Pregnancy Loss: What You Need to Know

Pregnancy is a happy time for couples, but it comes with worries. Miscarriage is probably the number one fear shared by expectant parents.

While most pregnancies reach term, an estimated 10 percent of all clinically recognized pregnancies end in miscarriage and approximately 80 percent of miscarriages happen within the first three months of pregnancy. That’s why couples typically wait a handful of weeks to announce they’re pregnant. Some women fear a miscarriage means they have a fertility problem, but this is not the case. At least 85% of women who have miscarriages go on to have normal pregnancies and births.

The good news is once a normal pregnancy is seen on ultrasound at the first pregnancy visit, the likelihood of miscarriage is reduced. When you reach the second trimester, the likelihood is further reduced.  

A little worry is normal, but I urge couples to keep things in perspective by being informed about the causes, risk factors, prevention and symptoms of miscarriage. 

Miscarriage Causes

Most miscarriages happen when the unborn baby has a fatal genetic problem that is not related to the mother. These generally cannot be prevented, though taking folic acid (400 mcg daily, starting 1-2 months pre-conception) is strongly recommended to help reduce birth defects. 

Who Might be at Higher Risk for a Miscarriage?

Women who are at a higher risk of miscarriage include those who are older than age 35, have conditions such as diabetes or thyroid problems or have had three or more previous miscarriages. 

Can Miscarriage be Prevented?

Prevention includes optimizing any known medical conditions before pregnancy, which means addressing diabetes, thyroid disease or hypertension, for example. Women who are overweight or obese can benefit from mild weight loss. Other health issues to address include: 

• Infections
• Abnormal menstrual cycles
• Immune system conditions
• Uterine or cervical abnormalities
• Smoking, alcohol and/or street drug use
• Exposure to radiation/toxic substances

Symptoms

You should watch for symptoms of miscarriage throughout pregnancy. These include: 

• Bleeding that goes from light to heavy
• Severe cramps
• Belly pain
• Weakness
• Worsening or severe back pain
• Fever with any of the above symptoms
• Prolonged or unprovoked spotting or bloody discharge 
• Contractions
• Tissue that looks like blood clots passing from your vagina

If you have any of these symptoms, contact your health care provider right away. 

Pregnancy loss is devastating for couples. We are here to provide compassionate care during this time of healing. As with any grief, everyone’s experience is different. At CHI Health, we offer resources including support groups and bereavement organizations for patients who experience pregnancy loss. 

For more questions, reach out to your Women's Health provider.

Original post date: March 2021. Revised: Nov. 2023.