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A miscarriage is the loss of a pregnancy that happens sometime during the first 20 weeks. A miscarriage obviously comes as a terrible and unexpected shock to most women. Unfortunately it is all too common. It happens in about 10-20 % of women once they realise they pregnant. Around three quarters of miscarriages happen during the first 12 weeks of pregnancy (the first trimester). The incidence decreases after 12 weeks to low single figures – so it is relatively rare after this stage. 

Symptoms of miscarriage

A miscarriage usually starts with some bleeding. This is followed by bad period pains and usually needs urgent medical attention and assessment. If you think you are miscarrying then you should call your GP or midwife (if you already have one). They will instruct you on what to do next. If you are closer to 12 weeks, you will probably be asked to go into hospital for a scan.

The causes of miscarriage

The causes of a miscarriage are often undetermined. Often they can be due to abnormalities in the baby such as chromosomal problems. Sometimes they’re due to diseases of mother or anatomical problems in the pelvis. Other causes may be subtle immunological and clotting problems. The incidence of miscarriage also increases with the age of mother.

The diagnosis is usually made by a scan and examination. Occasionally, a miscarriage is not detected until the 12 week scan. This is because there has been no bleeding and no other signs to suggest that the pregnancy has ended. This can be particularly distressing and is called “a missed miscarriage”.

Treating a miscarriage

Once the diagnosis is made there are several choices. The conventional method is to have short operation to empty the womb. This is a very safe and short procedure usually done under a short general anaesthetic. This is called an evacuation of retained products of conception (ERPC).

Alternatives to this procedure include a medically induced procedure which is often supervised in hospital or over phone at home. You will be given 2 courses of tablets. The first course is to switch off the pregnancy hormones and facilitate the action of the second course of tablets. The second course will give you contractions which will cause the cervix to open and the womb to expel the tissue. The tablets work pretty quickly, within a few hours and you may feel like you are having a very heavy period with some cramping and heavy bleeding. You are unlikely to see anything that is recognisable, just clots and tissue. The bleeding may last up to 3 weeks. 

Alternatively the most conservative approach is to wait for a natural miscarriage. The results of this will also be like having a heavy and painful period, and again, bleeding can last for up to 3 weeks. For more than half of miscarriages, this method is unsuccessful in removing foetal tissue. In this situation, you will need either medication or surgery. 

These last 2 options are a little unpredictable and occasionally bleeding can be heavy and distressing and need emergency treatment.

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After a Miscarriage


Recurrent miscarriages are rare and the chances of a successful pregnancy the next time are usually unaltered by having one or two miscarriages. Occasionally, after miscarriages, if the cause is known or suspected, then treatment with hormones or special procedures such as a stitch in cervix may be necessary in future pregnancies.

A miscarriage does not normally seriously affect a woman’s physical health. However, it can have a significant emotional impact. Many women and even men can experience feelings of loss and grief, particularly if the miscarriage occurs during a first pregnancy. If you find you are having difficulty coping after a miscarriage you should speak to your GP who can help you by perhaps organising some counselling.

Sex after a Miscarriage

You should not have sex until all of your miscarriage symptoms such as bleeding and pain have gone. If you do not want to get pregnant again soon you should use contraception every time you have sex.

You should get a period within four to eight weeks of your miscarriage. However it may take several months to settle into a regular cycle. If you would like to get pregnant again, there is no reason why you cannot try as soon as you feel psychologically and physically able to do so.

A Chemical Pregnancy

A chemical pregnancy is one that has never been confirmed clinically, by blood tests or scans and that results in an early miscarriage in about the 5th week, or a week after your missed period.

For example, you may do a pregnancy test that gives a positive result, yet start to bleed a few days later.

For many women who are trying to conceive, this is as devastating as any miscarriage. One day they think they are pregnant and the next day they are no longer.

The causes are thought to be the same as an ordinary miscarriage.  Noone knows how common they are as some women who are perhaps not trying to conceive or who do not watch they cycles closely may experience these without noticing.

A Story of a Miscarriage at 6 Weeks

I knew I was pregnant as I have only ever had heartburn once before – when I was pregnant with my first baby. So I took a test 9 days after ovulation and got a very very faint line. I knew how many days Post Ovulation I was as I had been doing Ovulation tests at home. I then had some dark brown bleeding on the 11th day. This lasted one day and the next day I had a tiny bit of pink bleeding. Very light pink and that was just a wipe.

Obviously I was very concerned, probably more so since I did not experience any bleeding in my first pregnancy. I did a pregnancy test everyday. For about 3 days the line was not getting any darker. Eventually it did get darker until it was darker than the control line. I felt more confident about things.

An early trans-vaginal scan

That said, I decided to have an early trans-vaginal scan to see how things were looking. I went on what should have been (according to my ovulation dates) 6 weeks and 3 days. Whilst there was a sac, and fetal pole (heartbeat) the sonographer was slightly concerned that the baby was only measuring 5 weeks something… I knew that this was not possible as I was 100% sure of my dates. I was obviously very worried but hoped that it was just a mistake with the measurements. This apparently can happen at this early stage. I asked my GP for a referral to get a scan 2 weeks later.

During this 2 weeks, I didn’t feel pregnant at all. I didn’t have full or painful breasts like last time. Whilst morning sickness appeared, it was in no way as bad as I had it before. I didn’t have any more bleeding, but at the same time, I didn’t have any symptoms at all. Even though you are told that each pregnancy is different, it’s very hard not to compare with the last time.

Finding out about the miscarriage

After 2 weeks I went for another trans-vaginal scan at which point I should have been 8 weeks 4 days. But the sonographer said that the sac and baby were measuring 6 weeks. I knew that meant bad news.

Also she didn’t immediately say that there was a heartbeat. Looking back I should have noted as that’s something they like to confirm asap. So I asked her if there was a heartbeat and she said that there wasn’t. She said the baby had probably stopped developing at about 6 weeks.

I was obviously devastated as was my husband. It’s a horrid feeling. Lying there with your pants down and legs apart with some nice woman apologising to you and saying how sorry she is for your loss. I just wanted to say thanks and get up and leave and go and have a meltdown on our own. But we had to stay and wait for a room to become available so that we could talk to a nurse about our options.

Talking through the options

The nurses were very sympathetic and talked us through our options:

  1. Wait for the miscarriage to occur naturally. There is no telling how long this might take. It would involve some heavy bleeding with clots sometimes as big as your hand. It also comes with significant pain (intense period pains).
  2. ERPC (Evacuation of Retained Products of Conception) which is done under a general anaesthetic.

The thing that I found the hardest was that they do expect you to make the decision there and then. I couldn’t do it! Thankfully, they were happy for me to call them later in the day with my decision. It’s a lot to take in. To find out that you have lost your baby, and then to have to decide what to do immediately. There’s so little time to digest the information which I found to be really tough.

Having an ERPC

We decided to have the ERPC as we both wanted to have some kind of closure. We wanted to be able to move on and start again. Also, I knew someone who had gone through the process naturally and they said it was extremely traumatic. Given the choice again they would have had the ERPC. Also I was working and have a 12 month old daughter… We had to consider all of that before we came to a decision.

The process was very straightforward. The procedure itself actually only takes 5 minutes. However, you are normally under for about 45 mins to an hour. I came round in tears. It was almost automatic and I was obviously distressed, although I wasn’t conscious of being so.  I was given some painkillers and some antibiotics to take. My recovery was very quick. I had very light bleeding with some cramps for about 4 days and then heavier bleeding for about 5 or 6 days. It was like a medium period, dark red blood. You can’t wear a tampon and you are not meant to swim whilst you are still bleeding.

After the miscarriage

You are asked to take a pregnancy test 3 weeks after the procedure to make sure there are no retained products. If you get flu like symptoms or very heavy bleeding with clots you are advised to seek immediate medical help.

It took a long time to get my head around not being pregnant. You spend all that time thinking about BEING pregnant. It feels like a bad dream. But talking to people about it really helped, although initially I asked my husband to tell people as I didn’t want to talk to anyone apart from close family. I couldn’t bear to tell people. At the same time I wanted them to know to save their own embarrassment. My worst fear would have been for people (that knew I was pregnant) to ask how I was feeling and for me to have to tell them we lost the baby. Everybody would feel awful!

Going forwards we are both realistic about why this happened; we understand that it was for a reason. I am looking forward to moving on and trying for a baby again. I realise that this is incredibly common and one of those things that happen to people. You just never think it will happen to you.

A Story of a Miscarriage at 16 Weeks

I had been well all during this, my 4th pregnancy, with no worries. I had some spotting but I’d had with both the girls throughout. My first pregnancy had ended with a miscarriage just before 12 weeks. I had found it very upsetting, as I had no idea whether I would ever be able to have babies. Luckily I got pregnant again very quickly and had two healthy babies within 18 months!

When I was 15 weeks I spent a week by the sea with the two girls and my mother. At the weekend my husband came down to stay and I became unwell. I had a slight fever,  headache and aching limbs. But this only lasted for 24 hours and then all was well again.

Discovering the miscarriage

Halfway through the week I returned to London for my antenatal appointment. To our horror, my obstetrician was unable to find a heartbeat. 

A scan confirmed that there was no live pregnancy. I went straight to hospital, and had an ERPC that evening and went home the next day.

It had been quite a shock as I had not felt “unpregnant” and the whole thing was quite a mystery. This all happened in the 1980s. Only a bit later did it appear that there might be a link between Listeria and miscarriage, and that this might be linked to certain foods, such as pates, unpasteurised cheese etc so we think perhaps this was the cause. 

While we were very sad that this pregnancy came to such an unexpected end, we were grateful that we still had our lovely girls. We felt that even if there were to be no more babies, we had been lucky.  However, I happily went on to have a son a year later.

You may like to read these reader questions related to Miscarriage.

Trying to Conceive After a Miscarriage.  How long should I wait?

Missed Miscarriage – Have I got Retained Products?

Miscarriage but a Positive Pregnancy Test?

Do I need to take Extra Folic Acid after 3 Miscarriages?

other articles you might be interested in:

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