Second miscarriage in a row: what to know and what to do

Your clinician may review your pregnancy history, examine you if needed, and discuss tests based on your symptoms and personal history. Sometimes no single cause is found. A miscarriage is not usually caused by something you did, and grief can remain intense even when the pregnancy was early.

Two consecutive losses can prompt a conversation about recurrent pregnancy loss and whether an assessment is appropriate now. Possible contributors include changes in the pregnancy's chromosomes, conditions affecting the uterus, hormone or metabolic disorders, blood-clotting or immune factors, and issues involving sperm. These possibilities are not a diagnosis, and several may not apply to you.

An assessment can include a detailed history, blood tests, and imaging of the uterus. A transvaginal ultrasound may help assess the uterus and confirm what is happening after a loss; you can read more about [Transvaginal Ultrasound](/treatments/diagnostics-and-imaging/transvaginal-ultrasound/).

Arrange an appointment with an obstetrician-gynaecologist or fertility specialist when you feel ready. Take records of both pregnancies, scan reports, medicines, medical conditions, and any family history of pregnancy loss. Ask whether you need tests before trying again and whether any current medicine should be changed.

After a miscarriage, your body may need time for bleeding and pregnancy hormones to settle. Follow the discharge advice you were given, use the recommended pain relief, and seek emotional support from someone you trust. If tissue remains in the uterus, options may include waiting, medicines, or a procedure. These are explained in [Medical Management of Miscarriage](/treatments/medical-gynaecology/medical-management-of-miscarriage/) and [Surgical Management of Miscarriage](/treatments/gynaecological-surgery/surgical-management-of-miscarriage/).

Get urgent medical help for very heavy bleeding, severe or worsening abdominal pain, one-sided pain, shoulder-tip pain, fainting, marked dizziness, fever, or feeling acutely unwell. These symptoms can signal significant blood loss, infection, or an ectopic pregnancy and need prompt assessment, even if you have already been told that a miscarriage is occurring.

Contact your maternity or gynaecology team if bleeding or pain is not improving as expected, or if you are unsure whether the miscarriage has completed. Keep any follow-up appointment so recovery and the next plan can be checked.

Useful questions include: What follow-up do I need after this loss? Should we investigate possible causes now? Which tests would change my care? When is it medically reasonable to try again? Should I take a prenatal vitamin or manage a health condition before pregnancy? What symptoms should send me to urgent care?