Miscarriage

Medically Reviewed by Zilpah Sheikh, MD on December 28, 2023
Written by Stephanie Langmaid
9 min read

A miscarriage is the loss of a pregnancy before the 20th week.

Miscarriages are common. But it's hard to know exactly how often they happen because many times it's before you've even missed a period or know you're pregnant. About 10%-20% of recognized pregnancies will end in a miscarriage. But researchers estimate the overall rate is closer to 40%.

Miscarriage rates by week

More than 80% of miscarriages happen within the first 3 months of pregnancy.

One study found that after week 5, your overall chances of miscarriage are about 1 in 5. From weeks 8 to 13, the rate of miscarriage drops to 2%-4%. Beyond week 14, your risk is 1% or less.

The loss of a pregnancy after week 20 is called a stillbirth.

Sometimes a miscarriage causes no symptoms. However, you may have: 

If you have these symptoms, contact your doctor right away. They’ll tell you whether to come to the office or go to the emergency room.

Most miscarriages happen when the embryo or fetus has fatal genetic problems. Usually, these problems are not related to the mother. Sometimes, a fertilized egg gets implanted in your uterus but stops developing. That's called an anembryonic pregnancy, or a blighted ovum. It also results in a miscarriage.

Other problems that can increase the risk include:

You have a higher risk of miscarriage if you:

  • Are over age 35
  • Have certain diseases, such as diabetes or thyroid problems
  • Have had two or more miscarriages

Cervical insufficiency 

A miscarriage sometimes happens when you have a weakness in your cervix. Doctors call this cervical insufficiency. It means the cervix can’t hold the pregnancy. This type of miscarriage usually happens in the second trimester.

There are usually few symptoms before a miscarriage caused by cervical insufficiency. You may feel sudden pressure, your water might break, and tissue from the baby and placenta could leave your body without much pain. Doctors usually treat an insufficient cervix with a “circling” stitch in the next pregnancy, usually around 12 weeks. The stitch holds your cervix closed until the doctor removes it around the time of delivery. If you never had a miscarriage but your doctor finds that you have cervical insufficiency, they might add the stitch to prevent a miscarriage.

There are different kinds of miscarriages, including:

  • Chemical pregnancy. Also called a biochemical pregnancy, this type of miscarriage happens before 6 weeks. You've had a positive urine or blood test, but it's too early to have seen the pregnancy on an ultrasound.
  • Threatened miscarriage. You’re bleeding and there’s the threat of a miscarriage, but your cervix hasn’t dilated. Your pregnancy will likely continue without any problems.
  • Inevitable miscarriage. If you’re bleeding and cramping, and your cervix is dilated, a miscarriage is likely.
  • Incomplete miscarriage. Some tissue from the baby or the placenta leaves your body, but some stays in your uterus.
  • Complete miscarriage. All the pregnancy tissues leave your body. This type of miscarriage usually happens before the 12th week of pregnancy.
  • Missed miscarriage. This is also called an asymptomatic or silent miscarriage. The embryo dies or was never formed, but the tissues stay in your uterus.
  • Recurrent miscarriage. You lose two or more pregnancies in a row. This type of miscarriage only affects about 1% of couples trying to have a baby.
  • Septic miscarriage. In this situation, the pregnancy loss is accompanied by an infection in your uterus. It's rare but can be life-threatening.

What’s the difference between a miscarriage and stillbirth?

Both are pregnancy losses, but the difference is in the timing. Doctors in the U.S. consider it a miscarriage if it happens in the first 20 weeks, and a stillbirth beyond 20 weeks. In the U.K., the dividing line is at 24 weeks, while the World Health Organization considers it to be 22 weeks.

What’s the difference between a miscarriage and an abortion? 

In scientific terms, any pregnancy that ends before a baby is able to survive on its own is an abortion. A spontaneous abortion is more commonly called a miscarriage. An induced abortion is what most people think of when they hear the word -- the intentional termination of a pregnancy by either a medical procedure or medication.

Many doctors simply use the term pregnancy loss to refer to a miscarriage.

To check whether you've had a miscarriage, your doctor will do:

  • A pelvic exam. They’ll check to see if your cervix has started to dilate.
  • An ultrasound test. This test uses sound waves to check for a fetal heartbeat. If the results aren’t clear, you may go back for another test in a week.
  • Blood tests. The doctor uses them to look for pregnancy hormones in your blood and compare it to past levels. They may also test you for anemia if you’ve been bleeding a lot.
  • Tissue tests. If tissue leaves your body, the doctor may send it to a lab to confirm that you had a miscarriage. It can also help make sure there wasn’t another cause for your symptoms.
  • Chromosome tests. If you’ve had two or more miscarriages, the doctor might do these tests to see if you or your partner’s genes are the cause.

How to confirm a miscarriage at home

If you're having miscarriage symptoms such as bleeding and cramping, or you've stopped feeling pregnancy symptoms such as morning sickness or sore breasts, you can try taking a home pregnancy test. If it's negative, that's a good indication you've lost the pregnancy. But pregnancy hormones don't leave your body immediately, so a positive test doesn't necessarily mean everything's OK. You should see your doctor to confirm what's happening with your pregnancy.

If the miscarriage is complete and your uterus is empty, you probably won’t need further treatment.

Sometimes, all the tissue doesn’t come out. If that happens, your doctor might recommend waiting a week or two for it to pass naturally. Or they may do a dilation and curettage (D&C) procedure. They’ll dilate your cervix and gently remove any remaining tissue. There are also medications you can take that cause any tissue left in your uterus to leave your body.

If it’s later in the pregnancy and the fetus has died in the uterus, the doctor will induce labor and delivery.

When the bleeding stops, you should be able to go back to your normal activities. If your cervix dilated on its own but you’re still pregnant, you could have a condition known as incompetent cervix. Your doctor might do a procedure called cerclage to close it.

If your blood type is Rh negative, the doctor may give you a blood product called Rh immune globulin (RhoGAM). This prevents you from developing antibodies that could harm your baby or any future pregnancies.

You may get blood tests, genetic tests, or medication if you’ve had two or more miscarriages in a row (recurrent miscarriage). To diagnose this condition, your doctor might use tests such as:

  • Pelvic ultrasound
  • Hysterosalpingogram, an x-ray of the uterus and fallopian tubes
  • Hysteroscopy. The doctor uses a thin, telescope-like device inserted through your vagina and cervix to look inside your uterus.

If you've had two miscarriages in a row, use a form of birth control and talk to your doctor about tests to find the cause.

Treatments for ‘recurrent miscarriage’

There are several ways doctors can help you have a successful pregnancy when you've experienced recurrent miscarriage, depending on what's causing it. They include:

  • In vitro fertilization after testing for genetic problems with the embryo, or using donor sperm or eggs
  • Surgery to correct problems in your uterus
  • Medical treatment for infection or other health problems
  • Hormone therapy
  • Immune therapy

About half of the time, doctors can't find a cause. In that case, they may suggest boosting your overall health and practicing self-care, such as reducing stress and getting psychological support or therapy. Even if they don't find a cause, your chances of having a baby are still good. Two out of three people who've had recurrent miscarriages go on to have a successful pregnancy the next time.

Bleeding and mild discomfort are common symptoms after a miscarriage. If you have heavy bleeding with fever, chills, or pain, contact your doctor right away. These may be signs of an infection.

Besides the physical effects, you may also feel a range of emotions, from sadness and guilt to grief and worry about future pregnancies. What you’re feeling is normal. Let yourself grieve.

If you’re up to it, talk to people in your life who are supportive, such as your partner, a friend, or a family member. You can also talk to a professional mental health counselor. Pregnancy loss support groups may also be a valuable resource to you and your partner. Ask your doctor for more information about these resources. And remember that everyone heals at a different pace and in different ways.

You can get pregnant after a miscarriage. At least 80% of women who have had a miscarriage go on to have normal pregnancies and births. Having a miscarriage doesn’t mean you have a fertility problem. On the other hand, about 1%-2% of women may have repeated miscarriages. Some researchers believe this is related to an autoimmune response.

Discuss the timing of your next pregnancy with your doctor. Some experts say you should wait a certain amount of time (from one menstrual cycle to 3 months) before you try again. But research has shown there's no medical benefit to waiting.

Taking time to heal both physically and emotionally after a miscarriage is important. Above all, don't blame yourself. Counseling is available to help you handle your loss.

Most miscarriages happen because there’s a problem with the pregnancy. You can’t prevent them. If your doctor does tests and finds a problem, treatment options may be available.

If you have an illness, treating it can improve your chances of a successful pregnancy. One step you can take is to get as healthy as you can before you try to have a baby:

While this isn't a widespread practice, your doctor may suggest treatment with progesterone to prevent another miscarriage. Progesterone is a hormone that helps the embryo implant and supports early pregnancy in your uterus.

Miscarriage is the loss of a pregnancy before 20 weeks. It happens in 10%-20% of confirmed pregnancies, and many more before someone even knows they're pregnant. The vast majority of people who have a miscarriage go on to have a healthy baby. It can be an emotionally devastating experience, so take time to grieve and get support if you need it.

How do I know if I'm having a miscarriage?

Most people having a miscarriage will have vaginal bleeding and abdominal pain or cramping. You may pass tissue from your vagina. But these symptoms don't always mean you're having a miscarriage. And sometimes, you may have no symptoms at all. Your doctor can confirm it with an ultrasound or blood test.

How long would a miscarriage last?

A miscarriage can take anywhere from a few hours to a few weeks. It depends on how far along the pregnancy was, what kind of miscarriage you have, and how it's treated. You may have light bleeding for up to 2 weeks after it's over.

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