Vaginal blood loss and mild menstrual-like pain may be the first sign of a miscarriage. Signs of pregnancy such as breast tenderness and morning sickness sometimes lessen just before a miscarriage occurs.

A miscarriage usually occurs within a few days of the initial blood loss, although sometimes it can take a week or even a few weeks. With a miscarriage, you can experience gradually increasing cramps in the uterus and blood loss, like a heavy menstrual period.

When the amniotic sac is expelled from the uterus over the course of several hours, the miscarriage has occurred. The amniotic sac is recognizable as a fluid-filled sac with a membranous sheath partially coated with pink flakes. Often, blood clots are also expelled, which are dark red and smooth.

After the expulsion of the amniotic sac and clots, the pain stops almost immediately. Blood loss slows and is similar to the last days of menstruation. Call the midwife should you miscarry, so that we know what has happened.

Why do we miscarry?
The cause of miscarriage is almost always a chromosomal deformity that happens as a result of egg fertilization. This leads to problematic maintenance of a pregnancy whereby the pregnancy can not move forward, and the fertilized egg is expelled.

Preventing a miscarriage
Completely preventing a miscarriage is simply not possible. If you want to become pregnant again after a miscarriage, you should live as healthy as possible. This means a healthy and varied diet, avoiding alcohol or cigarette smoke, and not taking any medication without consulting with your GP first. You should take the recommended dose of 0.5 mg of folic acid per day. Folic acid will not reduce the risk of miscarriage, but it will minimize the chances of giving birth to a child with spina bifida.

When should you call us?

• Heavy blood loss. If you seem to be losing large quantities of blood (long-term blood loss of greater volumes than by a heavy period) this can be dangerous. If you see stars or feel faint you need to contact us immediately.
• Consistent, continuous complaints. If you, after a spontaneous miscarriage, experience cramping and severe blood loss which does not reduce, this indicates an incomplete miscarriage.
• Any temperature above 38°C during or shortly after a miscarriage.
• Anxiety. There is always a listening ear for those of you worried about how the miscarriage will occur or any other worries or fears. Just call the on-duty midwife at the practice.