After A Miscarriage: What Happens, And What Nobody Tells You

Trying to overcome the pain after miscarrying is one of the hardest battles any parent has to fight. We share the best ways to cope with the pain.

If you’re reading this because it’s just happened: it wasn’t your fault, and there was almost certainly nothing you could have done differently.

That isn’t a comforting phrase. It’s the medical position, and it comes first because most women assume the opposite.

Miscarriage is common. Around one in five recognised pregnancies ends in miscarriage, most of them in the first twelve weeks. The true figure is higher, because many happen before a pregnancy is known about.

The usual cause is a chromosomal error in the embryo: a random fault at the point of cell division, not an inherited problem and not something either parent did.

What doesn’t cause miscarriage

Women replay the weeks beforehand looking for the moment they broke it. Almost every candidate on that list isn’t a cause:

Exercise, including vigorous exercise
Working, including standing all day or a stressful job
Stress, an argument, a fright, or bad news
Sex
Lifting a toddler, or lifting shopping
Having been on contraception previously
A cup of coffee, spicy food, or most of what you’ve been told to avoid
A minor fall or knock
Not wanting the pregnancy at first, or being ambivalent about it
Travel or flying

Some things do raise risk: smoking, heavy alcohol use, certain infections, some medical conditions, and maternal age. None of those means an individual miscarriage was caused by them, and none of them makes it a failure.

When to get help urgently

Go to A&E immediately if you’ve:

One-sided abdominal pain, especially with shoulder-tip pain, faintness or dizziness: this can indicate an ectopic pregnancy, which is a medical emergency
Bleeding that soaks a pad an hour or more, or large clots
Fever, chills, or offensive-smelling discharge
Feeling faint, or collapsing

Otherwise, contact your obstetrician or go to the hospital’s early pregnancy service. Bleeding in early pregnancy is common and doesn’t always mean miscarriage, but it always needs assessing.

What happens physically

Where a miscarriage is confirmed, you usually have options, and you generally get a say:

Expectant management: waiting for it to complete naturally, over days or a couple of weeks.
Medical management: medication to help it complete.
Surgical management: a short procedure under anaesthetic to empty the uterus.

None is medically better in most situations, and the right one depends on what you can bear as much as anything clinical. It’s reasonable to ask which you can choose, how long each takes, what the pain will be like, and what happens if it doesn’t work.

Practical things nobody mentions: bleeding can continue for one to two weeks; period-like or stronger cramping is expected; your milk may come in if the loss was later, which is distressing if unexpected; and if you’re rhesus negative you may need an anti-D injection. Ask, because it’s occasionally missed.

The grief

It’s a bereavement, and the fact that it happened at six weeks instead of twenty doesn’t determine how much it hurts. Women grieve the pregnancy, the child they’d imagined, the due date, the plans already made.

There’s no correct timeline. Some people feel steady in weeks; others are ambushed months later by a due date or a scan photograph.
Anniversaries land hard, the due date especially. Knowing it’s coming helps.
Partners grieve too, and are routinely overlooked. They’re asked how their wife is and not how they are. Ask them.
Guilt is near-universal and misplaced. Re-read the list above when it returns.
Anger is normal, including at pregnant friends. It doesn’t make you a bad person.
Tell whoever you want to tell. There’s no obligation to keep it private, and there’s no obligation to explain it either.

Get help if the low mood isn’t lifting after several weeks, you can’t function, you feel hopeless, or you’re having thoughts of not wanting to be here. Speak to your doctor, ask the hospital about counselling or a medical social worker, or call the Samaritans of Singapore on 1767 at any hour.

If you’re supporting someone


Avoid	Try
“At least it was early”	“I’m so sorry.”
“Everything happens for a reason”	“That’s awful. Do you want to talk about it?”
“You can always try again”	“I’m here whenever you want.”
“At least you know you can get pregnant”	Nothing. Just sit with them.
Avoiding them because you don’t know what to say	Saying “I don’t know what to say, but I’m thinking of you.”

Practical help lands better than words: a meal, taking the older children for an afternoon, a message that says no reply is needed.

Trying again

Physically, most doctors say you can try once bleeding has stopped and you feel ready, often after one normal period. There’s no general evidence that waiting longer improves the outcome.
Emotionally is a separate question with a different answer, and the two partners often arrive at it at different times.
Most women who miscarry go on to have a healthy pregnancy. One miscarriage doesn’t meaningfully raise the risk of another.
Recurrent miscarriage, usually defined as two or three consecutive losses, warrants investigation, and there are treatable causes. Ask for a referral, don’t wait to be offered one.
Anxiety in the next pregnancy is normal and often intense. Tell your obstetrician about the previous loss; many units will offer earlier reassurance scans.
Start folic acid before trying again, not after.

Frequently asked questions

Did I cause my miscarriage?

Almost certainly not. The usual cause is a random chromosomal error in the embryo. Exercise, working, stress, sex, lifting, a fright, a minor fall, travel, coffee and previous contraception don’t cause miscarriage, and neither does having felt ambivalent about the pregnancy.

How common is miscarriage?

Around one in five recognised pregnancies, most in the first twelve weeks, and the real rate is higher because many happen before a pregnancy is known about.

When is bleeding in pregnancy an emergency?

Go to A&E immediately for one-sided abdominal pain, particularly with shoulder-tip pain, faintness or dizziness, which can indicate an ectopic pregnancy. Also for bleeding that soaks a pad an hour, large clots, fever or offensive-smelling discharge. Any bleeding should be assessed, though it doesn’t always mean miscarriage.

What are the options for managing a miscarriage?

Waiting for it to complete naturally, medication to help it complete, or a short surgical procedure. None is medically superior in most situations, so the choice often comes down to what you can bear. Ask which you can choose, how long each takes and what the pain will be like. And if you’re rhesus negative, ask about an anti-D injection.

How long until I can try again?

Physically, usually once bleeding has stopped and you feel ready, often after one normal period. There’s no general evidence that waiting longer improves outcomes. Emotionally is a separate question, and partners frequently reach the answer at different times.

Will it happen again?

Most women who miscarry go on to have a healthy pregnancy, and one miscarriage doesn’t meaningfully raise the risk of another. Two or three consecutive losses warrant investigation, and there are treatable causes. Ask for a referral, don’t wait to be offered one.

What should I say to someone who has miscarried?

“I’m so sorry” and “I’m here” are enough. Avoid “at least it was early”, “everything happens for a reason” and “you can try again”. Practical help lands better than words: a meal, taking older children for an afternoon, a message that needs no reply. And ask the partner how they are; they’re almost always overlooked.

What to remember

It wasn’t your fault. The cause is usually a random chromosomal error, and the list of things people blame themselves for is a list of things that don’t cause miscarriage.

Go to A&E immediately for one-sided pain with faintness or shoulder-tip pain. That can be ectopic and it’s an emergency.

Grief has no correct timeline and no minimum gestation. Partners grieve too and nobody asks them. And most women who miscarry go on to have a healthy pregnancy.