Miscarriage 2025: Causes, warning signs and modern support

Author photo
Zappelphilipp Marx•
Two hands comforting each other after a miscarriage

A miscarriage is one of the most common yet most stigmatized pregnancy losses. Many people affected feel guilty or isolated, even though there is usually nothing they could have done medically to prevent it. This guide explains in plain language what a miscarriage is, which warning signs to take seriously, what treatment options exist, and how to regain physical and emotional stability.

What is a miscarriage?

A miscarriage, medically called a spontaneous abortion, is a pregnancy loss before the point at which a baby could survive outside the uterus. Many guidelines place this boundary between the 20th and 24th week of pregnancy. Later losses are classified as stillbirth.

Clinicians distinguish, among others:

  • Early miscarriage: loss before 12 weeks of pregnancy
  • Late miscarriage: loss roughly between 12 and 24 weeks of pregnancy
  • Complete or incomplete miscarriage: depending on whether pregnancy tissue remains in the uterus
  • Missed miscarriage: an embryo or fetus without cardiac activity, without bleeding or expulsion starting

Crucially: most miscarriages are not caused by diet, exercise or a single stressful event. The most common cause is random errors in early development that people cannot control.

Statistics and frequency

Estimates suggest that about 10 to 20 percent of clinically recognised pregnancies end in miscarriage. Because very early losses often occur before a pregnancy test is taken, the actual rate is likely higher. The World Health Organization (WHO) notes that pregnancy loss affects millions of families worldwide each year and is still rarely discussed openly.

The risk changes with age. Miscarriage is less common in younger people; the probability increases with age, particularly from the mid-30s onward. Still, many people over 35 have completely uncomplicated pregnancies.

Causes and risk factors

After a miscarriage many ask: why us? Often no single cause can be identified. Multiple factors frequently interact. Key known mechanisms and risk factors include:

  • Chromosomal abnormalities: A large proportion of early miscarriages are due to random errors in chromosome division. These usually arise in the egg or at fertilization.
  • Hormonal disorders: Thyroid disease, poorly controlled diabetes, luteal phase deficiency or PCOS can affect implantation and early development.
  • Anatomical causes: Fibroids, uterine malformations, adhesions or an undetected cervical insufficiency can increase risk.
  • Infections: for example bacterial vaginosis or specific pathogens such as Listeria, Chlamydia or rubella.
  • Lifestyle: smoking, high alcohol intake, certain drugs, very low or high body weight and severe sleep deprivation.
  • Parental age: As maternal age increases, the risk of genetic errors rises; increased paternal age may also play a role.
  • Clotting and autoimmune disorders: for example antiphospholipid syndrome or other coagulation disorders.

It is important to distinguish between modifiable and non‑modifiable factors. Nobody can change their age or random genetic events. At the same time, it is worthwhile to investigate treatable causes, especially after recurrent miscarriages.

Warning signs and diagnosis

Not every bleeding means a miscarriage, but any concerning symptoms should be taken seriously. Seek medical help promptly if any of the following occur:

  • Vaginal bleeding, from spotting to heavier bleeding with fresh blood or tissue
  • Cramping pain in the lower abdomen or lower back
  • Severe dizziness, circulatory problems or feeling faint
  • Sudden loss of previously strong pregnancy symptoms
  • Fever, chills or foul-smelling discharge

Diagnosis is usually made by a combination of ultrasound and blood tests. Ultrasound assesses cardiac activity, the size of the gestational sac and embryo, and location. Serial measurements of the pregnancy hormone hCG help evaluate the course. National health services (e.g., Health Canada) recommend that bleeding in pregnancy be medically evaluated.

Reducing risk: what you can do yourself

Not every miscarriage can be prevented. Many losses would have occurred even under perfect conditions. Nevertheless, there are strategies that can reduce risk and support overall pregnancy health:

  • Good preparation: take folic acid, check vaccination status, and ensure chronic conditions are well controlled.
  • Weight and nutrition: a healthy body mass index and a Mediterranean-style, mostly plant-based diet support hormone balance and circulation.
  • Quit smoking and avoid alcohol: ideally stop during the preconception period.
  • Review medications: have regular medications checked for pregnancy safety.
  • Reduce stress deliberately: prolonged high stress can worsen existing risks. Breaks, good sleep hygiene and relaxation techniques help the nervous system recover.

If you have already experienced a miscarriage, discuss with your obstetrician-gynecologist or a fertility centre whether tests such as thyroid screening, clotting diagnostics or other investigations are appropriate. International professional societies such as ESHRE publish regularly updated recommendations.

Treatment and medical follow-up

The chosen treatment depends on gestational age, symptoms and ultrasound findings. The WHO handbook for quality abortion and miscarriage care describes three basic approaches:

  • Expectant management: the body expels the tissue naturally. This can take several days to a few weeks and is accompanied by follow-up checks.
  • Medical treatment: medications such as misoprostol, sometimes combined with mifepristone, accelerate the expulsion of pregnancy tissue.
  • Surgical intervention: suction curettage or manual vacuum aspiration, particularly for heavy bleeding, signs of infection or retained tissue.

After a miscarriage, follow-up is important to ensure the uterus is empty and there is no lingering infection. Rh‑negative patients are commonly offered anti‑D prophylaxis to prevent complications in future pregnancies.

National clinical guideline collections, for example those by the Society of Obstetricians and Gynaecologists of Canada (SOGC), provide evidence-based recommendations for clinicians and those affected.

Planning your next pregnancy

Physically, a new pregnancy is often possible sooner than many expect. It is commonly recommended to wait at least one natural menstrual cycle after a miscarriage. After surgical procedures or complicated courses, a slightly longer interval may be advised to allow the uterine lining to fully recover.

Equally important is the emotional aspect. Some people feel ready to try again relatively quickly; others need much more time. A detailed follow-up conversation with your treating physician helps clarify questions, understand findings and decide together whether genetic or hormonal tests are appropriate.

Mental health and support

A miscarriage is not only a medical event but a farewell to a hoped-for future. Sadness, anger, anxiety or guilt are normal reactions. The WHO calls for breaking the silence and stigma around pregnancy loss and for offering respectful, continuous support to those affected.

  • Psychotherapy and counselling: grief counselling or cognitive behavioural approaches can help integrate the loss.
  • Support groups and online communities: connecting with people in similar situations reduces feelings of isolation.
  • Partner and family conversations: differing grieving reactions can strain relationships. Open communication helps avoid misunderstandings.
  • Rituals and remembrance: memorial rituals, letters or keepsakes can help give the pregnancy a place in your life.

Support is available through obstetric clinics, midwives, psychosocial pregnancy counselling services or specialised bereavement care. Many of these services are free or covered by insurance.

Outlook 2025: research and innovation

Research worldwide is intensively focused on better understanding miscarriage risks and providing targeted support to affected couples. Some key areas are:

  • Improved genetic diagnostics: less invasive analyses of embryos and pregnancy tissue help better classify chromosomal causes.
  • Microbiome research: studies investigate how the bacterial communities of the genital tract influence inflammation, implantation and early pregnancy courses.
  • Digital tools and artificial intelligence: apps and analysis algorithms may in future help identify individual risk profiles and refer people earlier to specialist centres.

Despite all technology, it remains essential that medical quality is combined with empathetic communication and reliable psychosocial support.

When you urgently need medical help

Go to an emergency department or call emergency services immediately if any of the following apply:

  • Very heavy bleeding, for example if pads or pads are soaked through hourly over several hours
  • Severe, persistent pain in the lower abdomen or referred shoulder pain
  • Marked dizziness, loss of consciousness or feeling faint
  • Fever, chills or foul-smelling discharge after a suspected or confirmed miscarriage

Even with lighter bleeding, uncertainty or distressing anxiety, it is sensible to seek medical advice early. Contacts include obstetrician-gynecologist offices, early pregnancy clinics, midwives or the medical on-call service.

Conclusion

A miscarriage is a profound event that affects body and mind and yet is very common. No one is to blame when a pregnancy does not progress. Clear information, safe medical care and feelings that are taken seriously can help people get through this time. Many couples go on to have a healthy pregnancy after a miscarriage—with time, support and care tailored to their situation.

Disclaimer: Content on RattleStork is provided for general informational and educational purposes only. It does not constitute medical, legal, or other professional advice; no specific outcome is guaranteed. Use of this information is at your own risk. See our full Disclaimer.

Frequently asked questions (FAQ)

Estimates suggest that about 10 to 20 percent of clinically recognised pregnancies end in miscarriage, most of them in the first trimester. Many very early losses go unnoticed, so the true frequency is higher.

Typical warning signs are vaginal bleeding, cramping pain in the lower abdomen or back, a sudden decrease in previously strong pregnancy symptoms, and dizziness or circulatory problems. With such signs, people should seek medical advice promptly.

Short-term daily stress is not thought to cause a miscarriage. However, prolonged, very high stress can affect overall wellbeing and other risk factors such as high blood pressure, poor sleep or unhealthy habits and should therefore be taken seriously.

Yes, as maternal age increases, average egg quality declines and genetic abnormalities become more common. This gradually increases miscarriage risk, particularly from the mid-30s and more markedly from age 40, although many pregnancies in these age groups proceed without problems.

In certain situations, such as confirmed luteal phase deficiency or recurrent early miscarriages, progesterone therapy may be useful. Whether treatment is recommended and at what dose should always be discussed individually with a specialist clinician.

Both procedures aim to remove remaining pregnancy tissue from the uterus. Today, a gentle vacuum aspiration is often preferred because it is generally associated with a lower risk of scarring and a faster recovery compared with traditional sharp curettage.

If you are Rh-negative and the other parent is likely Rh-positive, anti‑D prophylaxis is generally recommended. It prevents your immune system from forming antibodies that could endanger a future pregnancy.

Often it is sufficient to wait for one natural menstrual cycle before attempting a new pregnancy. After surgical procedures or complicated courses, a somewhat longer interval may be advisable. In addition to medical assessment, your physical and emotional recovery are important factors.

In most cases a miscarriage is an isolated event and the next pregnancy proceeds normally. After two or more consecutive miscarriages, more extensive evaluation is often recommended to identify possible genetic, hormonal or anatomical causes.

Early studies suggest that an imbalance of the bacterial flora in the genital tract may promote inflammation and thus influence early pregnancy courses. Research is still at an early stage, and routine therapies based on the microbiome are under investigation.

In many regions there are support groups, bereavement circles and initiatives for parents who have lost a child during pregnancy or shortly after birth. People can get information about these resources through hospitals, counselling services, midwives or local search portals.

A mostly plant-focused, Mediterranean-style diet rich in vegetables, fruit, whole grains, healthy fats, sufficient protein, folate and vitamin D supports general health and can have a positive effect on hormones and fertility.