min. lectura
Surviving a miscarriage and losing a child can be a very painful, sad and an emotional experience. If you or a loved one are grieving from a recent miscarriage, it’s important to know you’re not alone and, more than anything, it’s not your fault.
Take time to heal and take care of your body to help process and recover from a miscarriage. Everyone processes grief differently, and we offer resources for support, comfort and information.
Miscarriages and miscarriage rates
Miscarriages are common. Many people are surprised to learn that 1 in every 4 to 5 pregnancies result in miscarriage. Additionally, about 15% of women have more than one miscarriage. The American College of Obstetricians and Gynecologists estimates somewhere between 9% to 17% of known pregnancies end in miscarriage in women who are 20–30 years old, with about 80% occurring in the first trimester. A variety of factors can influence miscarriage rates.
Dealing with the aftermath of a miscarriage and healing may take time. Below are some of the most frequent concerns and questions we receive from women who have experienced miscarriages and pregnancy loss.
Information in this blog about miscarriages and coping:
- Common causes of miscarriage
- What happens after a miscarriage?
- Getting pregnant after a miscarriage
- Frequently asked questions about miscarriage
Common causes of miscarriage
Most of the time, the cause of a miscarriage is unknown. About 50% of pregnancy losses result from fetal chromosome abnormalities. Some common miscarriage risk factors include:
- Advanced maternal age (particularly age 40+)
- Being underweight or overweight
- Chronic conditions, such as uncontrolled diabetes or thyroid disease
- Previous miscarriages
- Smoking, alcohol, heavy caffeine use and illegal drugs
- Uterine or cervical problems
What happens after a miscarriage?
Experiencing a miscarriage can be life-changing and how you deal with it is personal. After a miscarriage, you’ll likely have some cramping and bleeding that’s heavier than your normal menstrual period, lasting up to 2 weeks. How long bleeding and other symptoms last after a miscarriage can vary from person to person. Light bleeding or spotting can continue for 4 to 6 weeks. About 2 weeks after the tissue passes, your doctor may suggest doing an ultrasound exam or other tests to ensure all the tissue has passed.
Most women have their menstrual cycles resume to normal within 4 to 6 weeks. You may experience hormonal changes as hCG levels decrease, too. Learn more about options for managing a miscarriage.
It’s important after a miscarriage that you take time for recovery, both physically and emotionally. Sometimes hearing about how other women handle their personal experience with a miscarriage can help too.
Getting pregnant after a miscarriage
After having a miscarriage, it’s completely possible to become pregnant again without having another miscarriage. When you feel ready, talk with your doctor about next steps. Most couples are advised to avoid sex for 2 weeks after a miscarriage to avoid infection.
Having one miscarriage doesn’t necessarily mean you’ll have another, although having a prior miscarriage is a risk factor for future pregnancies. However, only 2% of pregnant women will have two consecutive losses and less than 1% will have three consecutive losses.
Risks of multiple miscarriages and pregnancy after a miscarriage:
- After one miscarriage, your risk of a future miscarriage is about 20%.
- After two consecutive miscarriages, your risk of a future miscarriage is about 30%.
- After three miscarriages, your risk is as high as 40% for consecutive losses.
Miscarriage resources and support
Having a miscarriage can be an emotional and life-changing experience. Texas Children's has resources to help women with miscarriages. Know it's common for women to experience many feelings with miscarriages. Our Texas Children’s Pavilion for Women helps women through every stage of life, including pregnancy and miscarriages.
Frequently asked questions after a miscarriage
Bleeding will vary from person to person and how the miscarriage was managed (whether tissue passed naturally or managed with medication or surgery). In general, however, you can expect some cramping and bleeding that’s heavier than your normal menstrual period, lasting up to 2 weeks. Light bleeding or spotting can continue for 4 to 6 weeks.
Women are encouraged to live a healthy lifestyle before pursuing pregnancy. Avoiding known risk factors, such as smoking, is recommended. A healthy weight before pregnancy also decreases risks for pregnancy complications, including miscarriage.
Some factors that may contribute to having a miscarriage are beyond your control, like age or having had a prior miscarriage. Some women may have variations in their uterus that increase the risk of a miscarriage, including a uterine septum, fibroids or scar tissue in the uterine cavity.
Certain infections may impact miscarriage risk if you’re already pregnant, including listeria, parvovirus B19 and herpes simplex, among others. Endocrine conditions, including thyroid dysfunction and diabetes, can increase the risk of miscarriage if not well managed.
Women who require fertility treatments have a similar rate of miscarriage as women who conceive spontaneously. As in the general population, the age of the egg provider affects the risk of miscarriage.
While miscarriage can’t be prevented, the best chance for a successful pregnancy is when it’s planned and you’re in good health. It’s always a good idea to schedule an appointment with your doctor to discuss preconception planning. Taking a prenatal vitamin with at least 400 mcg of folic acid before getting pregnant is very important in supporting an embryo’s early development.
About 80% of miscarriages occur in the first trimester, or the first 12 weeks of pregnancy. They become less common further along in pregnancy. Miscarriages are significantly less common after 12 weeks. The incidence of miscarriage decreases to 1–2% after the first trimester and continues to decrease as the fetus develops.
Although miscarriages can still happen after 20 weeks, the risk of pregnancy loss is less than 0.5%. While chromosomal abnormalities are the most common cause of first trimester loss, second trimester losses tend to result from:
- Fetal abnormalities
- Poorly controlled maternal health conditions, some autoimmune diseases, thrombophilias (disorders associated with abnormal blood clot formation) or trauma
- Prior surgery on the cervix
- Uterine abnormalities (fibroids, abnormal uterine shapes [e.g., bicornuate uterus])
Generally, there are three options for someone who miscarries: expectant management, medical management or surgical management. The decision as to which option is best after a miscarriage should be based on your doctor’s recommendation and your preference.
- Expectant miscarriage management, or watchful waiting, is allowing time to see if the body passes the pregnancy on its own. In most cases, tissue passes within the first 2 weeks after diagnosis of an abnormal pregnancy. Some pregnant women and doctors may prefer to wait until closer to 4 to 6 weeks to see if tissue passes on its own. While this may be the most “natural” process, it comes with the uncertainty of when and all tissue will pass on its own.
- Medical miscarriage management includes using a medication like misoprostol or Cytotec, which is a prostaglandin analog that is commonly used to pass uterine contents after a miscarriage. This medication is highly effective, low cost and has few side effects. Additional benefits to medical management include avoiding surgery, enabling you to be at home for the process and control over the timing. You’ll need to be followed by your doctor to ensure the process is complete.
- Surgical miscarriage management or dilation and curettage, more commonly known as D&C, is the fastest and most effective way to treat a miscarriage. While it does carry some minor risks associated with surgery and anesthesia, it has the added benefits of allowing the patient to not feel or remember the process. Some facilities, including the Pavilion for Women, also may be able to offer genetic testing of the fetal tissue, which may confirm a chromosomal cause for the miscarriage.
In the case of a D&C, which is typically an outpatient procedure for miscarriage, you’ll go home after a couple hours of observation. Most of the time, women feel relatively normal after the first 24 hours. We typically recommend allowing at least 1 day of recovery after the miscarriage D&C procedure for physical and emotional healing.
You may gradually increase your physical activity as tolerated. After a miscarriage, your body is healing and adapting from being pregnant. Your body may experience pain or you may be extra emotional; it varies by individual. You can expect spotting for a few weeks, and your period may take time to normalize. You should avoid intercourse for 2 weeks after a miscarriage due to infection risk.
Talk with your doctor about your next steps for trying to conceive after a pregnancy loss. The latest research suggests that an otherwise healthy woman does not have to wait beyond the completion of the miscarriage before trying again. Recent studies also showed improved pregnancy outcomes when pregnancy occurred within the first 3 to 6 months after pregnancy loss. Some doctors may recommend waiting until your next normal period to allow accurate pregnancy dating.
Some of the most common myths about miscarriage include:
- Myth: Miscarriage is rare. As discussed earlier, 1 in every 4 to 5 pregnancies result in miscarriage.
- Myth: It’s the woman’s fault she miscarried. Chromosomal abnormalities are the most common cause of miscarriage.
- Myth: Stress causes miscarriage. Stress or arguments do not cause miscarriages.
- Myth: Bleeding in the first trimester always means miscarriage. Up to 40% of patients have bleeding in the first trimester.
- Myth: Exercise, work or lifting can cause miscarriage. There are very few restrictions during pregnancy for most patients. Exercise is encouraged for physical and mental well-being during pregnancy and very few patients need to avoid it.
- Myth: Having one miscarriage means there’s no chance of having a successful pregnancy. Only 2% of pregnant women will have two consecutive losses.
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