A pregnancy lasts about 40 weeks for most women. Miscarriage occurs when there is a loss of pregnancy before Week 20 of the pregnancy. Doctors sometimes refer to miscarriage as a "spontaneous abortion." It is estimated that miscarriage occurs in about 15% to 25% of pregnancies.
The risk of miscarriage is highest within the first 13 weeks of pregnancy. Some women have a miscarriage before they even know they are pregnant. The risk of miscarriage is higher for women who are older than 35 and for women who previously had a miscarriage.
Most of the time, the cause of miscarriage is unknown. Although many women may feel guilty that they did something to cause a miscarriage, most pregnancy losses could not have been prevented. A miscarriage usually occurs when there is a problem that makes it impossible for the baby to develop properly.
Possible causes for a miscarriage include:
- chromosome (genetic material) problems
- problems with implanting the fertilized egg in the uterus
- hormone problems
- injury to the fetus
- abnormal sperm or egg cells
- physical problem with the woman's reproductive organs (e.g., cervix, placenta, or uterus abnormality) – these problems are usually not discovered unless a miscarriage occurs
Despite common misconceptions, exercising, having sex, previous birth control use, and working have not been proven to cause miscarriage.
The most common symptom of miscarriage is bleeding. Bleeding at the beginning of pregnancy is called threatened miscarriage. Most women who have threatened miscarriage during the first few months of pregnancy have healthy babies, but some of these women will have a miscarriage. Other symptoms of miscarriage include lower back pain, lower stomach pain, or clot-like material that passes from the vagina.
If you bleed while you are pregnant, you and your doctor will need to monitor your symptoms for a few days. Your doctor may order tests, such as blood tests (to detect the pregnancy hormone, human chorionic gonadotropin or hCG) or an ultrasound (to get a visual of the baby's development). The diagnosis of miscarriage is based on your symptoms and these tests.
If you have spotting or bleeding, heavy or persistent bleeding with pain or cramping, a lot of fluid discharge from your vagina with no pain or bleeding, or if you suspect that you have passed fetal tissue, you should get medical attention immediately.
Pregnancy loss can have a huge impact on a couple's relationship. Read "Coping with the loss" and "Moving on from miscarriage" in this health feature to learn more about feelings of loss and grief that a couple must cope with when they have a miscarriage.
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