Missed miscarriage at 14 weeks: care and next steps

In a missed miscarriage, an ultrasound shows that the pregnancy is no longer developing although miscarriage tissue remains in the uterus. Because the cervix may remain closed, there may be no obvious bleeding or cramping. Pregnancy-related nausea or breast tenderness can also take time to fade.

The clinician considers the scan, earlier imaging and pregnancy dates before confirming what has happened. You can ask to have a support person present for the discussion. Hearing the diagnosis can make it difficult to absorb details, so requesting a written care plan is reasonable.

The hospital team may discuss expectant care, medicines that prompt the uterus to empty, or a surgical procedure. Which choices are appropriate depends on bleeding, infection risk, scan findings, other medical conditions and what services can support safely at this gestation. Ask how pain and nausea will be managed for each route.

Before leaving, confirm where care will occur, what bleeding to anticipate, how to reach the unit and what follow-up is arranged. Having sanitary pads, prescribed pain relief, transport and a trusted adult available can make the process more manageable. Emotional support is part of care, whether wanted immediately or later.

Seek urgent medical help if bleeding is heavy or escalating, pain is severe or not controlled by the recommended medicine, or you develop fever, chills, foul-smelling discharge, ongoing vomiting or a strong sense that you are becoming unwell. Fainting, confusion, shortness of breath or profound weakness alongside bleeding calls for emergency services.

Consider asking whether confirmation needs any further scan, which care settings are available, and how each option affects timing, anaesthesia and follow-up. Discuss handling of pregnancy tissue, any tests relevant to your history, recovery from bleeding, return to usual activity, contraception or trying again, and access to bereavement support.