Tommy's miscarriage: what to know

Bleeding and cramping can occur in early pregnancy for several reasons, so symptoms alone cannot confirm miscarriage. A clinician may ask about the bleeding, pain, pregnancy dates and previous scans. A transvaginal ultrasound can examine the pregnancy and uterus in detail. Sometimes repeat assessment is needed when the pregnancy is too early to see clearly or the findings are uncertain.

If miscarriage is confirmed, care may involve waiting for the tissue to pass naturally, medicine to help the uterus empty, or a procedure to remove pregnancy tissue. The appropriate option depends on bleeding, infection, scan findings, medical history and your preference. Grief can be intense even when the pregnancy was early; support from a trusted person or counsellor can help.

Contact your pregnancy or gynaecology service for advice, especially if bleeding or pain is new. Keep track of symptom changes, avoid inserting anything into the vagina while bleeding unless your clinician advises otherwise, and use the pain relief recommended for your situation. Ask what follow-up will confirm that the miscarriage is complete and when you can return to usual activities.

If treatment is recommended, ask how long bleeding and cramps may last, what medicine effects to expect and who to call outside clinic hours. Medical management and surgical management are different pathways, and your clinician can explain the benefits and limitations of each for you.

Seek urgent medical help for heavy or rapidly increasing bleeding, severe or one-sided pain, faintness, shoulder-tip pain, fever, chills, offensive discharge or feeling very unwell. These symptoms can signal blood loss, infection or an ectopic pregnancy and should not wait for routine follow-up.

What does my scan show, and is repeat imaging needed? Could this be an ectopic pregnancy? Which management options are suitable for me? How will I know the miscarriage is complete? What symptoms require emergency care? What emotional support is available, and when can we discuss a future pregnancy?