Miscarriage: signs, care and support

Bleeding in pregnancy needs checking, but it does not always mean a miscarriage. Some losses cause cramps and bleeding; others are found at a scan without earlier symptoms. An assessment can help you find out what is happening.

Get help for bleeding or pain

Call 999 now (UK) or 911 (US), or your local emergency number, for heavy bleeding in pregnancy, or if pregnancy is possible and you have sudden severe tummy pain, shoulder-tip pain, marked weakness or fainting, even without vaginal bleeding. The NHS describes heavy bleeding here as soaking a period pad soon after putting it on.

Contact your maternity or early pregnancy unit, or NHS 111 in the UK, your obstetric clinician in the US, or your local pregnancy care service today for light bleeding, spotting or fluid leaking from your vagina. Contact the same services for pain in early pregnancy. You can ask for assessment without knowing the cause.

What an assessment can involve

A clinician will ask about this pregnancy, previous pregnancies and your health. Tests may include an ultrasound scan and blood or urine tests. An internal vaginal scan may be offered, and the clinician can explain what it involves before you agree.

Sometimes repeat scans or blood tests are needed before a pregnancy loss can be confirmed. Ask what the next appointment is for, when it will happen and who to contact if symptoms change while you wait.

The language differs between countries. The NHS describes miscarriage as a pregnancy loss before 24 weeks; US MedlinePlus uses before the 20th week. Your loss matters whichever term is used.

Why it happens

Often no definite cause is found. Problems with the pregnancy’s chromosomes, which carry genetic information, are a common explanation for early loss. Miscarriage is usually a random event.

Working, exercising, stress, arguments and sex do not cause miscarriage. Having used contraceptive pills before getting pregnant does not cause it either. These everyday activities are not a reason to blame yourself.

Care after a loss is confirmed

For an early miscarriage, the team may offer waiting for the pregnancy tissue to pass, medicine to help it pass, or a procedure to remove it from the womb. The choice depends on your symptoms, the stage of pregnancy and your preferences. If the miscarriage is complete, further treatment may not be needed.

Waiting is a care plan with follow-up. Ask what bleeding and pain to expect and what happens if the plan does not work for you. Medicine can cause bleeding and cramps too; your doctor or pharmacist can advise about the medicines prescribed and pain relief.

Surgery may be advised urgently for heavy, continuing bleeding or infection. Later miscarriage may involve labour and birth, with support from a care team. Ask the team to explain the options clearly and go over them again if you need them to.

Follow-up and emotional support

Follow the care team’s plan for checking that the miscarriage has finished. This may include a pregnancy test, scan or blood test. Contact your pregnancy unit, GP or NHS 111 (UK), obstetric clinician (US), or local urgent care service now for fever, chills or foul-smelling discharge after a loss. Call 999 now (UK) or 911 (US), or your local emergency number, for heavy bleeding, severe pain or feeling very unwell after a loss, even without vaginal bleeding.

Grief can last longer than physical recovery. A partner may also grieve and may express it differently. Ask your GP or pregnancy team in the UK, or your doctor elsewhere, about counselling if you are struggling. You can ask for support whatever you decide about another pregnancy.

For urgent mental health support, call NHS 111 and select the mental health option in England, or contact your local urgent mental health service elsewhere. 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 cannot keep yourself safe or there is immediate danger to life.