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This topic is about the
loss of a baby before 20 weeks of pregnancy. For information about the loss of
a baby after 20 weeks of pregnancy but before the baby is born, see the topic
A miscarriage is the loss
of a pregnancy during the first 20 weeks. It is usually your body's way of
ending a pregnancy that has had a bad start. The loss of a pregnancy can be
very hard to accept. You may wonder why it happened or blame yourself. But a
miscarriage is no one's fault, and you can't prevent it.
Miscarriages are very common. For women who already know they are pregnant,
about 1 out of 6 have a miscarriage.footnote 1 It is also
common for a woman to have a miscarriage before she even knows that she is
happen because the fertilized egg in the uterus does not develop normally. A
miscarriage is not caused by stress, exercise, or sex.
In many cases, doctors don't know what caused the miscarriage.
The risk of miscarriage is lower after the first 12 weeks of the
Common signs of a
Call your doctor
if you think you are having a miscarriage. If your symptoms and a pelvic exam
do not show whether you are having a miscarriage, your doctor can do tests to
see if you are still pregnant.
No treatment can stop a
miscarriage. As long as you do not have heavy blood loss, a fever, weakness, or
other signs of infection, you can let a miscarriage follow its own course. This
can take several days.
If you have
Rh-negative blood, you will need a shot of Rhogam.
prevents problems in future pregnancies. If you have not had
your blood type checked, you will need a blood test to find out if you are
Many miscarriages complete on their own. But
sometimes treatment is needed. If you are having a miscarriage, work with your
doctor to watch for and prevent problems. If the uterus does not clear quickly
enough, you could lose too much blood or develop an infection. In this case,
medicine or a procedure called a
dilation and curettage (D&C) can more quickly
clear tissue from the uterus.
A miscarriage doesn't happen all at
once. It usually takes place over several days, and symptoms vary. Here are
some tips for dealing with a miscarriage:
Miscarriage is usually a chance event, not a sign of an ongoing
problem. If you have had one miscarriage, your chances for future successful
pregnancies are good. It is unusual to have three or more miscarriages in a
row. But if you do, your doctor may do tests to see if a health problem may be
causing the miscarriages.
Learning about miscarriage:
Health Tools help you make wise health decisions or take action to improve your health.
Symptoms of a
It is not always easy to tell whether a miscarriage is
taking place. A miscarriage often does not occur as a single event but as a
chain of events over several days. One woman's physical experience of a
miscarriage can be very different from another woman's experience.
Things that may
increase your risk of miscarriage include:
It is normal to wonder whether you did something to
cause your miscarriage. It may help to know that most miscarriages happen
because the fertilized egg in the uterus does not develop normally, not because
of something you did. A miscarriage is not caused by stress, exercise, or
miscarriage is diagnosed with:
If you have not had a blood test before, you may have one
to see if you have
Recurrent miscarriage. If you have three or more miscarriages,
your doctor can test for possible causes, including:
There is no treatment that can stop
miscarriage. As long as you do not have heavy blood
loss, fever, weakness, or other signs of infection, you can let a miscarriage
follow its own course. This can take several days.
If you have an
Rh-negative blood type, you will need a shot of
prevents problems in future pregnancies. Your doctor can do a
blood test to see if you are Rh-negative.
If a miscarriage is
causing intense pain or bleeding or is taking longer than you are comfortable
with, talk to your doctor about using medicine or surgery (such as a procedure
dilation and curettage, or D&C) to clear the
family medicine doctor, or a
certified nurse-midwife can manage a
If you have vaginal
bleeding but tests suggest that your pregnancy is still progressing, your
doctor may recommend:
Sometimes all or some of
the fetal tissue stays in the uterus after a pregnancy miscarries. This is
called an incomplete miscarriage (incomplete or missed spontaneous abortion).
If your doctor determines that you have had an incomplete miscarriage, you will
have one or more treatment options:
If you are bleeding
heavily, you will be tested for
anemia and treated if needed.
In very rare cases, removal
of the uterus (hysterectomy) is needed for women who have severe,
uncontrollable bleeding or a severe infection that is not cured with
If you plan to become pregnant
again, check with your doctor. Most doctors and nurse-midwives recommend
waiting until you have had at least one normal
menstrual period before trying to become pregnant.
Your chances of having a successful pregnancy are good, even if
you've had one or two miscarriages.
If you have had three or more
miscarriages (recurrent miscarriage), your doctor may suggest further testing
to help find the cause.
There is nothing you can do to prevent
miscarriage. It is usually the body's way of ending a
pregnancy that has had a bad start, often at the earliest stage of cell
It is important to be alert to the symptoms of a
miscarriage so that you can seek medical evaluation. If you are having symptoms
of a miscarriage, avoid sexual activity (called pelvic rest) and strenuous
activity until your symptoms have been evaluated by a doctor.
Call 911 anytime you think you may need emergency care. For example, call if:
Call your doctor now or seek immediate medical care if:
Watch closely for changes in your health, and be sure to contact your doctor if:
It is normal to go
through a grieving process after a miscarriage, regardless of the length of
your pregnancy. Guilt, anxiety, and sadness are common and normal reactions
after a miscarriage. It is also normal to want to know why a miscarriage has
happened. In most cases a miscarriage is a natural event that could not have
To help you and your family cope with your loss,
consider meeting with a support group, reading about the experiences of other
mothers, and talking to friends or a counselor or member of the clergy. For
more information, see the topic
Grief and Grieving.
Your local bookstore
or library may have books on coping with miscarriage. Also, your doctor will be
able to address your questions and concerns about the miscarriage.
The intensity and duration of the grief varies from woman to woman. But
most women find that they can return to the daily demands of life in a fairly
short time. The loss and the hormonal swings that result from a miscarriage can
cause symptoms of depression, such as feeling sad and hopeless and losing interest in daily activities. It is important to call your doctor if you
symptoms of depression that last for more than a
couple of weeks.
A healthy, full-term pregnancy is possible for most
women who have had a miscarriage. This is true even after repeated miscarriages.
If you want to become pregnant again, check with your doctor or nurse-midwife.
Most health professionals recommend waiting until you have had at least one
normal menstrual period before trying to become pregnant after a
National Institute of Child Health and Human Development (2010). Research on Miscarriage and Stillbirth. Available online: http://www.nichd.nih.gov/womenshealth/research/pregbirth/miscarriage_stillbirth.cfm. American College of Obstetricians and Gynecologists (2015). Early pregnancy loss. ACOG Practice Bulletin No. 150. Obstetrics and Gynecology, 125(5): 1258-1267. Duckitt K, Qureshi A (2015). Recurrent miscarriage. BMJ Clinical Evidence. http://clinicalevidence.bmj.com/x/systematic-review/1409/overview.html. Accessed April 15, 2016.
Other Works Consulted
American College of Obstetricians and Gynecologists (2011). Antiphospholipid syndrome. ACOG Practice Bulletin No. 118. Obstetrics and Gynecology, 117(1): 192-199. American College of Obstetricians and Gynecologists (2015). Early pregnancy loss. ACOG Practice Bulletin No. 150. Obstetrics and Gynecology, 125(5): 1258-1267. Dempsey A, Davis A (2008). Medical management of early pregnancy failure: How to treat and what to expect. Seminars in Reproductive Medicine, 26(5): 401-410. National Institute of Child Health and Human Development (2010). Research on Miscarriage and Stillbirth. Available online: http://www.nichd.nih.gov/womenshealth/research/pregbirth/miscarriage_stillbirth.cfm. Porter TF, et al. (2008). Early pregnancy loss. In RS Gibbs et al., eds., Danforth's Obstetrics and Gynecology, 10th ed., pp. 62-70. Philadelphia: Lippincott Williams and Wilkins.
ByHealthwise Staff Primary Medical Reviewer Sarah Marshall, MD - Family Medicine Kathleen Romito, MD - Family Medicine Adam Husney, MD - Family Medicine Specialist Medical Reviewer Femi Olatunbosun, MB, FRCSC - Obstetrics and Gynecology
Current as ofApril 28, 2017
Current as of:
April 28, 2017
Sarah Marshall, MD - Family Medicine & Kathleen Romito, MD - Family Medicine & Adam Husney, MD - Family Medicine & Femi Olatunbosun, MB, FRCSC - Obstetrics and Gynecology
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