If you would like to learn about the symptoms and diagnosis of miscarriage, and miscarriage treatment, you will find the following information of help.
About 1 in 4 pregnancies end in miscarriage. Always tell your doctor if you have symptoms of miscarriage - vaginal bleeding when you are pregnant. Call an ambulance if bleeding is severe.
What is a miscarriage?
Miscarriage is the loss of a pregnancy at any stage up to the 24th week. A loss after this time is called a stillbirth. Most occur before 13 weeks of pregnancy, but some occur later.
How common is miscarriage?
About 1 in 7 confirmed pregnancies end in miscarriage. But, the rate of miscarriage is much higher than this. As many as 1 in 4 pregnancies end in miscarriage. This is because in many cases a very early pregnancy ends before you miss a period, and before you are aware that you are pregnant.
The vast majority of women who miscarry go on to have a successful pregnancy next time. Recurrent miscarriages, that is 3 or more miscarriages in a row, occur in about 1 in 100 women.
What causes miscarriage?
It is thought that most early miscarriages are caused by a a 'one-off' chromosome fault. This is usually an isolated genetic mistake, and rarely occurs again.
There are other less common causes of miscarriage including: hormonal imbalance; abnormalities of the womb; weakness of the cervix; certain infections like listeria and rubella.
Investigations into the cause of a miscarriage are not usually carried out unless you have 3 or more miscarriages in a row. This is because most women who miscarry will not miscarry again. Even two miscarriages are more likely to be due to chance than to some underlying cause.
Some wrong ideas about the cause of miscarriage
After a miscarriage it is common to feel guilty and to blame the miscarriage on something you have done or failed to do. This is almost always not the case. In particular, miscarriage is not caused by lifting, straining or working, constipation or straining at the toilet, stress or worry, sex, eating spicy foods, or normal exercise. There are many such myths about the cause of miscarriage.
What is a 'threatened miscarriage'?
It is common to have some light vaginal bleeding sometime in the first 12 weeks of pregnancy. This does not always mean that you are going to miscarry. Often the bleeding settles and the the growing baby is healthy. This is called a 'threatened' miscarriage. You do not usually have pain with a threatened miscarriage. If the pregnancy continues, there is no harm done to the baby.
In some cases, a threatened miscarriage progresses to a miscarriage.
What are the symptoms of miscarriage?
The usual symptoms are vaginal bleeding and lower abdominal cramps. You then pass some 'tissue' from the vagina. In many cases, the bleeding then gradually settles. The time it takes for bleeding to go varies. It is usually a few days, but can last 2 weeks or more.
In most cases, the bleeding is heavy with clots, but not severe - more like a heavy period. However, it can be severe in some cases.
In some cases there are no symptoms. The baby dies, but remains in the uterus. You may have no pain or bleeding. This may not be found until you have a routine ultrasound scan.
Do I need to go to hospital?
You should always report any bleeding in pregnancy to your doctor. It is important to get the correct diagnosis as miscarriage is not the only cause of vaginal bleeding. If you bleed heavily, call an ambulance immediately.
Most women with bleeding in early pregnancy are seen by a doctor who specialises in pregnancy. It is usual to have an ultrasound scan. This helps to determine whether the bleeding is due to
- A 'threatened' miscarriage, (the baby will be seen to be alive).
- A miscarriage.
- Some other cause of bleeding (such as an ectopic pregnancy).
Do I need any treatment?
Once the cause of bleeding is known, and a miscarriage is confirmed, your doctor will advise on options.
For many years it was common to do a small operation to 'clear the uterus' (womb) following a miscarriage or partial (incomplete) miscarriage. The logic was that this would make sure all pregnancy tissue was gone, and may prevent infection or prolonged bleeding. However, there is little evidence that an operation is needed in most cases.
Many women now opt to 'let nature take its course'. In most cases the pregnancy tissue is passed out naturally and the bleeding will stop within a few days. An operation to 'clear the uterus' can still be an option if the bleeding does not stop within a few days, or if bleeding is severe.
Feelings
Many women and their partners find that miscarriage is distressing. Feelings of shock, grief, depression, guilt, loss, and anger are common.
It is best not to 'bottle up' feelings but to discuss them as fully as possible with husbands or partners, friends, or with a doctor or midwife, or with someone who can listen and understand. As time goes on, the sense of loss usually becomes less. However, the time this takes varies greatly. Pangs of grief sometimes recur 'out of the blue'. The time when the baby was due to be born may be particularly sad.
Further help
The Miscarriage Association
c/o Clayton Hospital, Northgate, Wakefield, West Yorkshire, WF1 3JS
Tel (Helpline): 01924 200799 Web: www.miscarriageassociation.org.uk
c/o Clayton Hospital, Northgate, Wakefield, West Yorkshire, WF1 3JS
Tel (Helpline): 01924 200799 Web: www.miscarriageassociation.org.uk
The Miscarriage Association is a national charity which supplies support and information on pregnancy loss. It co-ordinates a network of volunteer telephone contacts and support groups.
©EMIS and PIP 2004
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