Miscarriage can be a distressing, highly emotional experience. In most cases, your body can tell you what’s happening — and signal that something may be off during your pregnancy. Unfortunately, you can still have a miscarriage without even knowing it.
These undetected, or “missed,” miscarriages can add a layer of anxiety during pregnancy, or grief to an already difficult situation. Learn what a missed miscarriage is, how to determine if you’ve had one and where to find support.
What is a missed miscarriage?
First of all, miscarriage, or early pregnancy loss, is defined by The American College of Obstetricians and Gynecologists (ACOG) as any pregnancy loss occurring during the first 13 weeks of pregnancy (the first trimester). About half of early miscarriages happen when the embryo doesn’t develop properly — often due to an abnormal number of chromosomes.1
A missed miscarriage is a form of early pregnancy loss. Often in these cases, your body won’t give you any signs that a miscarriage happened.2 You might even continue to still feel pregnant for a while, and a pregnancy test could still show as positive.2 This can make a missed miscarriage even more shocking when you find out.
As soon as you suspect any abnormality in your pregnancy or if you have any concerns or pain, consult your doctor immediately.
What causes a missed miscarriage?
Miscarriages are usually random.1 Remember: A miscarriage is never your fault. Don’t blame yourself for what happened — or, in the case of a missed miscarriage, that you didn’t know sooner. It’s nearly impossible to tell if you’ve had a missed miscarriage without the help of your ob-gyn.
These activities most likely won’t cause a miscarriage1:
- Moderate Exercise
- Everyday Stress
- Having sex
- Having used birth control pills in the past
- Morning sickness (like nausea or vomiting)
However, the risk of miscarriage can increase with age, weight, the use of alcohol or drugs, smoking and drinking too much caffeine.3 Consult your doctor to know your own risk factors.
How common is a missed miscarriage?
Studies show that one in four women experience miscarriage.4 But since it can happen before you even know you’re pregnant, that number may be higher.5
In one study, researchers found that missed miscarriages are becoming increasingly common — possibly due to more advanced ultrasound technology which may detect a miscarriage that has not developed other symptoms. Missed miscarriage made up 38.8% of participants’ miscarriages.6
What are the signs of missed miscarriage?
Since there usually aren’t any symptoms of a missed miscarriage, it may be harder to figure out whether you’ve had one without the help of your ob/gyn.
Common miscarriage symptoms you may see and want to ask your doctor about include5:
- Vaginal spotting or bleeding (though spotting in early pregnancy could mean something else)
- Pain or cramping in your abdomen or lower back
- Passing fluid or tissue from your vagina
The only way to know for sure if you’ve had a missed miscarriage is through an ultrasound scan.7
During the ultrasound, your ob-gyn will check for a fetal heartbeat and see if the embryo is developing normally. With a missed miscarriage, the scan may show an embryo that looks smaller than it should be, or the scan may not detect one at all.2 The currently most common practice in the US is for your ob-gyn to schedule you for another ultrasound in a week or so to check again.7
In the meantime, your doctor may monitor your hCG levels. The hormone hCG is made by cells in the placenta, and its presence can indicate you’re pregnant. While hCG levels are different for everyone, hCG typically doubles about every two days during the first ten weeks of pregnancy.8 hCG not rising as expected could be an indicator of early pregnancy loss.9 Monitoring hCG levels is especially important if you have a history of miscarriages.
Suggestions for after a missed miscarriage
After the ultrasound results come back, your ob-gyn can talk you through some suggestions for your care plan. Here are some of the options they may suggest:
This is the “wait and see” approach, so consult your doctor before adopting this suggestion. During a miscarriage, pregnancy tissue will pass naturally over time. For missed miscarriages, it could take as long as three to four weeks. You may have some spotting or bleeding (like a period) at first — then heavier bleeding and cramps after the pregnancy tissue passes.7
Waiting it out can take longer than other treatments. However, some women may find comfort in the natural process. It can also give you more time to grieve and process your emotions.
Your ob-gyn may recommend this option if you have no signs of infections.7 If it doesn’t happen on its own, they may recommend medicine or surgery.
Treatment and medication
Medicine can help speed up the passing of pregnancy tissue. These medications are designed to be taken either by mouth or insertion in the vagina. Taking the medication vaginally may work faster11 and minimize side effects.7
Like any medication, it is generally known that there can be possible side effects, including:
- Heavier bleeding (after the tissue passes)11
- Cramping (after the tissue passes)11
Medical treatment may take up to 24 hours to work for missed miscarriages.7 If medication doesn’t successfully assist your body in passing the tissue, surgery can be a helpful option.
Surgical treatment after the miscarriage
Surgery for miscarriage is called dilation and curettage (or curette). It’s a more immediate solution and necessary if you’re experiencing heavy bleeding or an infection.7 If you’re considering this option, be sure to check local regulations.
During the operation, you’ll typically:
- Receive anesthesia.10
- Have your cervix dilated.7
- Get pregnancy tissue removed.7
The actual procedure only takes a few minutes, but you may need to stay in the hospital for a few hours to recover.
This surgery is considered low risk, but possible risks include:
- Post-miscarriage issues
- Damage to the cervix or uterus (very rare)10
I’ve experienced a missed miscarriage. Where can I get support?
Talking about miscarriage can be hard. Even thinking about it can create a whirlwind of emotions. But you don’t have to go through it alone, and it is much more common than you might think.5 There are many places to find support and comfort during this incredibly difficult time.
Your doctor has been with you on this journey. They may have seen a lot of your pregnancy highs and lows, and they should be able to empathize with you on a different level. This can help you get more direct insight into what’s happening with your body, and what steps to take to stay healthy and well.
Your loved ones
Friends and family can offer a shoulder to lean on. While they may not fully understand what you’re going through, they can be there to listen to your feelings. Doing things you love, with the people you love, can also help lift your spirits. You may be surprised to hear they’ve gone through a similar experience.
It can take courage to be vulnerable about what’s on your mind, but if you’re willing to, a therapist can be a big help. Therapists are trained to help you work through your emotions—and can give you the tools to process them on your own.
While your immediate circle may not have gone through miscarriage, others have. Learning about others’ stories, like those shared on the Clearblue® Conceivinghood page, or joining a support group can help — they’re a reminder that you really aren’t alone.
In a support group, you help others, and your struggle is felt and validated by them. If there isn’t a group in your area, or meeting on your schedule, you may want to try online support groups for miscarriage like March of Dimes.
Even after your body’s healed, you might need time to process mentally and emotionally — and that’s okay. Take all the time you need. Be patient with yourself, and let others be there for you. Above all else, know that you’re stronger than you might feel.
Related Blog Content
- The American College of Obstetricians and Gynecologists. “Early Pregnancy Loss” Accessed 07 Sept. 2022. https://www.acog.org/womens-health/faqs/early-pregnancy-loss
- Miscarriage Association. “Missed Miscarriage” Accessed 07 Sept. 2022. https://www.miscarriageassociation.org.uk/information/miscarriage/missed-miscarriage/
- The National Health Service. “Causes: Miscarriage” Accessed 07 Sept. 2022 https://www.nhs.uk/conditions/miscarriage/causes/
- Hardy, K., & Hardy, P. J. (2015). 1st trimester miscarriage: four decades of study. Translational pediatrics, 4(2), 189–200. https://doi.org/10.3978/j.issn.2224-4336.2015.03.05
- Mayo Clinic. “Miscarriage: Overview” Accessed 07 Sept. 2022. https://www.mayoclinic.org/diseases-conditions/pregnancy-loss-miscarriage/symptoms-causes/syc-20354298
- Linnakaari, R., Helle, N., Mentula, M., Bloigu, A., Gissler, M., Heikinheimo, O., & Niinimäki, N. (2019). Trends in the incidence, rate and treatment of miscarriage—nationwide register-study in Finland, 1998–2016, Human Reproduction, 34(11), 2120–2128. https://doi.org/10.1093/humrep/dez211
- Mayo Clinic. “Miscarriage: Diagnosis & Treatment” Accessed 07 Sept. 2022. https://www.mayoclinic.org/diseases-conditions/pregnancy-loss-miscarriage/diagnosis-treatment/drc-20354304
- Gnoth, C., & Johnson, S, (July, 2014), “Strips of hope: accuracy of home pregnancy tests and new developments,” Geburtshilfe und Frauenheilkunde, 74(07), 661-669, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4119102/
- Konrad G. (2007). First-trimester bleeding with falling HCG: don't assume miscarriage. Canadian family physician Medecin de famille canadien, 53(5), 831–832. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1949168/
- Mayo Clinic. “Dilation and curettage (D&C).” Accessed 13 Oct. 2022. https://www.mayoclinic.org/tests-procedures/dilation-and-curettage/about/pac-20384910
- Marwah, S., Gupta, S., Batra, N. P., Bhasin, V., Sarna, V., & Kaur, N. (2016). A Comparative Study to Evaluate the Efficacy of Vaginal vs Oral Prostaglandin E1 Analogue (Misoprostol) in Management of First Trimester Missed Abortion. National Library of Medicine. Accessed 14 Sept. 2022. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4948485/