Miscarriage

Miscarriage is the loss of a pregnancy before 20 weeks. It happens in about 1 in 5 known pregnancies. It is almost never caused by anything you did.

What it is

Miscarriage is the loss of a pregnancy before 20 weeks. If you are soaking a pad an hour or feel faint right now, call 911. If the grief feels unbearable, call or text 988, day or night.

Early loss is common. About 10 to 20 in 100 known pregnancies end in miscarriage, and 8 in 10 of those happen in the first 13 weeks. A chemical pregnancy is a loss in the first five weeks, often known only from a test. A missed miscarriage is one found on ultrasound, with no bleeding yet.

Most early losses come from a random error in the chromosomes when egg and sperm met. Lifting, sex, stress, a glass of wine before you knew, a fall: none of these cause miscarriage.

When a loss is confirmed there are three paths. Waiting for the body to pass it. Medication, usually misoprostol, sometimes with mifepristone first, which brings it on at home. Or a short procedure, called a D&C or aspiration, that empties the uterus. All three are safe. Your provider will say which fit your case.

What's typical

Bleeding and cramps, often heavier than a period, with clots and tissue. The heaviest part lasts hours. Bleeding then tapers over one to two weeks. Medication usually works within a day or two. A D&C takes about ten minutes and bleeding is lighter after. Pregnancy tests stay positive for two to four weeks. A period returns in four to six weeks for most.

What's known

ACOG describes all three options as equally safe for early loss and leaves the choice to the mother where possible. Research finds no medical need to wait before trying again; many providers now say after one normal period. If your blood type is Rh negative, ask whether you need a RhoGAM shot. Many cultures mark early loss with ritual. Japan's mizuko kuyo ceremony names and honors the lost pregnancy.

What helps

Have someone with you. The heaviest hours are easier with a person in the next room.
Heat on the belly, overnight pads, dark towels on the bed, and food you do not have to make.
Ask your provider what you will see and what to do with tissue. Knowing takes some of the fear out.
Take the time off. California gives up to five days of reproductive loss leave; ask the Civil Rights Department.

When to call someone

Nowsoaking two pads an hour for two hours, feeling faint, fever, or severe pain on one side. Call 911 or go to the emergency room.
Nowthoughts of ending your life. Call or text 988.
Todaybleeding or pain with a positive test and no scan yet. An ectopic pregnancy has to be ruled out.
At your next visitsadness or numbness past a few weeks, or dread about trying again. Ask about a perinatal therapist and a loss group.

Who helps

OB-GYNMidwife Perinatal therapist Family and community resources

Tools: My Birth Team · Birthworker Directory

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Sources

American College of Obstetricians and Gynecologists — Early pregnancy loss practice bulletin
American College of Obstetricians and Gynecologists — Early pregnancy loss FAQ
March of Dimes — Miscarriage
Postpartum Support International — Loss and grief in pregnancy and postpartum
California Civil Rights Department — Reproductive loss leave fact sheet

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