Early signs and symptoms of a miscarriage - all you need to know

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When you are pregnant your number one priority is, of course, the safety of your unborn child, and you might want to be aware of the early signs and symptoms of a miscarriage.

This article covers the signs and symptoms of miscarriage, the causes of miscarriage, what to do if you think you are experiencing a miscarriage and how to cope after you have experienced a miscarriage.

When discussing miscarriage you may hear the terms 'early miscarriage' and 'late miscarriage' but wonder what exactly this means.

What is an early miscarriage?

An early miscarriage is anything that happens in the first 12/13 weeks of the pregnancy. The signs and symptoms of an early miscarriage can be confusing for expectant mums. With 50% of pregnancies ending in the first two weeks, sometimes these signs and symptoms can be missed altogether.

How common are early miscarriages?

Early miscarriages are sadly much more common than you might think - in fact it is believed that up to 50% of fertilized eggs do not make it past the first and second week of pregnancy.

Often women do not even know that they are pregnant during an early miscarriage, as they haven't yet taken a pregnancy test.

After a pregnancy test has shown as positive between 10-20% of pregnancies still end in miscarriage, most of which happen in the first 12 weeks (first trimester).

What is a late miscarriage?

Late miscarriage is anything that happens between 14 and 24 weeks of pregnancy. It is also called a second trimester miscarriage. This is different from a stillbirth which is in the third trimester.

How common are late miscarriages?

Of all miscarriages about 1-2% happen in the 'late' stage or the second trimester. It is generally considered that once the baby is past the 12 week stage it is in a 'safer' zone.

What is a threatened miscarriage?

Sometimes a woman will experience the symptoms of bleeding and period-style cramps for several days, but this doesn't always mean a miscarriage is happening.

With a threatened miscarriage these symptoms can occur but then the pregnancy can carry on as normal.

What are the early signs and symptoms of a miscarriage?

The most common signs or symptoms of a miscarriage are vaginal bleeding and stomach cramps. Others include:

  • Vaginal bleeding that can be anything from light spotting to a heavy bleed perhaps with some blood clots. It can also be a brownish discharge or bright red blood.
  • Strong period-type cramping pains are also a common sign that a miscarriage might be occurring.
  • The NHS also recommends that mums look out for a discharge of fluid from your vagina or a discharge of tissue.
  • The symptoms of pregnancy, such as breast tenderness or morning sickness, may subside if you have experienced them up to that point.

  • Kate Pinney, a midwife from Tommy's baby charity, says; 'It is possible to have some spotting in early pregnancy, generally around 3-5 weeks, usually when the next period would have been due, this is called an implantation bleed, however we do advise with any bleeding in pregnancy to be reviewed to ensure there are no concerns.'

    What should I do if I have early signs of a miscarriage?

    If you begin to experience any prolonged bleeding or strong abdominal and back pain during your pregnancy then you should call your GP or your EPU (early pregnancy unit) at your hospital.

    These services have out-of-hours numbers that you can call if you are concerned too.

    However, as Kate says; 'If a mum is unfortunately miscarrying there is nothing she can do to prevent it.'

    How do I know if I did have a miscarriage?

    Some miscarriages are only discovered during the routine pregnancy ultrasound scan when the nurse will find an empty embryo sac - this can be known as a missed or silent miscarriage.

    If you are admitted to hospital with miscarriage symptoms sometimes they can't always tell you straight away whether you have lost the baby.

    They might send you home and ask you to come back to hospital a couple of weeks later to check with an ultrasound scan.

    Why did I have a miscarriage?

    Miscarriages can happen for a variety of reasons, but fundamentally the embryo isn't developing in the womb as it should be.

    This is mostly due to chromosome problems - for example, too many or too few chromosomes (human embryos need 23 from dad and 23 from mum) would cause a miscarriage.

    Studies now suggest that the older a man's sperm, the more vulnerable a foetus is to having chromosomal problems such as Down's syndrome.

    But remember that recurrent miscarriages (i.e. 3 or more) are uncommon, they affect about 1% of couples trying to conceive.

    What can cause a miscarriage?

    There are many potential causes of a miscarriage:

  • Blighted ovum - This is when a fertilised egg doesn't develop as it should.
  • Genetic factors - About half of all miscarriages are caused because your baby doesn't develop normally and so can't survive.
  • Illness in the mother - If you get a very high temperature in pregnancy it can be dangerous, as can some illness and infections, such as German measles. Minor infections like coughs and colds aren't harmful, though.
  • Hormone imbalance - You may find it more difficult to conceive if you have irregular periods and could then be more likely to miscarry.
  • Placental problems - if you have problems with the blood supply to the placenta, your baby can lack nourishment and the pregnancy can miscarry.
  • Womb problems - your cervix can be weak and open too early, causing a miscarriage. This can be rectified in future pregnancies. Sometimes your womb may be an unusual shape and prevent your baby from growing properly or large fibroids (growths) in your womb can cause miscarriage, too.
  • Ectopic pregnancy - This affects one in 100 pregnancies and is when the embryo develops in one of the fallopian tubes or elsewhere outside the womb. This can be risky for the mother as her tube may burst and the pregnancy ends.

    What can I do to reduce my risk of miscarriage?

    Most miscarriages are completely unavoidable and the mother is unable to influence the outcome of the situation. However it is worth thinking about the following factors when trying to get pregnant again.

    Kate at Tommy's charity says; 'Following the routine early pregnancy advice can reduce chances of a miscarriage, for example taking a folic acid supplement, ideally from before conceiving up until at least the end of the first trimester. Additionally looking after yourself and leading a healthy lifestyle which includes managing body weight to maintain a normal BMI, if possible, eat a healthy balance diet with lots of fruits and vegetables, take some gentle regular exercise and not to smoke. However many women who do miscarry take all of this advice, it is unfortunately something that women largely do not have control over.'

    Tommy's advises all mums-to-be to do the following as part of their pregnancy...

  • Don't smoke - it can affect your baby's growth and the health of your placenta.
  • Drugs and alcohol are also linked to an increase in complications.
  • Report any bleeding or abnormal abdominal pain immediately.
  • Avoid the risk of infections - such as salmonella (from raw eggs) and listeria (from unpasteurised cheeses).
  • Go to all your antenatal appointments - monitoring can pick up problems early.
  • Be aware of your baby's movements - if they noticeably slow down, seek advice from your midwife or maternity unit straight away.
  • Talk to your midwife about risk factors for stillbirth. If you are at higher risk, your pregnancy care should take this into account.

  • Can my doctor investigate the cause of my early miscarriage?

    Kate Pinney, midwife, says; 'Unfortunately many women never receive an answer as to why they miscarried. In the NHS women normally have to endure three consecutive miscarriages before full investigations are carried out.'

    'But if your miscarriages are all in the first trimester, you may have to suffer three in a row before you and your partner are referred for tests.'

    Ruth Bender Atik of The Miscarriage Association explains, 'Late miscarriages (at 14-23 weeks) are more likely to be investigated than early ones, because they're far less common and a cause is more likely to be found.'

    Are miscarriages becoming more common?

    Britain has the third highest rate of stillbirths in developed countries (ranking 33 out of 35). 

    'The growing number of older mums is a good reason to assume that miscarriage - at any stage of pregnancy - is on the increase,' says Ruth. 

In the past 20 years, the number of new mums over the age of 40 has nearly tripled, from 9,336 in 1989 to 26,976 in 2009.

'Just as older women find it harder to conceive, they will also find it harder to hold on to a pregnancy.'

    MORE: After a miscarriage: How to cope with miscarriage

    Why are late miscarriages talked about more than early miscarriages if they are so common?

    After 12 weeks mums-to-be are considered to be in a safer stage of their pregnancy than those in the early weeks, but that isn't always the case.

    Obviously miscarriage is devastating at any stage, and even if you suffered a loss in the first weeks you should allow yourself to grieve however you wish to. Later miscarriages can be particularly hard to cope with, as mothers have to go through the trauma of giving birth.

    Celebrities Lily Allen, Amanda Holden, and Kelly Brook have all suffered the agony of a late miscarriage - losing a baby that was almost old enough to live.

 Ruth stresses that late miscarriages are very unusual, with figures showing only one to two per cent of women lose babies in the second trimester.

    Continued below...

    'We have what appears to be a cluster of late-term losses, and it's easy to assume this might be a problem, but it's not,' she says.

 'It's just awful coincidence that three pregnant celebrities have suffered the same tragedy over such a short period of time.'

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