Natural miscarriage: what to know

A miscarriage can involve vaginal bleeding, cramping and passing tissue or fluid. Symptoms vary, and bleeding alone cannot confirm that a pregnancy has ended. A clinician may use a transvaginal ultrasound and sometimes repeat assessment to check the pregnancy and whether tissue remains in the womb. The timing and amount of bleeding are not reliable ways to predict the course.

If miscarriage is confirmed, options may include waiting for the body to complete the process, medicine to help it happen, or a procedure to remove remaining tissue. The suitable choice depends on bleeding, infection, scan findings, your health and your preferences. Emotional responses can be intense or mixed, and support is appropriate.

Contact a pregnancy or emergency service for advice if you have bleeding or pain in early pregnancy. Use pads rather than tampons while bleeding so you can observe changes, rest as needed, and follow the pain-relief advice given to you. Keep any tissue only if a clinician asks for it. Attend follow-up so ongoing bleeding, infection and completion of the miscarriage can be checked. Do not blame yourself; ordinary activity, sex or an argument do not usually cause a miscarriage.

Seek urgent help for heavy bleeding, severe or one-sided abdominal pain, shoulder-tip pain, fainting, marked dizziness, fever, chills, or feeling seriously unwell. These symptoms can signal significant blood loss, infection or a pregnancy outside the womb. Call emergency services if you collapse or have difficulty staying awake. A follow-up review is needed even when bleeding settles.

Ask how the diagnosis was confirmed, what bleeding and pain are expected, how you will know the miscarriage is complete, and which management option fits your circumstances. Discuss rhesus status if relevant, future pregnancy planning, emotional support and when to return for review.