Frequently asked questions about miscarriage
A miscarriage is the loss of a pregnancy before 20 weeks gestation. Sadly, up to one in four pregnancies end in miscarriage.
What are the possible physical symptoms to expect when you have just miscarried your baby?
The symptoms can vary and may depend on the gestation of the pregnancy and the type of miscarriage you experience.
Most commonly, bleeding and cramping like a heavy period is experienced. Sometimes women have severe cramping like that experienced in labour, from the uterus contracting to pass the pregnancy tissue.
If you have experienced a ‘missed miscarriage’ or ‘silent miscarriage’ you most likely have not had any signs or symptoms, and your loss has been diagnosed by the absence of a heartbeat on routine ultrasound.
If your miscarriage was diagnosed by ultrasound but the process of passing the pregnancy hasn’t started, you can decide with your GP or gynaecologist what the best management option is for you, from both a physical and emotional perspective. These options include waiting for the body to expel the pregnancy, a tablet or pessary to help the uterus contract, or a D&C ‘dilatation and curettage’ where the tissue is removed surgically under anaesthesia.
What are symptoms that are ‘not normal’ and when should I worry?
All women who suspect they are going through a miscarriage should see their GP, midwife or gynaecologist, even if your symptoms are mild and you don’t want any intervention. If you are ever unsure if something is normal or not, never hesitate to seek a review.
Symptoms that warrant a trip to your nearest Emergency Department.
- Very heavy bleeding, soaking one pad per hour or passing large clots (golf ball / small plum size)
- Severe abdominal pain that is not controlled with pain relief at home
- Pain localised to one side of the abdomen
- Shoulder tip pain
- Dizziness or fainting may be a sign that you have lost too much blood
- Signs of an infection such as fevers, chills or a vaginal discharge that smells unpleasant.
There are a few recommendations to minimise the risk of infection- using pads instead of tampons and avoiding penetrative sex and swimming until the bleeding stops or otherwise advised by your healthcare provider.
What is the minimum number of miscarriages before you should have investigations?
Couples who have experienced two or more losses are offered investigations for potential underlying causes. A late miscarriage (a loss between 13-20 weeks) may also warrant investigation, as most miscarriages occur in the first trimester of pregnancy due to chromosomal errors.
Some people may be reassured to know that having had one miscarriage you are not at increased risk of having a second.
When is it considered safe for couples to try to conceive again after a miscarriage?
It’s important to wait until you have physically recovered and feel emotionally ready. This time will be unique to you. Many couples who are trying to conceive feel that they want to fall pregnant again as soon as possible. Some will need more time. Medically it is recommended you wait for one normal period before trying to conceive. If you do conceive before your next period, it will make the pregnancy harder to date and this may cause increased anxiety.
Outdated recommendations advised waiting three months before trying again, but there is no evidence for this. Studies have found no increased pregnancy complications if you conceive within three months of a miscarriage.
Is it normal to feel like this?
The emotional impact of a miscarriage can be very overwhelming. People experience a range of emotions after a miscarriage, all of which are valid. The only thing I will say is that whilst guilt is often felt, it’s almost impossible for you to have done anything to have caused your loss.
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