Bleeding and miscarriage

Miscarriage in early pregnancy is a common experience. The Miscarriage Association (2019) say that an estimated one in four pregnancies will end in miscarriage but other estimates vary.  It is difficult to be precise, as miscarriage may occur before a woman has even realised she is pregnant, and she may assume it is a heavy period. Most miscarriages happen in the first 12 weeks of pregnancy (Miscarriage Association 2019) and the risk of miscarriage gets lower with each week of pregnancy (NCT 2019).

For many women, the first worrying symptom was vaginal bleeding, sometimes with abdominal cramps or backache. Women described the terrible sinking feeling that they might be losing their baby, especially if this had happened to them before.

On this occasion the bleeding settled down and the baby was fine, although she had had a miscarriage before, and another one since. Many women who experience vaginal bleeding go on to have a normal pregnancy, but several described the anxiety of waiting to find out, knowing they could do nothing about it.

Having sought medical advice, one woman (herself a GP) decided to carry on with her camping holiday.

(Women who have persistent and severe abdominal pain should see a doctor, as the pregnancy may be ectopic - when the embryo implants and develops in a fallopian tube, rather than the womb. An operation is then needed to remove the embryo as soon as possible. See also 'Symptoms and feelings in the early weeks').

Many hospitals now have an Early Pregnancy Unit which can provide emergency scans and support people who may be having a miscarriage. Several people valued this service and its staff.

Some women thought something was wrong because other signs of pregnancy such as sickness or tender breasts suddenly disappeared. Other people had no sign that anything was wrong, and discovered during a routine antenatal scan that there was no heartbeat and their pregnancy had ended. This is called a missed or delayed miscarriage (or a 'missed abortion') and sometimes an operation is needed to empty the womb. (This is normally an ERPC - evacuation of retained products of conception - although it is often referred to as a D&C or dilatation and curettage). Early miscarriage can also be managed using medicines rather that an operation (see NHS choices).

Some people had what is called a 'blighted ovum', an egg that is fertilised but never develops properly. Again, this is often picked up at a scan.

Most women we talked to found miscarriage a shocking and very sad experience, and thought others did not always understand how much grief it could cause.

A few were upset at the time but got over it quite quickly, especially if they then had a successful pregnancy. A specialist told one woman that 'all the hurt would go away' once she got pregnant again.

Having a miscarriage made people understandably more anxious in later pregnancies in case it happened again. (See also 'Emotions in pregnancy'). Views were mixed about when to tell friends and family about the next pregnancy. Some people wanted to keep it quiet so if they had another miscarriage they did not have to make it public. Other people felt it would be better if people knew so they could offer them support and understanding. This has to be a personal decision. (See also 'Discovering you are pregnant and telling others').

Many women never found a reason why they had a miscarriage and later had normal pregnancies. The cause is rarely investigated unless a woman has repeated miscarriages (three or more), and even then a cause is not always found (see Interview 16 above). Some people took part in research studies about miscarriage and found the research staff very supportive.

It's estimated up to two-thirds of all early miscarriages seem to happen because the baby has a genetic abnormality (NHS Choices 2015). One woman had three miscarriages and initial tests found no cause. Only when a serious chromosomal condition was found in her fourth pregnancy was a connection made with the miscarriages. Like several other people, she was relieved to find a cause and know she could have done nothing differently to prevent the miscarriages.

One woman whose third miscarriage happened quite late, at 17 weeks, was found to have a blood clotting disorder.

In her fourth pregnancy preterm labour started at just under 23 weeks. In her fifth pregnancy, a stitch was put into her cervix, to stop it opening as the uterus became heavier in later pregnancy (cervical incompetence) and causing another miscarriage or preterm delivery. The baby was born healthy at 37 weeks, but she had to spend several weeks being monitored in hospital. (See also 'Looking back - Preterm birth and special care').

It is always best to consult a doctor or midwife about bleeding in later pregnancy. It may be caused by harmless changes to the cervix, but it can also be a symptom of something more serious such as placenta praevia (see 'Other conditions in pregnancy').

Amniocentesis and chorionic villus sampling are diagnostic tests to check if the baby has a genetic condition. Both tests carry a small risk of miscarriage. For further information, see the Healthtalk Antenatal screening website.

For links to further information, see our pregnancy resources.

Last reviewed May 2017.
Last updated May 2017.


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