How to Tell If You're Having a Miscarriage

Understanding the Causes, Risk Factors, and Early Signs

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Miscarriage is one of those things that sits in the back of a woman's mind during pregnancy. And it’s a fair concern given that the rate of miscarriage can run anywhere from 10 to 20 percent among women who know they are pregnant.

Of these, 75 percent will occur during the first trimester. After 20 weeks, the rate will drop to as low as two percent.

Causes of Miscarriage in the First Trimester

Among the miscarriages that occur in the first trimester, more than half will be the result of a chromosomal abnormality.

These genetic abnormalities, in and of themselves, prevent the proper development of a fetus. As such, the miscarriage will have occurred not because the parents did anything "wrong;" it was simply the result of a pregnancy that couldn't be brought to term.

Other first-trimester causes can include a deficiency of progesterone, the hormone sometimes referred to as the "hormone of pregnancy." Without ample production of progesterone, the uterus is unable to properly accept and sustain the embryo during gestation.

Causes of Miscarriage in the First Trimester

When a miscarriage occurs during the second trimester, it is more commonly associated with the malformation of the uterus or the development of growths in the uterus (called fibroids).

Moreover, 20 percent of second-trimester miscarriages are caused by problems with the umbilical cord or a result of a placental abruption (the complete or partial separation of the placenta from the uterus) or placental previa (when the placenta covers the opening of the cervix).

Other factors can cause or contribute to the development of a miscarriage. These include:

  • hormone problems
  • immune system disorders, including antiphospholipid syndrome (APS)
  • certain bacterial infections that can inflame the lining of the uterus
  • certain chronic medical conditions like diabetes and thyroid problems
  • previous or multiple miscarriages
  • older age (since chromosomal abnormalities are more likely to occur in parents over 35)
  • smoking
  • excessive drug or alcohol use

After the 20th week, the loss of a pregnancy is no longer considered a miscarriage but is rather referred to as a stillbirth.

Signs and Symptoms of a Miscarriage

Signs of a miscarriage can include spotting or vaginal bleeding similar to a menstrual period. The bleeding will often have more clots than a regular period, appearing as tiny lumps in the vaginal discharge. Abdominal cramping may also accompany. 

While bleeding is not necessarily a sign of a miscarriage, it is important to have it checked out if it does happen. Generally speaking, if the bleeding is light and last for only a day or two, you probably won’t have any problem.

Heavier bleeding is another matter, particularly if accompanied by cramping. In some cases, there may also be back pain or the passing of tissue from the vagina. Morning sickness symptoms (nausea, vomiting) can also suddenly and inexplicably disappear.

Severe symptoms should never be ignored. Heavy bleeding accompanied by severe abdominal pain and/or dizziness could be the sign of an ectopic pregnancy and should be treated as a medical emergency.

This is not to say that all miscarriages will have symptoms. Some happen with little, if any, warning.

Chemical Pregnancy: Miscarriage During an Unknown Pregnancy

While as many as one in five known pregnancies will result in a miscarriage, research suggests that the rate may be as high as 50 percent when including women who are unaware of their pregnancy.

Very early miscarriage (also known as chemical pregnancy) occurs when a pregnancy is lost shortly after implantation. This typically results in heavy bleeding which usually doesn't last any longer than your usual period.

As such, it is possible that a late and/or especially heavy period could have, in fact, been a chemical pregnancy.

Whether or not this is important is debatable. In the end, unless there was a pregnancy test, there is really no way to know for sure if you’ve had a chemical pregnancy, and there could be any number of reasons for a heavy and/or late period.

A Word From Verywell

If you think you are having a miscarriage, call your doctor immediately or go to your nearest emergency room. This is especially true if the bleeding is heavy, the pain is severe, and you are experiencing dizziness or have passed out.

Even if your symptoms are not severe, avoid sex and strenuous activity until you’ve been fully evaluated by your doctor and given the all-clear.

Source:

Robinson, G. "Pregnancy loss.". Best Practice & Research: Clinical Obstetrics & Gynaecology. 2014; 28(1): 69-178.

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