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Although miscarriages are very common in women, there is still a very strong stigma and a lot of mothers get blamed for the depressing situation. This is bad enough as the mothers are most likely already ridden with guilt and sadness.
Miscarriages are of no fault of the mother and the majority of women do not get a diagnosed cause for the loss. Understanding more about what a miscarriage is, its symptoms and ways to cope after one will help a mother believe she’s not at fault and should speed up the healing process.
Miscarriage is the unintentional loss of a baby before the 20th week of pregnancy. It is also referred to as a spontaneous abortion. Most miscarriages occur in the first 13 weeks, often before a woman knows she’s pregnant. It’s estimated that 15%-25% of pregnancies end in miscarriage.
If a baby dies after the 20th week, it’s called a stillbirth, with about 24,000 cases each year in the United States. Worldwide, nearly 2 million babies are stillborn annually, many preventable. However, miscarriages and stillbirths are not always recorded, suggesting higher actual numbers as access to healthcare varies globally, with many hospitals and clinics under-resourced and understaffed.
If a miscarriage occurs within the first trimester, it is also referred to as an early miscarriage and if it occurs between the second trimester, before the 20th week, it is referred to as a late miscarriage. Early miscarriage can be classified into various types:
According to the National Health Service, the most common sign of a miscarriage is vaginal bleeding, though light vaginal bleeding in the first trimester doesn’t always indicate a miscarriage. This bleeding can range from light spotting or brownish discharge to heavy bleeding with bright-red blood or clots, and it may come and go over several days. Other symptoms include:
In a study, some women reported causes for their miscarriages, such as antiphospholipid syndrome (where the immune system attacks blood fats, causing clots and pregnancy issues) (6.8%) and chromosomal abnormalities (6.5%). However, 77.5% of women were not given a cause. Most miscarriages (about 3 out of 4) occur in the first trimester due to foetal issues. Miscarriages after the first trimester are often due to maternal health problems.
Chromosomal abnormalities: Chromosomes are DNA structures that hold detailed instructions for various traits, from cell development to eye colour. Sometimes, during conception, the foetus might receive an abnormal number of chromosomes, leading to developmental issues and miscarriage. The exact cause is often unknown. However, this is usually a one-time occurrence and does not imply any inherent problems with either parent.
Maternal health conditions: Certain maternal medical conditions, like fibroids, or thyroid issues, may result in miscarriage. Additionally, rare disorders affecting blood clotting can also contribute to miscarriage risk. Women experiencing three or more consecutive miscarriages should undergo evaluation for these conditions, which may include:
Miscarriages can be distressing. While it is usually caused by genetic abnormalities, other factors can increase the risk and understanding these factors helps in ensuring a healthy pregnancy.
Miscarriages can occur even in healthy women, but good health can enhance your chances of a successful pregnancy. If you’ve had a previous miscarriage, your next pregnancy will likely be normal. However, if you’ve had three consecutive miscarriages, further testing is advised.
Although preventing a miscarriage isn’t always possible, it’s crucial to focus on self-care and looking after your baby. Here are some tips for a healthy pregnancy:
When facing the possibility of a miscarriage, healthcare providers employ various tests to assess the situation and provide guidance. These tests provide valuable insights for both diagnosis and management, guiding healthcare professionals in providing appropriate care and support to individuals experiencing a potential miscarriage.
These are commonly used to measure the level of human chorionic gonadotropin (hCG), a hormone produced during pregnancy. Changes in hCG levels, particularly if they are low or declining, can indicate a potential miscarriage. Additionally, blood type may be checked, especially if the individual is Rh-negative, to determine the need for Rh (rhesus) immunoglobulin treatment.
These checks are done to see if the cervix is starting to open, which could mean a miscarriage might happen. During a pelvic exam, the healthcare provider looks at the cervix to see if it’s dilating too soon. Finding this early helps them keep a close eye on the pregnancy and take steps to prevent problems.
Ultrasounds are important during pregnancy to check the baby’s heartbeat and growth. They use sound waves to create pictures of the foetus and womb, helping doctors monitor the pregnancy’s health and development. The ultrasound can also assess if your cervix is weakened. Typically, this test is done during a subsequent pregnancy, and you’ll likely be scheduled for a scan around 10 to 12 weeks into your pregnancy.
If tissue is passed during vaginal bleeding, laboratory tests may be done on the tissue to confirm a miscarriage and rule out other causes. Also, chromosomal tests might be suggested for those who have had repeated miscarriages to find genetic factors that could raise the risk of miscarriage.
These are commonly used to measure the level of human chorionic gonadotropin (hCG), a hormone produced during pregnancy. Changes in hCG levels, particularly if they are low or declining, can indicate a potential miscarriage. Additionally, blood type may be checked, especially if the individual is Rh-negative, to determine the need for Rh (rhesus) immunoglobulin treatment.
These checks are done to see if the cervix is starting to open, which could mean a miscarriage might happen. During a pelvic exam, the healthcare provider looks at the cervix to see if it’s dilating too soon. Finding this early helps them keep a close eye on the pregnancy and take steps to prevent problems.
Ultrasounds are important during pregnancy to check the baby’s heartbeat and growth. They use sound waves to create pictures of the foetus and womb, helping doctors monitor the pregnancy’s health and development. The ultrasound can also assess if your cervix is weakened. Typically, this test is done during a subsequent pregnancy, and you’ll likely be scheduled for a scan around 10 to 12 weeks into your pregnancy.
If tissue is passed during vaginal bleeding, laboratory tests may be done on the tissue to confirm a miscarriage and rule out other causes. Also, chromosomal tests might be suggested for those who have had repeated miscarriages to find genetic factors that could raise the risk of miscarriage.
After a miscarriage, women often feel intense emotions like grief, anger, guilt, and depression, worsened by hormonal changes. Anxiety and distress are also common and can continue into future pregnancies. Even early miscarriages can create a strong emotional bond, adding to the pain.
According to the American Pregnancy Association, the following are common stages which may be experienced during grief:
This is the first stage of grief. You might find it hard to accept what’s happening, questioning if the doctors could be wrong or if there’s still hope. Discussing the physical aspects with your doctor, such as when hormone levels will return to normal, can provide clarity and help you prepare for what’s ahead.
To balance hormone levels naturally, eat well, exercise, get enough sleep, manage stress, stay hydrated, and avoid toxins. Include healthy fats, consider herbal supplements with a doctor’s advice, and limit sugar and refined carbs. Always consult a healthcare professional for guidance.
This is the second stage of grief. Feelings of anger may arise, directed at various targets including yourself, your partner, or even a higher power. You may blame yourself and question if you could have done more.
Remember, miscarriage is often a natural occurrence, and it’s not your fault. Seeking support from loved ones, counsellors, or writing down your feelings can help manage these emotions.
This is the third and final stage of grief. Acceptance doesn’t mean you’re okay with what happened, but rather acknowledging the reality of the situation. This stage allows you to seek help, join support groups, or share your experience with others.
Keep in mind that each step in the grieving process takes time, allow yourself to feel the emotions rather than suppressing them.
The primary goal of treatment during or after a miscarriage is to prevent haemorrhaging and infection. Here are the steps and options for managing a miscarriage and medical interventions:
Expulsion of pregnancy tissues: Early in the pregnancy, your body may naturally expel all foetal tissue without needing further medical intervention. If not all tissue is expelled, Dilation and Curettage (D&C) might be suggested, a common procedure to stop bleeding and prevent infection. Medications may be prescribed post-D&C to help control bleeding. Monitor bleeding closely at home, and contact your physician immediately if you notice an increase or experience chills or fever.
Rest and Monitoring: If there is vaginal bleeding but lab tests and ultrasound show the pregnancy is intact, your healthcare provider may recommend rest and close monitoring for further bleeding. Additional hCG blood tests and ultrasounds may be done to check the foetus’s growth and heartbeat.
Medical Treatment: Medical management involves using medications like misoprostol to aid in the expulsion of pregnancy tissue, while a combination of mifepristone and misoprostol can be more effective, reducing the need for surgical intervention. Another option is to use misoprostol or prostaglandin to open the cervix and assist the uterus in expelling the foetus and tissues. These methods are typically recommended for miscarriages occurring in the first trimester or after 20 weeks.
Expectant Management: This form of miscarriage management involves allowing the miscarriage to occur naturally with frequent check-ups. It should occur typically within a few weeks but possibly up to eight weeks. If the pregnancy tissue isn’t passed, medical or surgical treatment will be necessary.
Surgical Management: Pregnancy tissues may undergo genetic or chromosomal testing in a laboratory. Surgical intervention becomes necessary in the presence of heavy bleeding or signs of infection. Antibiotics are prescribed in cases of infection. A minor surgical procedure known as suction dilation and curettage (D&C) is performed to remove tissue from the uterus, utilising either suction or a curette. Anaesthesia is administered for pain relief during the procedure.
If you notice signs of infection like fever or increased bleeding at any stage, it’s important to contact your healthcare provider right away for help.
Dealing with the loss of a baby due to a miscarriage can be incredibly challenging, but there are strategies to help cope with this difficult experience:
Miscarriages in the first trimester are often caused by chromosomal abnormalities and are not due to anything the mother did. Remind yourself that most of the time, there’s no medical explanation for the miscarriage, and focus on processing your emotions instead of blaming yourself.
Losing a pregnancy can trigger intense feelings of guilt and sorrow, which may intensify on significant dates like the miscarriage anniversary or the baby’s due date. Do not hold back emotions and allow yourself to mourn the loss of your baby along with the dreams you had for them.
Reach out to friends and family for support during this challenging time. Consider joining a support group for parents who have experienced similar losses. Talking to others who understand your emotions can provide comfort and help you navigate through feelings of guilt and grief.
Experiencing one miscarriage doesn’t mean you won’t have a healthy pregnancy in the future. Do not give up on the hope of having a child and discuss any concerns with your doctor. Make sure you continue taking care of yourself to minimise stress and promote overall well-being.
Even though they mean well, some comments from friends and family might unintentionally upset you. For example, phrases like “you’ll have another child” can sometimes feel distressing. It’s important to understand that these remarks are meant to be supportive, even if they don’t always come across that way.
Engage in activities that help you remember and honour the life of your lost baby, such as naming them, establishing anniversary rituals, or holding memorial services. Focus on what brings you comfort and solace, rather than adhering to others’ expectations. You might want something tangible to remember your baby by. Some hospitals provide a certificate for this.
Healing from a miscarriage takes time, and it’s important to allow yourself the space to grieve and mourn. Be patient with your emotions and allow yourself to heal at your own pace. If you’re struggling to cope after two months or more, consider seeking professional help from a doctor or therapist to develop a support and treatment plan for depression or other challenges you may be facing.
Miscarriages in the first trimester are often caused by chromosomal abnormalities and are not due to anything the mother did. Remind yourself that most of the time, there’s no medical explanation for the miscarriage, and focus on processing your emotions instead of blaming yourself.
Losing a pregnancy can trigger intense feelings of guilt and sorrow, which may intensify on significant dates like the miscarriage anniversary or the baby’s due date. Do not hold back emotions and allow yourself to mourn the loss of your baby along with the dreams you had for them.
Reach out to friends and family for support during this challenging time. Consider joining a support group for parents who have experienced similar losses. Talking to others who understand your emotions can provide comfort and help you navigate through feelings of guilt and grief.
Experiencing one miscarriage doesn’t mean you won’t have a healthy pregnancy in the future. Do not give up on the hope of having a child and discuss any concerns with your doctor. Make sure you continue taking care of yourself to minimise stress and promote overall well-being.
Even though they mean well, some comments from friends and family might unintentionally upset you. For example, phrases like “you’ll have another child” can sometimes feel distressing. It’s important to understand that these remarks are meant to be supportive, even if they don’t always come across that way.
Engage in activities that help you remember and honour the life of your lost baby, such as naming them, establishing anniversary rituals, or holding memorial services. Focus on what brings you comfort and solace, rather than adhering to others’ expectations. You might want something tangible to remember your baby by. Some hospitals provide a certificate for this.
Healing from a miscarriage takes time, and it’s important to allow yourself the space to grieve and mourn. Be patient with your emotions and allow yourself to heal at your own pace. If you’re struggling to cope after two months or more, consider seeking professional help from a doctor or therapist to develop a support and treatment plan for depression or other challenges you may be facing.
Recurrent miscarriages, meaning two or more pregnancy losses in a row, can happen due to different reasons. These include chromosomal issues, hormone imbalances, problems with the uterus or cervix, thyroid troubles, and medical conditions like diabetes. Infections and lifestyle choices like smoking, drinking too much alcohol, or being overweight can also play a role. Seeing a doctor for tests can help find out why this is happening and what can be done about it.
The timing for trying to conceive again after a miscarriage varies for each person and depends on emotional and physical recovery. Healthcare providers usually recommend waiting one or two menstrual cycles for the body to heal and hormone levels to normalise. However, recent research shows that couples can try to conceive as soon as they feel emotionally and physically ready.
Lifestyle changes can boost your chances of a healthy pregnancy. Ensure your diet includes a variety of fruits, vegetables, proteins, and whole grains. Stay active with regular exercise, steer clear of cigarettes, alcohol, and drugs, keep stress under control, and prioritise getting enough sleep and staying hydrated. Take your multivitamins, go for regular prenatal check-ups, and talk to your doctor about any concerns.
Stress and anxiety don’t directly cause miscarriages, but they can affect overall health and fertility. It’s important to manage stress through exercise, relaxation techniques, therapy, and support from others. If stress feels overwhelming, consider seeking professional help.
A healthy diet is important to reduce the risk of miscarriage. If you are pregnant, you should eat a variety of nutritious foods, such as fruits, vegetables, whole grains, lean proteins, and dairy products. Avoid eating risky foods like raw or undercooked meats, unpasteurized dairy products, fish high in mercury, and too much caffeine. Staying hydrated and following food safety guidelines can also help prevent foodborne illnesses and reduce miscarriage risk.
Recurrent miscarriages, meaning two or more pregnancy losses in a row, can happen due to different reasons. These include chromosomal issues, hormone imbalances, problems with the uterus or cervix, thyroid troubles, and medical conditions like diabetes. Infections and lifestyle choices like smoking, drinking too much alcohol, or being overweight can also play a role. Seeing a doctor for tests can help find out why this is happening and what can be done about it.
The timing for trying to conceive again after a miscarriage varies for each person and depends on emotional and physical recovery. Healthcare providers usually recommend waiting one or two menstrual cycles for the body to heal and hormone levels to normalise. However, recent research shows that couples can try to conceive as soon as they feel emotionally and physically ready.
Lifestyle changes can boost your chances of a healthy pregnancy. Ensure your diet includes a variety of fruits, vegetables, proteins, and whole grains. Stay active with regular exercise, steer clear of cigarettes, alcohol, and drugs, keep stress under control, and prioritise getting enough sleep and staying hydrated. Take your multivitamins, go for regular prenatal check-ups, and talk to your doctor about any concerns.
Stress and anxiety don’t directly cause miscarriages, but they can affect overall health and fertility. It’s important to manage stress through exercise, relaxation techniques, therapy, and support from others. If stress feels overwhelming, consider seeking professional help.
A healthy diet is important to reduce the risk of miscarriage. If you are pregnant, you should eat a variety of nutritious foods, such as fruits, vegetables, whole grains, lean proteins, and dairy products. Avoid eating risky foods like raw or undercooked meats, unpasteurized dairy products, fish high in mercury, and too much caffeine. Staying hydrated and following food safety guidelines can also help prevent foodborne illnesses and reduce miscarriage risk.
1. American College of Pediatricians. ‘Coping with a Miscarriage’. December, 2019.
2. American Pregnancy Association. ‘Signs of Miscarriage’.
3. American Pregnancy Association. ‘Miscarriage: Surviving Emotionally’.
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5. Mayo Clinic. ‘Miscarriage: Diagnosis and Treatment’. September, 2023.
6. National Health Service. ‘Miscarriage Symptoms’. March, 2022.
7. Northwestern Medicine. ‘How to Cope After Miscarriage’. April, 2024.
8. Stanford Children’s Health. ‘Miscarriage Overview’.
9. Taybeh, E., Hamadneh, S., Al-Alami, Z. et al. Navigating miscarriage in Jordan: understanding emotional responses and coping strategies. BMC Pregnancy Childbirth 23, 757 (2023).
10. The Women’s. ‘Miscarriage’.
11. University of North Carolina at Chapel Hill. ‘What are some ways of coping with a miscarriage?’. April, 2023.
12. World Health Organization. ‘Why We Need to Talk About Losing a Baby’.
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