Brian Levine, MD, MS, FACOG, is board-certified in obstetrics-gynecology, as well as reproductive endocrinology and infertility (REI). He is the director and founding partner of CCRM New York and was named a rising star by Super Doctors from 2017 to 2019.
Marley Hall is a writer and fact-checker who is certified in clinical and translational research. Her work has been published in medical journals in the field of surgery, and she has received numerous awards for publication in education.
Losing a child before they're born is not uncommon, but it's never easy. Whether you have just experienced a miscarriage or stillbirth or have been told by a healthcare provider that such an event is likely on the horizon, you may have many feelings at once, including worry, disbelief, disappointment, and grief.
Learning more about pregnancy loss causes and risk factors may help provide clarity, if not immediate comfort. Start here to understand why miscarriage and stillbirth can happen, how to cope physically and emotionally, and what to consider before trying to conceive again.
Usually, miscarriages happen when an embryo or fetus is not developing normally. Often due to genetics or chance, the developing fetus will have too few or too many chromosomes, information in cells that guide growth and allow a pregnancy to progress. Being older can increase the risk of chromosome abnormalities, and one-third of pregnancies in people ages 40 and older end in miscarriage. Sometimes, abnormalities in the cervix or uterus can lead to miscarriage, too. But miscarriages very rarely happen because of anything the pregnant individual has done. Work, exercise, stress, arguments, sex, and morning sickness won't cause a person to miscarry.
If a person miscarries before five weeks, sometimes called a "chemical pregnancy," they may have what feels like a normal, even painless period. But most miscarriages involve some cramping. A person may also pass blood, fluid, or tissue through the vagina (though bleeding does not always signal a miscarriage). If you think you're miscarrying, keep in close touch with your healthcare provider. They can prescribe medicine to ease discomfort and advise you to seek emergency care for excessive miscarriage pain or bleeding.
Cramping and bleeding can last for hours or days. Sometimes, a healthcare provider confirms by ultrasound that you have lost a pregnancy but still have tissue inside of you, which can take around two weeks to pass on its own. Taking medication called mifepristone or misoprostol will cause your body to expel the tissue quicker, usually within one week.
Miscarriage is more common than you may think. Some 10% to 15% of known pregnancies end in miscarriage, but experts think that as many as half of all pregnancies do. Most miscarriages happen before the 12th week of pregnancy, though one in five occurs between weeks 13 and 19.
You may be able to get pregnant as soon as your menstrual cycle begins again, usually four to six weeks after a miscarriage. Experts suggest you wait until you have one normal period before trying to conceive again. You may want to wait even longer if your healthcare provider recommends special testing to help determine what may have caused the miscarriage.
Miscarriage describes early pregnancy loss that occurs before 20 weeks gestation. Stillbirth is when a baby dies in the womb after 20 weeks. It's less common than miscarriage, affecting about 1 in 160 pregnancies. Stillbirth is often discovered when the pregnant person senses a lack of fetal movement or a second- or third-trimester ultrasound confirms that a baby has no heartbeat. Stillbirth rarely occurs amid labor these days, thanks to fetal monitoring.
Often, the cause of stillbirth isn't clear. Some stillborn babies have birth defects, genetic disorders, or growth restrictions linked to placental or maternal circulation problems. Some medical conditions (like high blood pressure and diabetes) and infections (including cytomegalovirus and listeria) put you at higher risk for stillbirth.
A chemical pregnancy is a very common form of early miscarriage that happens within the first five weeks of gestation. While there may be enough circulating hormones in the person's body for a positive pregnancy test, a just-formed embryo stops developing, and the body usually expels it through what may seem like a normal, albeit slightly late, period.
Affecting about one in 50 pregnancies, an ectopic pregnancy happens when a fertilized egg starts to develop outside the uterus, usually in one of the fallopian tubes. Ectopic pregnancies can be life-threatening because they can cause the fallopian tube to burst, leading to internal bleeding. Tell your healthcare provider right away if you have any symptoms like heavy bleeding, low-back pain, or one-sided abdominal pain.
Dilation and cutterage (D&C) is a short (five-to-10 minute) surgical procedure to remove tissue from inside the uterus or stem excessive bleeding, sometimes after an incomplete miscarriage. While under general anesthesia or sedated, a surgeon will dilate the cervix and use suction and a sharp instrument to scrape tissue from the uterus.
A child born after a previous pregnancy loss is sometimes called a rainbow baby. Nicknamed because of the hope and joy they can bring families following a dark period, rainbow babies may be born after a miscarriage, stillbirth, or death of a newborn sibling.
Human chorionic gonadotropin, or hCG, is a hormone the body produces as soon as conception happens. In early pregnancy, hCG levels typically double every few days, peaking around 10 weeks. Your healthcare provider may check your hCG levels through a simple blood test to make sure your pregnancy is progressing normally.
American College of Obstetricians and Gynecologists. Early pregnancy loss.
Planned Parenthood. How do I know if I’m having a miscarriage?
Reproductive Health Access Project. What are my choices for early pregnancy loss (miscarriage) treatment?
March of Dimes. Miscarriage.
Centers for Disease Control and Prevention. What is stillbirth?
American College of Obstetricians and Gynecologists. Stillbirth.
Cleveland Clinic. Chemical pregnancy.
American College of Obstetricians and Gynecologists. Ectopic pregnancy.
American Pregnancy Association. What is HCG?.
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