Miscarriage

About miscarriage

Early miscarriage is when a woman loses her pregnancy in the first three months. It may be accompanied by vaginal bleeding and pain.

Many early miscarriages occur before a woman has missed her first period or before her pregnancy has been confirmed. Once you have had a positive pregnancy test, there is around a one in five (20%) risk of having a miscarriage in the first three months. Most miscarriages occur as a 'one-off' (sporadic) event and there is a good chance of having a successful pregnancy in the future.

What is the reason for a miscarriage?

Much is still unknown about why early miscarriages occur. The most common cause is chromosomal problems. Chromosomes are tiny thread-like structures found in all the cells of the body. In order to grow and develop normally a baby needs a precise number of chromosomes. If there are too few or too many chromosomes, the pregnancy may end in a miscarriage.

What is the risk of having a miscarriage?

The risk of miscarriage is increased by a woman's age - the risk of early miscarriage increases with age. At the age of 30, the risk of miscarriage is one in five (20%). At the age of 42, the risk of miscarriage is one in two (50%).

There is a link with health problems - as an example, poorly controlled diabetes can increase the risk of an early miscarriage. Lifestyle factors such as smoking and heavy drinking are linked with miscarriage.

There is no scientific evidence to show that stress causes a miscarriage.

Bleeding and pain in early pregnancy

Vaginal bleeding in early pregnancy is common and does not always mean there is a problem. However it can be a warning sign.

See your doctor or midwife if you:

  • experience bleeding
  • feel pain
  • stop feeling pregnant

How can I get help?

You can get medical help from:

  • your general practice, midwife or obstetrician
  • the A&E department at your local hospital
  • NHS 24 on 08454 24 24 24 (if you are in Scotland)
  • NHS Direct Online www.nhsdirect.nhs.uk
  • Early Pregnancy Assessment Unit.  Details of the unit nearest to you can be found at www.earlypregnancy.org.uk/FindUs1/asp

What happens if it is a miscarriage?

  • If the miscarriage has completed, you will not need any further treatment.
  • If the miscarriage has not completed, there is a range of options available.
    Your nurse or doctor will refer you to the nearest Early Pregnancy Assessment Unit. You can phone for yourself and ask for advice, too. There are over 200 Early Pregnancy Assessment Units (EPAUs) across the UK. Details of the unit nearest to you can be found at: www.earlypregnancy.org.uk/FindUs1.asp

What do I need to expect after a miscarriage?

  • To reduce the chance of infection, sanitary towels are advised rather than tampons until the bleeding has stopped.
  • You may also be advised to wait until you have stopped bleeding before you have sex.
  • Your next period will be in four to six weeks time. Ovulation occurs before this, so you are fertile in the first month after a miscarriage. If you do not want to become pregnant, you should use contraception.

Making sense of what has happened can take time. You and your partner should be offered a follow-up appointment with a member of the healthcare team. Many couples find talking helps and you may be given information about other sources of support.

Your feelings

Losing a pregnancy is a deeply personal experience that affects everyone differently. It can affect the woman, her partner and others in the family. Many women grieve, but come to terms with their loss. Other women feel overwhelmed and find it difficult to cope. Physical symptoms such as fatigue, loss of appetite, difficulty concentrating and trouble sleeping can be signs of emotional distress. Some women feel fine initially and only later do they experience difficulties.

You should be given all the time you need to grieve. Talking about how you feel with your healthcare professional can help. If you feel you need further assistance in coming to terms with your miscarriage, ask for a referral for support or counselling.

When can we try for another baby?

The best time to try again is when you and your partner feel physically and emotionally ready. If you are planning a pregnancy, you should have 400 micrograms daily of folic acid when you first start trying until 12 weeks of pregnancy. This reduces the risk of your baby being born with a neural tube defect (spina bifida).

You should get as healthy as you can before as well as during your next pregnancy. You should eat a healthy balanced diet, and not smoke. It is advisable to stay within the maximum recommended units of alcohol.