Signs of Miscarriage with 6 Different Types

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A miscarriage, also called spontaneous abortion or pregnancy loss, is the loss of a pregnancy before the fetus can survive outside the womb. In the US, a loss after 20 weeks is usually called a stillbirth.

Early pregnancy loss is common. ACOG reports it happens in about 10 of every 100 known pregnancies.

The main signs of miscarriage are vaginal bleeding, which can range from light brown spotting to heavy bleeding, and cramping or pain in the lower belly.

Ectopic pregnancy and miscarriage

An ectopic pregnancy occurs when a fertilized egg implants and grows outside the uterus, almost always in a fallopian tube. It cannot continue normally. In the UK, about 1 in 90 pregnancies is ectopic.

If a growing ectopic pregnancy ruptures the tube, it can cause life-threatening internal bleeding. This is a medical emergency.

It is important to see your doctor if you experience any of the following symptoms:

Pain low in the belly, often on one side
Vaginal bleeding or spotting, or a brown watery discharge
Pain in the tip of your shoulder
Discomfort when peeing or pooping, or diarrhea and vomiting
Feeling very faint, dizzy or lightheaded. According to the NHS, symptoms usually appear between the 4th and 12th week of pregnancy.

Severe pain, shoulder tip pain, fainting or heavy bleeding need emergency care right away. In the US, call 911.

6 Different types of miscarriages

There are various types of miscarriages:

Signs of Miscarriage

1) Threatened miscarriage

You have vaginal bleeding and mild cramps, but your cervix stays closed. In many cases the bleeding stops and the pregnancy continues normally. In others, it progresses to a miscarriage.

2) Inevitable miscarriage

You have increasing bleeding, and your cervix opens. If this happens, there is no chance of continuing your pregnancy.

3) Incomplete miscarriage

Some pregnancy tissues come out of your uterus, and some stay inside. You may need follow-up treatment to remove the remaining tissue.

4) Complete miscarriage

All the pregnancy tissue comes out of your uterus. You do not usually require any additional treatment.

5) Missed miscarriages

You have no cramps or bleeding, but an ultrasound shows an embryo without a heartbeat or an empty pregnancy sac. The tissue may pass on its own, but you may need medicine or a procedure.

6) Recurrent miscarriage

Recurrent miscarriage means several losses in a row. The NHS uses three or more, while US guidance suggests testing for a cause after two or more. It is uncommon, and a cause is not always found.

Causes of miscarriages

It can be hard to know why a miscarriage happened, but it is almost never caused by anything the pregnant person did. Common activities such as sex, exercise, working and taking most medicines do not cause miscarriage. Minor injuries, such as falls, do not usually cause miscarriages.

Some of the things that cause miscarriage include:

When the embryo has an abnormal number of chromosomes. ACOG says this causes about half of early miscarriages. It happens at random, so you can't stop it or cause it to happen.
Some health conditions, such as poorly controlled diabetes, may increase the chances of miscarriage.
A very severe infection or a major injury may cause miscarriage.
Late miscarriages, after the first trimester, may be linked to problems with the uterus or cervix.
Having had several miscarriages in a row slightly raises the chance of another one.

What are the symptoms & signs of miscarriage?

A miscarriage often starts with spotting that turns into heavier bleeding, along with cramps that get stronger.

In pregnant women, any of the following symptoms can be a sign of miscarriage:

Vaginal bleeding, with or without cramps. This bleeding can happen earlier in your pregnancy(discharge), even before you know you are pregnant, or later. It is the most common symptom.
Mild to severe lower back pain or abdominal pain or cramps, either continuously or intermittently.
Blood clots, or pink, gray or white tissue passing from the vagina.
A sudden loss of pregnancy symptoms, such as breast tenderness or nausea.

The other symptoms may be such as

Stomach cramps and pain
Mild to severe back pain
Fluid suddenly coming out of the vagina
Vaginal tissue or clotted discharge
Feeling faint or lightheaded
Contractions

Sometimes there are no symptoms at all, and the loss is found at a routine scan.

How do you know if you had a miscarriage?

Bleeding and mild cramps are common for a while after a miscarriage. The NHS says bleeding or spotting may last up to 2 weeks.

If you are bleeding heavily or have fever, chills, severe pain or foul-smelling discharge, contact your healthcare provider immediately. These may be signs of an infection or retained tissue.

Can a Miscarriage Be Prevented?

Most miscarriages can't be prevented, because they usually happen when a pregnancy is not developing normally. If tests find a specific problem, treatment may be available. Sometimes, treating a mother's health condition can improve her chances of a successful pregnancy.

How is a miscarriage diagnosed and treated?

Doctors may do a pelvic exam, an ultrasound and blood tests to confirm a miscarriage. If the miscarriage is complete and the uterus is empty, further treatment is usually not needed.

Sometimes the uterus does not empty completely. A procedure such as suction or dilation and curettage (D&C) can remove the remaining tissue.

As an alternative to a procedure, you may be given medicine to help the uterus pass the tissue. This may suit someone who wants to avoid surgery and whose condition is otherwise stable. Blood tests for the pregnancy hormone hCG can help track progress.

When the bleeding stops, you will usually be able to continue your normal activities. In a later pregnancy, a cervix that opens too early (cervical insufficiency) can sometimes be treated with a stitch to keep it closed, called a cerclage.

If your blood type is Rh-negative and you were 12 weeks or more pregnant, your doctor may give you a shot of Rh immune globulin (such as RhoGAM). This helps prevent antibodies that could affect a future pregnancy.

What happens during a miscarriage?

Miscarriage varies from person to person, but there are some common symptoms. Not every miscarriage is painful, but most people have cramps. The cramps are strong for some people and light, like a period, for others.

Vaginal bleeding and passing blood clots are common. Seek emergency care if the bleeding soaks a pad soon after you put it on, or if you feel faint or dizzy.

The bleeding and cramps may ease quickly or last several hours. Your doctor can give you medicine and tips to manage pain.

However fast or painful it is, a miscarriage can be very upsetting. Talk to your doctor about what is happening and how you feel. They can tell you what is normal and point you to emotional support if you need it.

Can you get pregnant following a miscarriage?

Yes. Most women who have an early pregnancy loss go on to have successful pregnancies. A miscarriage does not usually mean you have fertility problems.

Repeated miscarriages are rare. Some researchers believe some cases are related to an autoimmune reaction, among other possible causes.

If you have had two or more miscarriages, talk to your healthcare provider about testing to look for a cause. You can try to conceive again when you feel ready and your symptoms have gone.

When these symptoms are not concerning?

Light vaginal bleeding or spotting in the first trimester is common and does not always mean a miscarriage. Some women have mild cramps from implantation, from the uterus stretching or after sex.

Pregnancy symptoms can also change and ease as time goes on. If anything worries you, talk to your doctor or midwife. If you have severe pain, heavy bleeding or feel faint, call 911 or go to the emergency room. In the UK, call 111 for urgent advice or 999 in an emergency.

Sources

Early Pregnancy Loss, American College of Obstetricians and Gynecologists
Miscarriage, NHS
Ectopic pregnancy, NHS