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Let’s talk about early pregnancy loss
Talking to your doctor is especially important. This article should not be considered medical or legal advice.
Early pregnancy loss — and the grief of what could have been — can be devastating. Often, it’s a quiet, lonely sorrow, especially if few people knew you were pregnant. And while time may heal your pain, it will always be part of you. But know this, especially if you’ve never had a child: this tangled web of love, sadness, and worry is the very essence of motherhood.
You were pregnant. Now you’re not. The question haunts you: What happened? We’re here to try to help.
What is early pregnancy loss?
Early pregnancy loss, also called chemical or biochemical pregnancy, is a form of miscarriage. It is not a false positive. If you’re experiencing early pregnancy loss, testing negative after a positive pregnancy test often means that your hCG levels are dropping and, therefore, are no longer detectable. Don’t let anyone tell you that you weren’t really pregnant. You were pregnant.
The American College of Obstetricians and Gynecologists (ACOG) defines early pregnancy loss, miscarriage, and spontaneous abortion as any pregnancy loss occurring during the first 13 weeks of pregnancy (the first trimester).1
There is no definitive medical timetable for first trimester loss, the term generally refers to a loss that happens very early—soon after implantation and a positive pregnancy test. In some cases, it occurs so early that, without testing, you may not have even known you were pregnant.
Why did this happen?
When considering causes of early pregnancy loss, ACOG reports that approximately 50% are attributed to chromosomal abnormalities in the embryo.1 It’s important not to blame yourself. Your morning runs didn’t cause this. The birth control pills you took before getting pregnant didn’t cause this. Having sex two nights ago didn’t cause this. Early pregnancy loss occurs in more than one-third of women over 40, but multiple factors contribute—not just age.1 Sometimes, it just happens (an unsatisfying sentiment, but true). In most cases, there’s nothing you could have done to prevent it.
How do I know I’m no longer pregnant?
Sometimes, early pregnancy loss has no symptoms and is only discovered during an exam. At-home signs could include bleeding, cramping, and/or a negative pregnancy test that follows a positive one. A physical exam can also help confirm a loss. Your ob-gyn may order an ultrasound or blood test, often a series, to see if your hCG levels are dropping.
Do I have to see a healthcare professional?
Yes. If you’ve had a positive pregnancy test, it’s important to see your healthcare professional. If you’re experiencing bleeding or cramping, it’s crucial to determine if it’s normal, whether it’s a sign of pregnancy loss, or another complication.
Management of Early Pregnancy Loss
Coping physically with early pregnancy loss
In most cases, early pregnancy loss doesn’t require any intervention beyond a visit to your healthcare professional. Typically, the tissue passes naturally, like a period, but heavier and longer than normal. You may pass small tissue that resembles a blood clot and may experience cramping, nausea, or diarrhea. Sometimes intervention is needed via medication for pain or an outpatient procedure to remove tissue from your uterus that doesn’t pass on its own or that causes infection. An ultrasound or blood test can determine if this is necessary. Your healthcare provider will guide you on what comes next, including when it’s safe to have sex or use tampons again.
Coping mentally with early pregnancy loss
You may feel alone in your grief. Often, family, friends, and co-workers didn’t even know you were pregnant and will expect you to be fine— the same — the next time they see you. But you aren’t the same. And that’s OK. You’ve experienced loss. Give yourself grace and time as you navigate through it.
Many women who open up about pregnancy loss are surprised by how many others share similar experiences. According to the ACOG, 10% of known pregnancies end in early pregnancy loss.1 Studies also show that one in four women experience pregnancy loss.2 This isn’t meant to soften the blow, but sometimes, there’s comfort in knowing you’re surrounded by a strong, resilient network of women who understand.
You may feel alone, but you are not alone.
If you or your partner need extra support, many in-person and online support groups exist. Search online or contact a medical professional for recommendations.
Looking ahead
You may not want to think about another pregnancy soon after an early pregnancy loss — it may even feel disrespectful. There’s no timeline to follow, and everyone grieves differently. You will know when you're ready to move forward.
It's natural to worry about future pregnancies, especially if you’ve never been pregnant before. Most women who experience early pregnancy loss do go on to have healthy pregnancies and births. Repeated pregnancy loss is rare - ACOG reports only a 1% chance of recurrent miscarriage.3
The human heart holds more love than you might realize. Your story is still unfolding, and the possibility of it being filled with even more love is very real. While that may feel impossible right now, let hope in.
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Sources
Early Pregnancy Loss. The American College of Obstetricians and Gynecologists. August 2015. Accessed February 19, 2025. https://www.acog.org/womens-health/faqs/early-pregnancy-loss?
Hardy, K., & Hardy, P. J. (2015). 1st trimester miscarriage: four decades of study. Translational Pediatrics, 4(2), 189–200. Accessed February 19, 2025.
https://doi.org/10.3978/j.issn.2224-4336.2015.03.05Repeated Miscarriages. The American College of Obstetricians and Gynecologists. May 2016. Accessed February 19, 2025.
https://www.acog.org/womens-health/faqs/repeated-miscarriages?
