Miscarriage: Common Causes, Symptoms and Risk Factors Explained

What Is a Miscarriage?

Pregnancy is often a time of hope and excitement, but it can also bring uncertainty. Miscarriage is one of the most common complications of pregnancy, yet it is rarely discussed openly. It is estimated that around one in four confirmed pregnancies ends in miscarriage. When it occurs, it can feel sudden, isolating and deeply emotional.

A miscarriage is defined as the loss of a pregnancy before 20 weeks of gestation, with most occurring in the first trimester (before 12 weeks). Many miscarriages happen before a woman even realizes she is pregnant.

This article explores what causes miscarriage, the symptoms to watch for and the factors that may increase risk, helping women and families navigate this challenging experience with knowledge and support.

What Are the Types of Miscarriage?

Miscarriages are classified based on how and when the pregnancy loss occurs:

• Threatened miscarriage: Bleeding occurs during early pregnancy, but the cervix remains closed. The pregnancy may still continue.
• Complete miscarriage: All pregnancy tissue has passed from the uterus.
• Incomplete miscarriage: Some tissue remains in the uterus, and medical treatment may be required to remove it.
• Missed miscarriage: The embryo stops developing, but there are no immediate symptoms. The loss is usually detected during a scan.
• Recurrent miscarriage: Defined as two or more consecutive pregnancy losses, often prompting further medical evaluation.

What Are Symptoms of Miscarriage?

Symptoms of miscarriage can vary widely. Some women experience clear warning signs, while others have very few symptoms.

Vaginal Bleeding

Bleeding is the most common symptom of miscarriage, ranging from light spotting to heavy bleeding with clots. Not all bleeding in early pregnancy indicates miscarriage, but any bleeding should be evaluated by a healthcare professional.

Abdominal Pain and Cramping

Lower abdominal pain or cramping may feel similar to strong menstrual cramps. Pain can be intermittent or constant. Severe or worsening pain requires urgent medical assessment.

Passing Tissue or Fluid

Passing tissue, clots or fluid from the vagina may signal a miscarriage. This is distressing and needs immediate medical attention.

Loss of Pregnancy Symptoms

A sudden decrease in pregnancy symptoms, such as nausea, breast tenderness or fatigue, may indicate that the pregnancy is no longer developing.

Fever or Feeling Unwell

Fever, chills or a foul-smelling vaginal discharge may indicate infection and requires urgent care. 

What Are Risk Factors for Miscarriage?

Certain factors can increase the likelihood of miscarriage, though having one or more risk factors does not guarantee that miscarriage will occur.

• Age: Maternal age is a strong risk factor. The risk of miscarriage increases gradually after age 30 and rises more significantly after 35, mainly due to changes in egg quality.
• Previous Miscarriage: Having experienced one miscarriage slightly increases the risk of another. Recurrent miscarriage, defined as two or more consecutive losses, may require further medical investigation, but many women go on to have healthy pregnancies.
• Underlying Health Conditions: Conditions such as diabetes, thyroid disorders, autoimmune diseases and blood-clotting disorders can increase miscarriage risk if not properly managed.
• Weight: Both underweight and obesity are linked to a higher risk of miscarriage. Achieving and maintaining a healthy weight before pregnancy may help reduce risk.
• Stress and Emotional Health: Severe or chronic stress may indirectly affect pregnancy through hormonal and immune pathways. Emotional well-being is an important part of overall health during pregnancy.

How Miscarriage Is Diagnosed?

Diagnosis of miscarriage typically involves a combination of clinical assessment, ultrasound and blood tests.

• Ultrasound: Used to assess fetal development and check for a heartbeat.
• Blood tests: Measure pregnancy hormone levels (such as hCG) over time to monitor the progression of pregnancy.

In some cases, a definitive diagnosis cannot be made immediately, and repeat tests may be needed to confirm the outcome.

Treatment and Management After Miscarriage

Treatment for miscarriage depends on the type of miscarriage, gestational age and the woman’s physical condition.

• Expectant management: Some miscarriages occur naturally without medical intervention.
• Medication: Medicines may be prescribed to help the body pass remaining tissue.
• Surgical management: Minor procedures, such as dilation and curettage (D&C), may be needed to remove tissue and prevent complications.

Emotional support is equally important. Feelings of grief, sadness, anger and guilt are common and valid and seeking help from healthcare providers, counsellors or support groups can aid recovery.

Emotional Impact of Miscarriage

Miscarriage is both a physical and emotional experience. Many women feel a deep sense of loss, even in very early pregnancy. Partners may also grieve, sometimes silently.

There is no right or wrong way to feel after a miscarriage. Speaking with a trusted healthcare provider, counsellor or support group can provide valuable support and help during the recovery process.

Future Pregnancy After Miscarriage

Most women who experience a miscarriage go on to have healthy pregnancies. In fact, the chance of a successful pregnancy after a single miscarriage is very high.

Doctors may recommend waiting until physical recovery is complete and emotional readiness is felt before trying to conceive again. If miscarriages recur, further medical testing can help identify underlying and potentially treatable causes.

When to Seek Medical Help?

Seek urgent medical care if you experience any of the following:

• Heavy bleeding that soaks through pads
• Severe abdominal pain
• Fever or chills
• Dizziness or fainting

Early medical attention can prevent complications and provide reassurance.

Conclusion

Miscarriage can be emotionally and physically challenging, but it is rarely caused by anything a woman did. Understanding the causes, symptoms and risk factors can help reduce guilt and fear. Recovery involves both physical healing and emotional support, including talking to healthcare providers or support groups. Most women go on to have healthy pregnancies and by caring for your body and well-being, you can move forward with knowledge, resilience and hope for the future.