Miscarriage: signs, care and support

Bleeding in pregnancy needs checking, but it doesn’t always mean a miscarriage. Some losses cause cramps and bleeding. Others are found at a scan with no symptoms before. A check-up can help you find out what’s happening.

Get help for bleeding or pain

Call 999 now (UK) or 911 (US), or your local emergency number, for heavy bleeding in pregnancy. Call the same number if you could be pregnant and you have sudden severe tummy pain, pain at the tip of your shoulder, marked weakness or fainting. This applies even if you have no vaginal bleeding. The NHS describes heavy bleeding here as soaking a period pad soon after putting it on.

For light bleeding, spotting or fluid leaking from your vagina, get help today. In the UK, contact your maternity or early pregnancy unit, or NHS 111. In the US, contact your obstetric clinician. Elsewhere, contact your local pregnancy care service. Contact the same services for pain in early pregnancy. You can ask to be checked without knowing the cause.

What an assessment can involve

A clinician will ask about this pregnancy, any past pregnancies and your health. Tests may include an ultrasound scan and blood or urine tests. You may be offered an internal scan through the vagina. The clinician can explain what it involves before you agree.

Sometimes you need more scans or blood tests before a loss can be confirmed. Ask what the next appointment is for and when it will be. Ask too who to contact if your symptoms change while you wait.

The words used differ between countries. The NHS describes miscarriage as a pregnancy loss before 24 weeks. US MedlinePlus uses before the 20th week. Your loss matters, whichever word is used.

Why it happens

Often no clear cause is found. A common reason for early loss is a problem with the pregnancy’s chromosomes, which carry genetic information. Miscarriage is usually a random event.

Working, exercising, stress, arguments and sex don’t cause miscarriage. Taking the contraceptive pill before you got pregnant doesn’t cause it either. None of these everyday things is a reason to blame yourself.

Care after a loss is confirmed

For an early miscarriage, the team may offer three options. You can wait for the pregnancy tissue to pass naturally, take medicine to help it pass, or have a procedure to remove it from the womb. The choice depends on your symptoms, how far along the pregnancy was and what you prefer. If the miscarriage is complete, you may not need any more treatment.

Waiting is a care plan with follow-up. Ask what bleeding and pain to expect, and what happens if the plan doesn’t work for you. Medicine can cause bleeding and cramps too. Your doctor or pharmacist can advise about the medicines you’re prescribed and pain relief.

Surgery may be advised urgently for heavy bleeding that won’t stop, or for infection. A later miscarriage may involve labour and birth, with support from a care team. Ask the team to explain the options clearly, and to go over them again if you need.

Follow-up and emotional support

Follow the care team’s plan for checking that the miscarriage is complete. This may include a pregnancy test, scan or blood test. For fever, chills or bad-smelling discharge after a loss, get help now. Contact your pregnancy unit, GP or NHS 111 (UK), obstetric clinician (US), or local urgent care service. Call 999 now (UK) or 911 (US), or your local emergency number, for heavy bleeding, severe pain or feeling very unwell after a loss. Call for severe pain or feeling very unwell even if you have no vaginal bleeding.

Grief can last longer than physical recovery. A partner may grieve too, and may show it differently. If you are struggling, ask about counselling. In the UK, ask your GP or pregnancy team. Elsewhere, ask your doctor. You can ask for support whatever you decide about another pregnancy.

For urgent mental health support in England, call NHS 111 and choose the mental health option. Elsewhere, contact your local urgent mental health service. In the UK, you can call Samaritans on 116 123. In the US, call or text 988.

Call 999 now (UK) or 911 (US), or your local emergency number, if you can’t keep yourself safe or a life is in immediate danger.