Miscarriage

Topic Overview

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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 Stillbirth.

What is a miscarriage?

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.¹ It is also common for a woman to have a miscarriage before she even knows that she is pregnant.

What causes a miscarriage?

Most miscarriages 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 pregnancy.

What are the common symptoms?

Common signs of a miscarriage include:

• Bleeding from the vagina. The bleeding may be light or heavy, constant or off and on. It can sometimes be hard to know whether light bleeding is a sign of miscarriage. But if you have bleeding with pain, the chance of a miscarriage is higher.
• Pain in the belly, lower back, or pelvis.
• Tissue that passes from the vagina.

How is a miscarriage diagnosed?

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.

How is it treated?

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. This 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 Rh-negative.

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:

• Use pads instead of tampons. You will probably have vaginal bleeding for a week or so. It may be like or slightly heavier than a normal period. You may use tampons during your next period, which should start in 3 to 6 weeks.
• Take acetaminophen (Tylenol) for cramps. Read and follow all instructions on the label. You may have cramps for several days after the miscarriage.
• Eat a balanced diet that is high in iron and vitamin C. You may be low in iron because of blood loss. Foods rich in iron include red meat, shellfish, eggs, beans, and leafy green vegetables. Foods high in vitamin C include citrus fruits, tomatoes, and broccoli. Talk to your doctor about whether you need to take iron pills or a multivitamin.
• Talk with family, friends, or a counselor if you are having trouble dealing with the loss of your pregnancy. If you feel very sad or depressed for longer than a couple of weeks, talk to a counselor or your doctor.
• Talk with your doctor about any future pregnancy plans. Most doctors suggest that you wait until you have had at least one normal period before you try to get pregnant again. If you don't want to get pregnant, ask your doctor about birth control options.

After a miscarriage, are you at risk for miscarrying again?

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.

Frequently Asked Questions

Learning about miscarriage:	What is a miscarriage? What are common symptoms of a miscarriage? What causes a miscarriage? What might increase my risk of miscarriage?
Being diagnosed:	How is a miscarriage diagnosed?
Getting treatment:	When should I call my doctor about cramping or bleeding? How is a miscarriage treated? Should I have medical, surgical, or no treatment to complete a miscarriage? How do I take care of myself at home when I am having a miscarriage? How can I cope with a miscarriage?
Ongoing concerns:	How soon can I try to conceive after a miscarriage?

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Author:	Sandy Jocoy, RN	Last Updated: May 7, 2009
Medical Review:	Sarah Marshall, MD - Family Medicine Deborah A. Penava, BA, MD, FRCSC, MPH - Obstetrics and Gynecology
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