depression and Anxiety Following Early Pregnancy Loss: Recommendations for Primary Care Providers.” The Primary Care Companion for CNS Disorders. 29 January 2015. Accessed: 24 January 2018.

  3. Miscarriage: symptoms.” NHS Choices. 21 May 2015. Accessed: 24 January 2018.

  4. Miscarriage.” Planned Parenthood. 2018. Accessed: 24 January 2018.

  5. Miscarriage: ateiologiy.” BMJ Best Practice. November 2017. Accessed: 20 April 2018.

  6. Understanding recurrent miscarriage.” Babycentre. March 2015. Accessed: 24 January 2018.

  7. Recurrent miscarriage.” The Miscarriage Association. Accessed: 24 January 2018.

  8. The chromosome analysis of the miscarriage tissue. Miscarried embryo/fetal crown rump length (CRL) measurement: A practical use.” Public Library of Science. 12 June 2017. Accessed: 24 January 2018.

  9. Miscarriage: causes.” NHS Choices. 21 May 2015. Accessed: 24 January 2018.

  10. A national survey on the public perceptions of miscarriage.” Obstetrics & Gynecology. June 2015. Accessed: 24 January 2018.

  11. First trimester miscarriage.” NHS Choices. 21 May 2015. Accessed: 24 January 2018.

  12. Chromosomal abnormalities in first-trimester miscarriages.” Acta Obstetricia et Gynecologica Scandinavica. November 2005. Accessed: 24 January 2018.

  13. Diagnosis and management of first trimester miscarriage.” British Medical Journal CME Clinical Review. 22 June 2013. Accessed: 24 January 2018.

  14. The anatomy of the normal placenta.” British Medical Journal: Journal of Clinical Pathology. 1 December 2008. Accessed: 24 January 2018.

  15. “Early pregnancy loss](https://reference.medscape.com/article/266317-overview#a9).” Medscape. 15 November 2017. Accessed: 19 April 2018.

  16. Office Management of Early Pregnancy Loss.” American Family Physician. 01 July 2011. Accessed: 24 January 2018.

  17. Ultrasound scans.” Miscarriage Association. 2018. Accessed: 24 January 2018.

  18. Fetal heart scanning in the first trimester.” Prenatal Diagnosis. 30 December 2004. Accessed: 24 January 2018.

  19. Expectant management of miscarriage.” Central Manchester University Hospital, NHS. October 2012. Accessed: 24 January 2018.

  20. Uses of Misoprostol in Obstetrics and Gynecology.” Reviews in Obstetrics and Gynecology. Summer 2009. Accessed: 24 January 2018.

  21. Medical miscarriage: information for patients.” Oxford Radcliffe Hospitals, NHS Trust. July 2010. Accessed: 24 January 2018.

  22. Surgical care of miscarriage under local anaesthetic using manual vacuum aspiration (MVA).” Guy’s and St. Thomas’s, NHS Trust. March 2016. Accessed: 24 January 2018.

  23. Dilation and Curettage (D&C).” The American College of Obstetrics and Gynecologists. February 2016. Accessed: 24 January 2018.

  24. The D&E for miscarriage.” Elizabeth Petrucelli. 2018. Accessed: 24 January 2018.

  25. Medical and psychological interventions after miscarriage and women's distress: a controlled study.” Kingston University London. 24 February 2012. Accessed: 24 January 2018.