It's a distressing fact that miscarriage is very common in early pregnancy. As many as one in five early pregnancies end in miscarriage. In later pregnancy, this figure falls to one in a hundred. The figures are thought to be even higher due to many pregnancies ending before the mother realises she is pregnant (known as a chemical miscarriage). Whatever the figures, miscarriage can be utterly heart-breaking for the parents, no matter what stage the pregnancy ended at.
Early miscarriages often occur because there is something amiss with the egg, or the embryo is not implanting or developing as it should. There are several different types of early miscarriage.
Missed miscarriage occurs when the embryo dies in early pregnancy but the placenta keeps growing, so you may still test positive. These miscarriages are often picked up at scans when no heartbeat is detected in the baby. In these instances there will still be a hormonal effect on the mother, so she may still feel pregnant. You may be offered a procedure known as a D&C where under anaesthetic; the contents of your uterus are removed. Alternatively, unless there are medical reasons why this is not suitable, you may choose to take medicine which will cause your body to miscarry "naturally" at home. If you choose this way, it is a good idea for you to have support around you; natural miscarriages can be difficult both emotionally and physically. You will need to return to hospital to check your uterus is clear after you have miscarried. There may also be side effects from the medicine you are given, including nausea and vomiting.
Complete miscarriage occurs when the embryo is expelled from the body spontaneously. In this instance, call your GP or midwife, or go to the early pregnancy unit of your nearest hospital where they may scan you to check whether you have miscarried or not, and to control the bleeding if necessary.
A weak cervix is often thought to be behind a late miscarriage (after 12 weeks), and may occur when the mother has had previous miscarriages or abortions. Any pain, blood or unusual discharge in later pregnancy should be checked with your midwife or GP as soon as possible. Babies who die in the womb in late pregnancy need to be delivered either naturally or by caesarean, and this causes huge distress to the parents. If you deliver your baby naturally, you will be given hormones to induce labour, but you should also ask for the support you need to cope with the psychological and emotional impact of this.
There are a number of factors which may increase your risk of miscarriage. The age of the mother when she conceives is a potential factor (over 38 the risk of miscarriage is considered to be greater). If you have had miscarriages previously you may be in a higher risk group too. Other potential risk factors include: hormonal problems, caffeine, nicotine and alcohol consumption.
There is support available for grieving parents, which your midwife should point you towards or contact the Miscarriage Association for advice.