Miscarriage: symptoms, causes, what happens and recovery

The NHS says the main symptom is usually vaginal bleeding before 24 weeks of pregnancy. Bleeding in pregnancy can range from spotting to heavy bleeding. Other symptoms can include pain and cramping in the lower tummy, pink, grey or white lumps coming from the vagina, which may look or feel stringy, and fluid suddenly coming out of the vagina.

The NHS adds that sometimes there are no symptoms and you only find out at a pregnancy scan. This is called a missed miscarriage. It also stresses that vaginal bleeding and tummy pain in pregnancy can have other causes and are not always serious. Miscarriage UK says not all bleeding or pain means miscarriage, and some pregnancies continue normally despite symptoms.

The NHS says to get urgent medical help if you are pregnant and have light vaginal bleeding or spotting with no, or only mild, tummy pain that does not stop you doing daily tasks, or if you have vaginal discharge that is unusual for you or fluid leaking. Call your maternity unit if you have the number. If you are less than 20 weeks pregnant an early pregnancy unit may be able to help. If you cannot reach either, call NHS 111.

The NHS says to call 999 if you are pregnant, have vaginal bleeding and any of the following: severe pain in your tummy (you cannot do daily tasks or focus on TV or reading because of the pain), pain in your shoulder, feeling sick, faint or dizzy or losing consciousness, or heavy bleeding that soaks a period pad soon after putting it on. These can be signs you need immediate treatment.

If doctors think you might be having a miscarriage, the NHS says you will be asked about your pregnancy, previous pregnancies and general health, and may be offered blood or urine tests and an internal (transvaginal) ultrasound scan. Miscarriage UK says diagnosis usually involves a combination of history, pregnancy tests and ultrasound scans, and that sometimes multiple scans are needed.

The NHS says that you will usually be offered different options depending on your symptoms and how many weeks pregnant you are.

For early miscarriage managed by waiting, the NHS says symptoms usually take about 2 weeks to pass, but can take longer. After a miscarriage, it says you may have tummy pain which may last a few days, and vaginal bleeding or spotting for up to 2 weeks. You may feel physically better after a few days or weeks, but it can take longer, and you may feel many emotions including feeling anxious and upset.

The NHS suggests you rest if you need to, take paracetamol for pain, and talk to your partner, family or friends. It advises not having sex until symptoms have gone because of a risk of infection. It says that after a miscarriage it can take up to 8 weeks before you have a period again, and a few months for periods to return to what is usual for you.

The NHS says it is not always known what causes miscarriage, but it is often because there is a problem with the way the pregnancy develops. Miscarriage UK says many people never receive a clear explanation even after tests, and that miscarriage is very unlikely to have been caused by anything you did or did not do. Where causes are found they may include genetic changes, hormonal factors, blood clotting conditions, infections associated with high fever or specific illnesses, and differences in the shape of the uterus or cervix.

The NHS lists things that may increase the chance of miscarriage, which is not the same as causes.

• Being aged 35 or over, or the baby's father being aged 45 or over.

• Being from a Black African or Black Caribbean background.

• Polyendocrine metabolic ovarian syndrome (PMOS), diabetes, a blood clotting condition or a thyroid condition.

• A problem with the womb, low progesterone or vitamin D deficiency.

• Smoking, drinking alcohol or a lot of caffeine.

• Obesity or being underweight.

• Exposure to harmful chemicals or high air pollution.

The NHS says you can try to get pregnant again when you feel ready, after your symptoms have gone, and that most women who have had a miscarriage go on to have a successful pregnancy. It says to talk to a GP if you have had 3 or more miscarriages (recurrent miscarriage), when you will usually be referred for tests to look for a treatable cause and offered support.

The NHS says miscarriage can be difficult both physically and emotionally, and that your GP surgery or pregnancy unit can offer information about counselling and other support. Support is also available for partners, and it can help to talk to others at local or online support groups. National charities including Miscarriage UK and Tommy's offer information and support for anyone affected by baby loss.

On the NHS, suspected miscarriage is assessed through your maternity unit, an early pregnancy unit, your GP or NHS 111, with scans and blood tests as needed. Management options are offered by the care team.

Private early pregnancy clinics also offer scans and assessment on a self-paid basis. In an emergency, such as heavy bleeding or severe pain, use 999 or A&E.