Health News, Information and Advice from a British Doctor

Miscarriage (Spontaneous Abortion)

Miscarriage or spontaneous abortion is the loss of a pregnancy during the first 23 weeks. If the loss of pregnancy occurs later than 23 weeks, it is sometimes referred to as late miscarriage or stillbirth. The majority of women experience:

  • vaginal bleeding
  • cramps
  • tummy pain

Vaginal bleeding is probably the most common and significant symptom, as accompanying pain may or may not appear. Vaginal bleeding may vary from light bleeding to heavy bleeding and passing out of tissue. If you experience vaginal bleeding during pregnancy, you may want to seek medical help, as it could be a warning sign. However, completely harmless (benign) vaginal bleeding is quite common during the first 12 weeks of pregnancy (1st trimester), so do not jump to conclusions. Vaginal bleeding its own does not mean you are having a miscarriage and your pregnancy may be going perfectly fine. To see whether you are having a miscarriage or not, your doctor can carry out an ultrasound scan of your tummy and test the pregnancy hormone levels in your blood. That is the same pregnancy hormone-hCG (human chorionic gonadotrophin) that is tested for in pregnancy test kits, and you may have used yourself before. If the miscarriage is confirmed, you will discuss the most appropriate course of action with your doctor. Usually the pregnancy tissue will pass out naturally, but if pregnancy tissue remains in your womb, then your doctor may prescribe you specific medication to assist tissue expulsion. There are numerous causes of a miscarriage and usually it cannot be prevented. It is estimated that up to 3 out of 10 pregnancies end with a miscarriage, but often while the woman is still unaware that she is pregnant. Therefore, many miscarriages go unnoticed. Out of women who know they are pregnant, about 1 in 15 will have a miscarriage, and the vast majority will occur during the first trimester of pregnancy. Miscarriage in late pregnancy is much less common and tends to have a more exact cause. It is believed most miscarriages are caused by abnormal chromosome number in the baby. Chromosomes are blocks of DNA that carry our genetic information and should be of constant number in all our body cells. Abnormal chromosome number in a baby occurs naturally with no exact cause identified, and not by anything the mother has done. Nevertheless, the risk of chromosomal abnormalities is increased with advanced maternal and paternal age, as well as lifestyle factors such as smoking, excessive alcohol consumption or illicit drug use during pregnancy. Maternal obesity and environmental factors such as radiation or toxic substance exposure can also contribute. Because the exact cause of a miscarriage is usually not identified, there are many common misconceptions about it. Maternal mood swings, fright, exercise, sexual intercourse during pregnancy or airplane flights are certainly not medically plausible reasons for a miscarriage, but you have probably already heard about them somewhere. These commonly shared misbelieves may make you feel overwhelmed and cause unnecessary distress. Therefore, it is important to gather information from reliable sources and discuss all your questions with your doctor. We are here to help!  
Miscarriage can be a very painful and emotional experience. You may feel grief, anger or like you have been betrayed by your own body. It certainly is an unpleasant life event, but it is undoubtedly a part of conceiving and childbirth. We all use different coping strategies, so please use the time and support you need. Miscarriage is usually a one-off event and you should not be afraid your next pregnancy will end with a miscarriage. You can try to conceive again after you have had one period and feel physically and emotionally prepared. Recurrent miscarriage (more than 3 miscarriages in a row) is quite uncommon and happens to less than 1 in a 100 women. Even in the case of a recurrent miscarriage, majority of women eventually manage to have a full-term pregnancy and give birth to a healthy baby. Due to lack of information some people still believe miscarriage is a rare event brought on by maternal ignorance, consequently they may unintentionally cause pain or social stigma. You certainly know that is incorrect and miscarriage is not, and should not be, a taboo topic in our society. Summary: Definition: Miscarriage is a spontaneous loss of pregnancy Signs: Vaginal bleeding, cramps, tummy pain Tests: Ultrasound scan of your tummy Causes: Usually not identified and cannot be prevented. It mainly due to chromosome abnormalities, and there are known risk factors Treatment: Variable, you may need pain medication or medication to aid the expulsion of pregnancy tissue from your womb Future: Miscarriage is usually a one-off event, recurrent miscarriages are rare. You can try to get pregnant again after you have had your period and feel emotionally and physically ready to do so Content written by Dina Radenkovic, Medical Student at UCL, August 2015