Miscarriage: Symptoms, Causes, and Treatment

A miscarriage is when a pregnancy ends on its own before the 20th week. It's more common than many realize — about 10-20% of known pregnancies end this way. Most happen because of random problems with the baby's chromosomes that prevent normal growth. You didn't cause it, and usually nothing could have stopped it. Bleeding and cramps are common signs, but always check with your doctor to be sure.

In plain words

A miscarriage is when a pregnancy ends on its own before 20 weeks. It happens in about 1 out of 5 known pregnancies. Most miscarriages occur because of problems with the baby's chromosomes that happen by chance. You did not cause it, and it usually could not have been prevented. Signs include bleeding and cramps. Always talk to your doctor if you have these symptoms.

What is Miscarriage: Symptoms, Causes, and Treatment?

A miscarriage is when a pregnancy ends on its own before the 20th week. It's more common than many realize — about 10-20% of known pregnancies end this way. Most happen because of random problems with the baby's chromosomes that prevent normal growth. You didn't cause it, and usually nothing could have stopped it. Bleeding and cramps are common signs, but always check with your doctor to be sure.

Symptoms

Early symptoms

  • Vaginal bleeding: Light spotting or heavier bleeding, often with clots. May start suddenly or come and go over several days. The blood might be pink, red, or brown. (2) (6)
  • Cramping or pain: Pain in your lower belly that feels like strong period cramps. Some notice it in their back or pelvis instead. May be constant or come in waves. (2) (6)
  • Passing tissue or fluid: You might pass clumps of tissue or grayish material from your vagina. This is pregnancy tissue coming away. Not everyone sees this sign. (2)
  • Less pregnancy nausea or sore breasts: Some notice their usual pregnancy symptoms like morning sickness or breast tenderness suddenly get better before other signs appear. (8)

Serious or emergency symptoms

  • Very heavy bleeding: Soaking through a maxi pad in an hour or less for several hours in a row. This much blood loss can make you feel dizzy or faint and needs immediate medical care. Go to the emergency room if bleeding this heavily. (2)
  • High fever or chills: A temperature over 100.4°F (38°C) with pain could mean you have an infection in your uterus. This is serious and needs treatment right away. Call your doctor immediately or go to urgent care. (2)
  • Severe pain not helped by painkillers: Bad pain in your belly or pelvis that doesn't ease with ibuprofen or similar medications could signal an ectopic pregnancy or other problem. Seek emergency medical care. (6)

Causes

Primary causes

  • Chromosome problems in the baby: About half of miscarriages happen because the baby had extra or missing chromosomes — random mistakes in how cells divided very early on. This prevents normal growth. (1) (3)
  • Physical issues with the uterus: An unusually shaped uterus or weak cervix might lead to miscarriage later in pregnancy. Fibroids or scarring from past surgeries can also sometimes cause problems. (1) (8)
  • Usually not caused by everyday activities: Work, exercise, sex, or minor falls don't typically cause miscarriage. Even stress and diet don't usually play a role unless they're extreme. Most happen because of factors the mother couldn't control. (3) (8)

Risk factors

Age over 35

Women 35-45 have a 20-35% chance of miscarriage per pregnancy. After 45, it rises to around 50%. This is because older eggs are more likely to have chromosome errors. (3) (8)

Previous miscarriages

Having one miscarriage raises the risk slightly for future pregnancies. After 3 or more miscarriages, the rate increases more — about 40-60% for another one in the next pregnancy. (1) (8)

Chronic illnesses

Diabetes that's not well-controlled, thyroid disorders, lupus, or other health conditions can raise the chance of miscarriage. The risk is lower when these conditions are properly treated. (3) (8)

Diagnosis

Doctors usually diagnose miscarriage with an ultrasound to check the baby's heartbeat and your uterus. They may also do blood tests to check your pregnancy hormone (hCG) levels over several days. Some need a physical exam to see if the cervix has started to open. Expect your doctor to ask when your symptoms started and how they've changed. These steps help confirm if the pregnancy can continue or if a miscarriage is happening. It may take more than one visit to be sure.

Ultrasound scan

Checks for a fetal heartbeat and measures the baby's size to confirm it matches how far along you are in pregnancy. May be done through the belly or inside the vagina. (4)

Blood tests (hCG levels)

Measures pregnancy hormone levels over 2-3 days to see if they're rising normally (which suggests pregnancy is viable) or dropping (indicating miscarriage). (4)

Pelvic exam

Lets the doctor see if your cervix has started to open, which suggests the body is starting the miscarriage process. (6)

Treatment

Medication options

Misoprostol (Cytotec)

Helps the uterus pass pregnancy tissue with fewer complications than waiting for it to happen on its own. Often used when the body doesn't miscarry completely on its own. (5) (6)

Pain relief medications

Eases cramping during and after the miscarriage. Ibuprofen works well for many, but your doctor can suggest other options if the pain is severe. (5)

Lifestyle and self-care

  • Physical recovery time: Plan to rest for at least a few days afterward. Bleeding may last 1-2 weeks. Avoid tampons, swimming, and sex until your doctor says it's okay to prevent infection. (5)
  • Emotional support options: Consider joining a support group where others share similar experiences. Many hospitals and organizations offer free counseling for pregnancy loss. (7)
  • Communicating about your loss: Only share with people when you're ready. There's no right or wrong way to process grief after a miscarriage. Some find comfort in rituals like naming the baby or planting a memorial. (7)

Always discuss dosing and treatment changes with your own prescriber.

Possible complications

  • Infection (septic miscarriage): If tissue stays in the uterus too long, it can lead to dangerous infection with fever, smelly discharge, and worsening pain. Needs prompt treatment with antibiotics and sometimes surgery. (7)
  • Asherman's syndrome: Rare scarring inside the uterus after a D&C procedure can make periods lighter or affect future fertility. Most cases can be treated with minor surgery to remove the scarring. (7)
  • Prolonged grief or depression: One in four women reports lasting sadness after miscarriage. If grief interferes with daily life for months, ask your doctor about counseling or support groups for pregnancy loss. (7)

When to see a doctor

Routine follow-up

  • Call your doctor about any bleeding during pregnancy, even if it's light. They'll help determine if it could be a threat to the pregnancy or early miscarriage. (2)

Seek emergency care

  • Go straight to the emergency room or call an ambulance if you're bleeding enough to soak two maxi pads per hour for 2+ hours or feel faint from blood loss. (2)
  • Seek emergency care for fever over 100.4°F with abdominal pain during or after miscarriage — this could mean a dangerous infection that needs prompt treatment. (6)

Frequently asked questions

What causes miscarriage?

Most miscarriages happen due to random chromosome problems in the baby that prevent normal growth. These aren't inherited or caused by anything the mother did. Less often, physical issues with the uterus or chronic illnesses play a role. (1) (3)

How soon can I try to get pregnant again after a miscarriage?

Many doctors suggest waiting until after one normal period (about 4-6 weeks) to let your body fully recover physically and make dating easier for the next pregnancy. But medically, you can often try whenever you feel emotionally ready. (7)

Can stress cause a miscarriage?

No research proves everyday stress leads to miscarriage. The extreme physical stress of serious trauma might in rare cases, but normal worries about work, arguments, or life events don't increase the risk. (3)

Will one miscarriage affect my future pregnancies?

One miscarriage doesn't usually mean future problems — about 85% of women who miscarry once go on to have a healthy pregnancy later. However, tell your doctor about any past miscarriages so they can monitor you more closely. (1) (7)

How long does a miscarriage take?

It varies. Some finish in hours, while others take weeks for the body to fully pass all tissue. Doctors may suggest waiting a set time, then recommend medication or a procedure if it doesn't complete naturally to prevent complications. (5)

References

  1. CDC — About Miscarriage source 1
  2. NHS — Miscarriage Symptoms source 2
  3. NHS — Miscarriage Causes source 3
  4. NHS — Miscarriage Diagnosis source 4
  5. NHS — Miscarriage Treatment source 5
  6. MedlinePlus — Miscarriage source 6
  7. Mayo Clinic — Miscarriage Emotional Recovery source 7
  8. Mayo Clinic — Miscarriage Causes and Risk Factors source 8