Conditions Center: Miscarriage

Photo Illustration by Michelle Alfonso
Photo Illustration by Michelle Alfonso

This informational guide, part of POPSUGAR's Condition Center, lays out the realities of this health concern: what it is, what it can look like, and strategies that medical experts say are proven to help. You should always consult your doctor regarding matters pertaining to your health and before starting any course of medical treatment.

Miscarriage can be a devastating, isolating experience for those hoping to have children — and they're more common than many people realize. According to the Cleveland Clinic, between 10 and 20 percent of known pregnancies end in miscarriage, which the Mayo Clinic defines as "the spontaneous loss of a pregnancy before the 20th week." But the overall number of pregnancies that end in miscarriage is likely higher (as many as 50 percent, according to March of Dimes), considering miscarriages can happen before a person even knows they're pregnant. This is often called a "chemical pregnancy" and the loss occurs before the fifth week of pregnancy. "Testing positive on a pregnancy test only to get a negative result a few weeks later can signal a chemical pregnancy," the Cleveland Clinic explains. Most miscarriages happen in the first trimester, usually in the first 12 weeks of gestation, adds Khaled Zeitoun, MD, a board-certified ob-gyn and Reproductive Endocrinology & Infertility (REI) specialist at New Hope Fertility.

Miscarriages are not the fault of the pregnant individual. Most miscarriages are spontaneous and caused by developmental issues in the fetus (often chromosomal abnormalities), according to Mayo Clinic. But a lack of information about the condition can cause people to think they did something to cause the pregnancy loss, leading to feelings of shame and confusion. That's one reason it's so important to know about the causes of miscarriage — as well as the treatment and early signs.

Understanding Miscarriage

Most often, miscarriage happens due to abnormalities in an embryo that would have made it impossible for the fetus to grow to full term or live outside the womb. Recurrent miscarriages, however, can be a sign of fertility issues. "[Recurrent miscarriages] can be due to other factors like problems in the uterus, problems in the blood, which we call a coagulopathy, or some immunological factors, congenital abnormalities, or fibroids," says Dr. Zeitoun. In this case, a doctor can help determine the exact cause and the best treatment plan.

"The symptoms [of miscarriage] usually include bleeding and pain in early pregnancy," Dr. Zeitoun explains. If you are experiencing these issues, Dr. Zeitoun recommends contacting your ob-gyn for a visit immediately; it's especially important to rule out the possibility of an ectopic pregnancy, which is very serious and requires immediate treatment, he adds.

Worth noting: "Vaginal bleeding in the first trimester occurs in about one fourth of pregnancies," the American Family Physician journal reports. About half of people who experience it will miscarry. But there's also a condition known as threatened miscarriage, which occurs when a pregnant person experiences bleeding, but the pregnancy remains viable. "About 50% or more of all these pregnancies will continue normally," says Dr. Zeitoun, who adds that it's more common in people who used intrauterine insemination (IUI) or in vitro fertilization (IVF) to get pregnant. All that to say: light bleeding is not a definitive sign of a miscarriage — but it should be taken seriously.

Dr. Zeitoun adds that some miscarriages — known as missed miscarriages — cause no bleeding, pain, or other symptoms; they're typically diagnosed during a routine prenatal checkup, when an ultrasound detects that there's no fetal heart beat. There are also conditions known as incomplete miscarriages, which occurs when a pregnant person miscarries but some tissue is left in the uterus, and septic miscarriages, which occurs when an infection develops in the uterus. All of these conditions require medical attention.

Causes of Miscarriage

Miscarriage can stem from a variety of causes, including genetic, chromosomal, and maternal health problems. And there are certain risk factors that increase your chances of having a miscarriage.

  • Genes or chromosome problems: Half of miscarriages involve chromosomal abnormalities, either an extra or missing chromosome, per the Mayo Clinic.
  • Maternal health problems: Certain health conditions, including uncontrolled diabetes, certain infections, hormonal problems (like the low levels of progesterone or thyroid hormone imbalances) can lead to miscarriage, according to the Mayo Clinic, so if you are planning to become pregnant and have one of these conditions, it's worth meeting with your doctor to understand the risks and make a plan for mitigating them.
  • Maternal age. As you age, the body produces fewer eggs, and the eggs you do have are more likely to have chromosomal issues that result in pregnancy complications like miscarriages, according to the Mayo Clinic. Again, your doctor can help you determine your risk and whether you need to take any protective measures.

Previous miscarriages, smoking, drinking, or harmful drug use, exposure to toxic chemicals, chronic or autoimmune conditions, invasive prenatal tests, certain cervical conditions or weak cervical tissue, and weight are also important risk factors to keep in mind.

The Most Effective Miscarriage Treatment

In general, there is very little you can do to prevent a miscarriage, other than trying to monitor your health and the health of your baby. This includes avoiding miscarriage risk factors, taking multivitamins, and seeing your doctor regularly for prenatal care.

Miscarriage treatment varies depending on the type of miscarriage. Sometimes, the body will pass the tissue on its own, but other times, medical intervention, such as medication or surgery, may be needed, says Dr. Zeitoun. Regardless, it's always important to visit a doctor if you suspect you're having a miscarriage; even if you don't require medication or surgery, you'll need medical observation to make sure your body passes all of the tissue on its own, since incomplete miscarriages can lead to issues like infection.

In most cases, recovery time for a miscarriage is short. Mayo Clinic says people typically physically recover in a few hours to a couple of days. Emotional recovery may take longer, and some people find it useful to lean on therapists or support groups during this time. But when you're ready to try again, the data is generally optimistic: about 80 percent of people who miscarry go on to have healthy pregnancies.