Miscarriage, or early pregnancy loss, is defined as the spontaneous loss of a pregnancy before 24 weeks gestation (time since conception). The majority of miscarriages occur before the 13th week of gestation. Sadly, miscarriage is far more common than people sometimes think. One in every four to five pregnancies will end in miscarriage. Miscarriage is an incredibly difficult and emotional experience. There are physical, mental health, and social impacts from a miscarriage. If you have had a miscarriage, are worried about it, we want you to be reassured that there isn’t anything you have done wrong, and there is nothing you could have done differently or better. A miscarriage or even multiple miscarriages does not mean that you are not going to be a parent. If you have had multiple miscarriages, you should speak to your doctor as there are some instances where medical causes lead to an increased chance of miscarriage.
Common symptoms for miscarriage are cramping lower abdominal pain and vaginal bleeding with or without clots of blood. If you are pregnant and have any of these symptoms, they will need to be investigated. There are occasions when these symptoms can be caused by other things, and not necessarily a sign of miscarriage.
If you have symptoms of cramping lower abdominal pain and vaginal bleeding with or without clots of blood, you will need to see your medical team such as your doctor, midwife, or nurse. You can call your doctor for urgent advice, or attend your local hospital which may have an early pregnancy unit (like an emergency department for pregnant women), or attend your local emergency department. You should rest and keep hydrated and can take simple pain killers like paracetamol for pain. You should avoid sexual activity until you have been reviewed by your medical team.
The person reviewing you will want to ask about your symptoms and, if you are comfortable, examine you. This may include checking your pulse, feeling your tummy, and doing a speculum examination to look at your cervix with your consent. Depending on the possible diagnosis, blood tests or imaging (ultrasound) could be carried out, or you may be referred to a specialist department.
In some cases, pain and bleeding with a positive pregnancy test can indicate an ectopic pregnancy (pregnancy outside of the womb) which can be an emergency. If you have any of the following symptoms, you should go straight to the hospital; new pain in one or both of your shoulder tips, dizziness or a feeling of a very fast heart rate, severe one-sided abdominal pain, heavy vaginal bleeding (changing your pad or tampon every hour).