Many women have light bleeding during early pregnancy, but their pregnancy still progresses well. Pain in the lower abdomen, resembling menstrual pain, is possible during early pregnancy, and it is caused by the growing uterus.
Approximately 15–25% of all clinically recognised pregnancies end in a miscarriage. The majority of miscarriages, roughly 75%, happen before the 13th week. The most common reason is a severe chromosome abnormality. A miscarriage that is about to begin or is already happening cannot be medically prevented.
When a pregnancy ends before 12 weeks of gestation, it is referred to as an early pregnancy loss. A very early miscarriage may go unnoticed if the woman’s period is only a few days late and her bleeding is only slightly heavier than her normal menstrual bleeding. An early miscarriage does not require any treatment.
The pain associated with an early pregnancy loss is caused by the contracting uterus and opening cervix. If the bleeding and pain continue, you should have a physician perform an ultrasound to check how your pregnancy is progressing and what is causing the bleeding. The examination will verify whether the size of the foetus matches the gestation week, if the pregnancy in question is anembryonic, or if the pregnancy has ended.
A late pregnancy loss refers to a miscarriage that happens after the 12th week mark but before the 22nd, and usually at this point the foetus will weigh under 500 grams.
A miscarriage typically begins with light bleeding that progressively becomes heavier. The bleeding may contain large clots. Pain resembling menstrual cramps in the lower abdomen and back is common. Sometimes the foetus may have perished several weeks earlier, and the miscarriage is detected when the uterus stops growing. A late pregnancy loss may also begin with the woman’s waters breaking.
Recurring miscarriages refer to a situation where a woman has had three consecutive early pregnancy miscarriages, or two consecutive early pregnancy miscarriages, one of which took place during the second trimester.
After a single miscarriage, the next pregnancy is likely to progress normally.
How do I seek treatment?
In all emergency situations, you should call the emergency clinic before leaving for the hospital. You can find the contact information via the links below. Normally, a pregnant woman will need a referral from a physician or nurse to be admitted to an emergency clinic. However, you may come to the Gynecological Emergency Clinic during early pregnancy without a referral if you are having vaginal bleeding and strong abdominal pain, and pain medication is not helping.
Miscarriages during early pregnancy are primarily verified and treated during office hours at the Gynecological Outpatient Clinic. Only miscarriage patients who are bleeding heavily will need emergency treatment. An ultrasound is performed to confirm the miscarriage, and sometimes pregnancy hormone levels are measured from the woman’s blood. If the uterus has emptied itself or is in the process of doing so and the bleeding is not heavy, the situation will be monitored without further treatment. If the uterus needs to be emptied, the options include medical treatment with medication that causes contractions, or dilation and curettage (D&C).
Read HUS’s instructions on seeking emergency services
Talking about your emotions and grieving are important for your psychological coping and a possible future pregnancy. An abruptly ending pregnancy may cause crying, grief or guilt. Sometimes it can be mentally challenging to cope with a miscarriage. If you feel like you need professional help, you should mention this to a nurse or a doctor. If necessary, you can talk to your own nurse at the maternity and child health clinic if you already had an appointment there, or contact your health station.
Read about the Selma self-help programme on the website of Mielenterveystalo (in Finnish).
Age is a risk factor for miscarriage. After the age of 35, a woman’s risk of miscarriage increases. The man’s age will also have an impact.
- A couple hoping for a pregnancy should aim for a healthy lifestyle; excess weight, smoking and use of intoxicants should be avoided.
- The woman should ensure that she is getting enough vitamin D and folic acid when trying to become pregnant.
Frequently asked questions about miscarriage
Did I do something that caused the miscarriage?
It is not possible that you caused the miscarriage yourself. The most common reason is a severe chromosome abnormality. That is why a miscarriage that is about to begin or is already happening cannot be medically prevented.
How long will the bleeding last?
The duration of the bleeding will vary. It depends on the treatment method. After medical treatment, the bleeding may last from six days up to six weeks. After dilation and curettage with suction, the bleeding will last for 3–10 days on average.
How heavy will the bleeding be?
During the very early pregnancy miscarriages, the bleeding is often only slightly heavier than normal menstrual bleeding. The further along the pregnancy had progressed, the heavier the bleeding will be, as well. When a miscarriage is medically treated, the bleeding will be heavier than menstrual bleeding for the first few days, and may include clots. After the initial days, the bleeding will become less heavy. After a D&C, the bleeding will usually be lighter in comparison to menstrual bleeding.
Pain? Which painkillers can I use?
Everyone experiences pain differently, and several factors affect this. It is completely normal to have only slight pain. You should also ensure sufficient pain relief during a miscarriage. At home, you can take both ibuprofen 600 mg – 800 mg (e.g. Burana®, Ibumax®, Ibuxin®) and paracetamol 1 g (e.g. Panadol®, Paratabs®, Paramax®) every eight hours. Your doctor may have prescribed you with some other painkiller. Take this painkiller according to the prescription.
In addition, you can try drugfree pain reduction methods, such as an oat-filled heat pack, a warm shower or light exercise. If these means are not sufficient, contact the Gynecological Outpatient Clinic.
Will I have another miscarriage?
After a single miscarriage, the next pregnancy is very likely to progress normally. Even after three consecutive miscarriages, the next pregnancy has a 60% likelihood of being normal.