Miscarriage

What are the different types of miscarriage?

Miscarriages fall into a few categories. An early miscarriage is defined as a miscarriage that occurs before 13 weeks of pregnancy, but whether a miscarriage occurs before 13 or 20 weeks, it may be classified as one of the following.

• Asymptomatic (missed) miscarriage: No symptoms; miscarriage may go unnoticed with conception materials remaining in the body.
• Biochemical miscarriage: Diagnosed by declining hCG levels; pregnancy may or may not have been visible on an ultrasound.
• Complete miscarriage: All pregnancy tissue passes on its own; no medical treatment is typically needed if this occurs.
• Incomplete miscarriage: Some pregnancy tissue remains in the uterus. This may cause bleeding and pain, requiring medical treatment to remove remaining tissue.
• Repeat (recurrent) miscarriage: Defined as two or more consecutive miscarriages; may indicate structural issues, genetic problems or chronic health conditions.
• Threatened miscarriage: Possible miscarriage with symptoms like abdominal cramps and vaginal bleeding, but no miscarriage has occurred yet.

Risk factors for miscarriage

Risk factors for miscarriage include:

• Age: Risk of miscarriage increases significantly after age 45.
• Previous miscarriage: The likelihood of miscarriage rises with each prior miscarriage.
• Excess weight: Both being overweight and underweight are linked to a higher risk of miscarriage, possibly due to hormonal factors like insulin resistance.
• Reproductive organ issues: Structural problems or scar tissue in the uterus, often from conditions like fibroids and polyps, can hinder pregnancy. Surgical removal may help in some cases.
• Existing medical conditions: Autoimmune conditions (like antiphospholipid syndrome and lupus) and existing medical issues (such as high blood pressure, diabetes, thyroid disorders and PCOS) increase miscarriage risk.
• Infections: Infections such as the Zika virus and untreated sexually transmitted infections (STIs) like gonorrhea and chlamydia are linked to an increased risk of miscarriage.
• Smoking, alcohol, caffeine and illegal drugs: Smoking, heavy caffeine and alcohol consumption, and illegal drug use (such as cocaine) all increase the risk of miscarriage.
• Environmental factors: Exposure to pollutants like chemical solvents, heavy metals, radiation and air pollution can increase miscarriage risk for both partners.

How is miscarriage diagnosed?

OBGYNs typically diagnose miscarriages using a combination of a pelvic exam, blood tests and imaging.

Miscarriage treatments

If diagnostic tests confirm a miscarriage, your healthcare team may recommend one of the following treatment options:

How to prevent miscarriage

Miscarriages can’t always be prevented, and they are no one’s fault. Many women think that overexercising, accidents or taking birth control pills caused their miscarriage, but that is not true.

Taking care of your body is the best thing you can do. Some examples of ways to care for yourself include:

• Get regular prenatal care during and after pregnancy.
• Avoid risk factors like smoking, alcohol and illegal drugs.
• Take a daily multivitamin.
• If you’ve had previous miscarriages, consult your healthcare provider about taking low-dose aspirin.
• Limit caffeine to no more than 200 milligrams per day (about one 12-ounce cup of brewed coffee), and check food labels for caffeine content.
• Manage any long-term health conditions with your healthcare team.

Coping and support

Emotional healing after a miscarriage can be much longer than physical recovery. The loss can be deeply painful, and others might not fully understand your grief. You may experience different emotions, from anger and guilt to despair, and your partner's feelings might differ. Allow yourself time to grieve and seek support from loved ones if needed.

While you might never forget your hopes and dreams for pregnancy, acceptance may gradually help ease your pain. If you continue to experience sadness or stress, consult your healthcare professional. If you’re planning to become pregnant, talk to your healthcare provider about the best timing for your next pregnancy and address any questions you may have.