Indiana University Bloomington Pregnancy and Parenting Portal

What is miscarriage?

A term used to describe an unintended loss of pregnancy that occurs before 20 weeks of gestation

What causes it and what are the symptoms?

Potential Causes:

Disclaimer: More research is still needed to confirm direct causes of miscarriage, as most occurences do not have an identifiable cause. Below are what scientific researchers predict to be potential causes:

• Fertilized egg improperly forms a fetus
• Fetal heartbeat activity ceases during gestation
• Issues with fetal chromosomes
• Issues related to the internal structure of a uterus or the function of the cervix
• Infection or hormonal imbalances during pregnancy
• Immune system or antibody disorders during pregnancy

Symptoms:

• Vaginal discharge that progresses into heavy bleeding, blood clots, and/or fetal and uterine tissue
• Cramps and other abdominal, pelvic, or lower back pain
• Usual symptoms of early pregnancy like a sense of tenderness in the breasts and nausea begin to decrease

Additonal Notes:

• Not all bleeding during a pregnancy is a sign of miscarriage. Many pregnancies that are healthy and carried to term include a small amount of bleeding or spotting, different than what is described above. In either case, please seek counsel from a medical professional.
• Pain or vaginal bleeding during a pregnancy can also mean other complications such as ectopic pregnancy. If you experience any symptoms mentioned on this page or others that seem in any way concerning to you, address it with your medical care provider immediately.
• Likewise, healthy pregnancies will also see a decrease in early pregnancy symptoms overtime, so an experienced decrease is considered to be a rare sign of miscarriage. It is best practice to routinely check in with your medical care provider about your pregnancy experiences, so that they can ensure your progression remains healthy.

How likely is it to happen and what are the associated risks?

Between 10 and 20 percent of known pregnancies result in miscarriage and most occur before 12 weeks gestation. Rate of miscarriage is found to be statiscally lowest among individuals in their twenties, but miscarriage can still happen to anyone regardless of age. Some associated risks of miscarriage include infection, hemorrhaging, and slightly elevated risk of future miscarriages.

What do I do if I think I'm having a miscarriage, am actively having one, or have recently had one?

• Contact your medical care provider immediately. There is not yet a known preventative measure for miscarriage nor a way to intervene to stop the miscarriage once it begins, and you may need medical assistance.
• Maintain open lines of communication with your support network. Miscarriage can unfortunately happen to anyone and may leave a person with a lot unanswered questions and psychological impact. Talking through your experiences will help you process them, as well as assist others in supporting you during this difficult time.
• Following an experience with miscarriage, practice self-care, avoid environmental risks and hazards to the best of your ability, and continue to consult and check in with a medical care provider.
• Allow yourself the time and the grace to grieve and experience any pain you feel from this experience. Your emotions are perfectly normal, valid, and necessary to feel and process in order to heal.

What are some things I can do to support a loved one who experiences miscarriage?

• Listen with your undivided attention. You don't have to know exactly what to say in a situation like this and one of the best things you can do is be an active and attentive listener to your loved one and their emotions.
• Acknowledge the loss and be prepared to talk about the baby. The gut instinct of many is to ignore the topic in conversation, but this can inhibit the healing process.
• Remember that grief is natural and it will take time to process what has happened. Rushing the person and minimizing the miscarriage by saying things like "at least you weren't that far along" can be quite hurtful.
• Reassure the grieving person that their feelings and reactions are valid and encourage them to express pain when they experience it.
• If there is another parent/partner in the picture, ask how they are doing too. Similar to the person who miscarried, their partner needs to know they are equally cared for and supported during this difficult time.
• Offer to help with things like housework, cooking, caring for pets/plants/other children, etc. What would normally be routine might feel overwhelming to a grieving person.
• Offer to keep baby memorabilia until the person and/or their family are ready to have it again, as well as offer to return any items like maternity clothing for them.
• In addition to taking care of your loved one, remember to take care of yourself as well. Supporting someone through grief can at times feel draining, confusing, and/or challenging, so build in time for self-care and reach out to your network if you need support.

Support, Recovery, and Additional Resources for Miscarriage

• Miscarriage Association - Online support community and information center for those affected by miscarriage, molar pregnancy, or ectopic pregnancy.
• Coping with Pregnancy Loss - A website for Petra Boynton's book on pregnancy loss that also serves as a resource website for people who are seeking advice, information, and support surrounding miscarriage, ectopic pregnancy, molar pregnancy, stillbirth, etc.
• Mommies Enduring Neonatal Death (M.E.N.D.) - A faith-based, non-profit organization who provides support to families who have experienced pregnancy loss through miscarriage, stillbirth, or early infant death. They also provide regular publications, hold memorial services, host support groups, and create an environment where families can share stories and support one another.
• Pregnancy Loss Support Program (PLSP) - A community service of The National Council of Jewish Women of New York with a focus on providing free counseling and support to parents who have experienced miscarriage, stillbirth, newborn death or termination for fetal anomalies, and individuals who are pregnant after loss. Programs are not faith-based and are open to all backgrounds, religions, gender identities, and sexual orientations. Single parents are also welcome.
• Faces of Loss, Faces of Hope - An online community of parents who have experienced pregnancy/infant loss and talk openly about their experiences. Community members have the opportunity to write out their stories and submit them for publishing on the website as part of their grieving and acceptance of loss.

References

• Miscarriage, Harvard Health Publishing - Harvard Medical School, https://www.health.harvard.edu/a_to_z/miscarriage-a-to-z
• Miscarriage, U.S. National Library of Medicine, https://medlineplus.gov/miscarriage.html#cat_79
• Role of maternal age and pregnancy history in risk of miscarriage: prospective register based study., Magnus et al, https://www.ncbi.nlm.nih.gov/pubmed/30894356
• Miscarriage: Signs, Symptoms, Treatment, and Prevention, American Pregnancy Association, https://americanpregnancy.org/pregnancy-complications/miscarriage/
• After a Miscarriage: Supporting Friends & Family Through Loss, American Pregnancy Association, https://americanpregnancy.org/pregnancy-loss/supporting-others/