Kate Davies, Fertility Nurse Consultant, IVF coach and founder of Your Fertility Journey explains the different types of miscarriage and shares details of where you can find miscarriage support.
What are the different types of miscarriage and what does this mean for me?
There are so many different types of miscarriage and it can feel confusing when hearing these different terms, especially as many of the terms sound medicalised and often bear little relation to what you may be experiencing both physically and emotionally.
The term miscarriage means the loss of a baby in the first 23 weeks of pregnancy, with early miscarriage being the loss of a baby in the first 12 weeks. Sadly, miscarriage is very common with approximately one in four pregnancies ending in a miscarriage.
What happens during a miscarriage?
When a miscarriage occurs, it is often associated with vaginal bleeding and lower abdominal pain. However, confusingly not all miscarriages start out in this way. Below is an explanation of the different names you may hear and what this means and importantly what may happen during this type of miscarriage.
What are the different types of miscarriage?
Chemical Pregnancy: The term given to a pregnancy that ends in a miscarriage before the first 5 weeks of pregnancy. Advances in the sensitivity of pregnancy tests mean that you may find out that you are pregnant very early and in some circumstances a pregnancy does not develop as it should and whilst you may have enough pregnancy hormone to be picked up by a pregnancy test, a few days or weeks later the test may become negative. You may notice a heavier than normal period.
Threatened miscarriage: This is when you are experiencing bleeding or pain that ‘threatens’ to develop into a miscarriage. When examined by a doctor the entrance to the uterus is closed and the risk may resolve and the pregnancy continue, or you may go on to miscarry.
Inevitable miscarriage: This is as it sounds, the entrance to the uterus is open and a miscarriage will occur. Your doctor will likely inform you that a miscarriage will happen. It is likely that your doctor will advise that you miscarry at home.
Complete miscarriage: This means that a miscarriage has occurred, and no pregnancy tissue is left in the uterus. This is generally determined by having an ultrasound scan and an examination.
Incomplete miscarriage: This occurs when a miscarriage has happened, but some pregnancy tissue remains in the uterus. You may be experiencing bleeding and pain and to avoid the risks of infection your doctor may suggest that you have a minor surgical procedure to remove the remaining pregnancy tissue.
Missed or delayed miscarriage: This is when your baby’s heartbeat cannot be seen on an ultrasound scan and there is no further development or that the heartbeat has stopped. It is likely that you will be offered another scan a week or so later to confirm that the pregnancy has ceased. At this point you may still feel pregnant, but your pregnancy symptoms will start to subside. You may go on to miscarry or it may be necessary to remove the pregnancy tissue surgically.
Ectopic Pregnancy: An ectopic pregnancy is one that occurs in the fallopian tube or elsewhere in the pelvis. You may notice pain and have some bleeding. Unfortunately, a pregnancy is not able to survive outside the uterus and will not continue to develop. An ectopic pregnancy can be managed medical with drugs or removed surgically. On rare occasions an ectopic pregnancy can be life threatening but it is likely that you will be carefully monitored during this time to make sure that you stay well.
Molar Pregnancy: This is a pregnancy that doesn’t develop correctly. In general, the pregnancy tissue needs to be removed surgically and you may be advised to wait for a few months before trying to conceive again.
Blighted Ovum: A blighted ovum is where a pregnancy sac develops but when you have an ultrasound there is no embryo visible in the sac.
Recovering after a miscarriage
It is normal to have bleeding and crampy pain similar to a period for up to two weeks following a miscarriage. Your next period may be a little later or earlier than expected. It is also normal to feel tired after a miscarriage and you may prefer to take some time off work to recover.
It is also important to take the time to recover emotionally. Having a miscarriage can cause a great deal of emotional upset and it is quite normal to feel sadness, disappointment, frustration and anger. You might also be worrying about getting pregnant in the future and if you will miscarry again. The majority of women who experience a miscarriage go on to conceive and have a normal pregnancy. However, if you are concerned about this, speak with your doctor.
Causes of miscarriage
In most cases, the cause of an early miscarriage is not known and there is nothing you could have done to prevent it. Early miscarriages usually happen because the embryo is not developing as it should. Chromosome problems are thought to be one of the most common causes.
Investigating why you have miscarried
In general, you will only be offered further tests if you have had three or more miscarriages. This may feel upsetting at the time but because early miscarriage is common and often no treatable cause can be found, it is advised to wait until you have 3 miscarriages. After this time your doctors will thoroughly investigate and look for any potential causes and how they may be able to treat this.
When can I try to conceive again?
In general, you can start trying to conceive again as soon as you feel both physically and emotionally ready. You may wish to wait until you’ve had a period before trying again, however there is no reason why you can’t start trying as soon as you wish.
Where can I get support following my miscarriage?
There are many resources you can tap in to following a miscarriage. Some of these may be online support, forums and groups or local support groups. Below are some recommendations:
Kate Davies (RN, BSc (Hons), FP Cert) is a fertility nurse consultant and IVF coach. She is the founder of ‘Your Fertility Journey’, a clinic offering high quality advice and support for women and couples who were struggling to conceive. Find out more about Your Fertility Journey here. Kate is also co-host of The Fertility Podcast.