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 stigmatised, losses in pregnancy. Many people affected feel guilty or alone, even though medically they have done nothing wrong. This guide clearly explains what a miscarriage is, which warning signs you should take seriously, what treatment options are available and how you can regain physical and emotional stability.

What is a miscarriage?

A miscarriage, medically called a spontaneous abortion, is a pregnancy loss before the time at which a baby would be viable outside the womb. Many guidelines set 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: embryo or foetus without heart activity, without bleeding or expulsion starting

Crucially: most miscarriages have nothing to do with diet, exercise or a single stressful event. The most common cause is random errors in early development that those affected cannot influence.

Numbers and frequency

Estimates suggest that around 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) points out 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 and increases with age, particularly from the mid-30s onwards. Nonetheless, 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. Frequently several factors interact. Key known mechanisms and risk factors include:

  • Chromosomal changes: A large proportion of early miscarriages are due to random errors in chromosome division. These usually arise in the egg or at fertilisation.
  • Hormonal disorders: Thyroid disease, poorly controlled diabetes, luteal phase insufficiency or polycystic ovary syndrome (PCOS) can affect implantation and early development.
  • Anatomical causes: Fibroids, uterine malformations, adhesions or an unrecognised cervical insufficiency can increase risk.
  • Infections: for example bacterial vaginosis or certain pathogens such as listeria, chlamydia or rubella.
  • Lifestyle: smoking, high alcohol intake, certain drugs, severe under- or overweight and pronounced sleep deprivation.
  • Parental age: As the mother's age increases the risk of genetic abnormalities rises; higher paternal age can also play a role.
  • Clotting and autoimmune disorders: for example antiphospholipid syndrome or other blood clotting disorders.

It is important to distinguish between modifiable and non-modifiable factors. No one can control their age or random genetic changes. At the same time, it is worthwhile to investigate treatable causes, especially in cases of recurrent miscarriage.

Warning signs and diagnosis

Not every bleed means a miscarriage, but all unusual symptoms should be taken seriously. Seek medical help immediately if any of the following signs 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 examination and blood tests. Ultrasound assesses heartbeat, size of the gestational sac and embryo, and position. Serial measurements of the pregnancy hormone hCG help judge the course. National health services such as the NHS in the UK recommend having any bleeding in pregnancy checked by a healthcare professional.

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 reduce risk and strengthen overall pregnancy health:

  • Good preparation: take folic acid, check vaccination status, ensure chronic conditions are well controlled.
  • Weight and nutrition: a normal body mass index and a Mediterranean-style, mostly plant-based diet support hormonal balance and circulation.
  • Stop smoking and alcohol: ideally avoid these from the preconception period onwards.
  • Review medications: have regularly taken medicines checked for safety in pregnancy.
  • Reduce stress: prolonged severe stress can worsen existing risks. Breaks, sleep hygiene and relaxation techniques help ease the nervous system.

If you have already had a miscarriage, discuss with your gynaecology clinic or a fertility centre whether tests such as a thyroid screen, clotting investigations or further examinations are appropriate. International professional bodies such as ESHRE regularly publish 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 strategies:

  • Expectant management: the body expels the tissue naturally. This can take a few days to a few weeks and is accompanied by monitoring.
  • Medical management: drugs such as misoprostol, sometimes combined with mifepristone, speed up the expulsion of pregnancy tissue.
  • Surgical management: suction curettage or manual vacuum aspiration, especially for heavy bleeding, signs of infection or retained tissue.

After a miscarriage, follow-up checks are important to ensure the uterus is emptied and that no infection persists. Rh-negative patients are generally offered anti-D prophylaxis to prevent complications in future pregnancies.

UK guideline collections and recommendations on care for miscarriage and preterm birth can be found, for example, in the NICE guideline repository . There professionals and interested people can find evidence-based recommendations on management.

Planning the next pregnancy

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

The emotional side is equally important. Some people feel ready to try again relatively quickly, others need much longer. A thorough follow-up discussion with your gynaecologist 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 an imagined future. Sadness, anger, anxiety or guilt are normal reactions. The WHO, in its spotlight on pregnancy loss, calls for breaking the silence and stigma and for providing respectful, continuous support to those affected.

  • Psychotherapy and counselling: bereavement counselling or cognitive behavioural approaches can help integrate the loss.
  • Support groups and online communities: connecting with people in similar situations reduces the feeling of being completely alone.
  • Partner and family conversations: different grief reactions can strain relationships. Open communication helps avoid misunderstandings.
  • Rituals and farewell: memorial rituals, letters or keepsakes can help give the baby a place in your life.

You can get support from gynaecology clinics, midwives, psychosocial pregnancy counselling services or specialised bereavement support. Many of these services are free or covered by health insurance.

Outlook 2025: research and innovation

Intensive research worldwide aims to better understand miscarriage risk and to support affected couples more effectively. Some focus areas are:

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

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

When you urgently need medical help

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

  • Very heavy bleeding, for example when pads or sanitary towels are soaked through every hour over several hours
  • Severe, persistent pain in the lower abdomen or shoulder
  • 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. Points of contact include gynaecology clinics, early pregnancy units, midwives or the out-of-hours medical service.

Conclusion

A miscarriage is a profound event that affects people physically and emotionally and is nevertheless very common. No one is to blame when a pregnancy does not continue. Clear information, safe medical care and emotions that are taken seriously can help 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 around 10 to 20 percent of clinically recognised pregnancies end in miscarriage, most of them in the first trimester. Many very early losses are not noticed, so the true frequency is higher.

Typical warning signs are vaginal bleeding, cramping pain in the lower abdomen or back, a sudden reduction in previously strong pregnancy symptoms, as well as dizziness or circulatory problems. People with such signs should seek medical advice promptly.

Short-term everyday stress does not, according to current knowledge, cause a miscarriage. Prolonged, very severe stress can, however, 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 the mother's age increases average egg quality declines and genetic changes become more frequent. This causes the miscarriage risk to rise gradually, particularly from the mid-30s and more markedly from age 40, although many pregnancies in these age groups proceed without problems.

In certain situations, for example with proven luteal phase insufficiency or recurrent early miscarriages, progesterone therapy can be helpful. Whether treatment is recommended and at what dose should always be discussed individually with a specialist.

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

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

Often it is sufficient to wait one natural menstrual cycle before attempting a new pregnancy. After surgical procedures or complicated courses a somewhat longer interval may be advisable. Besides the medical assessment, your physical and emotional recovery also play an important role.

In most cases a single event remains isolated and the next pregnancy proceeds normally. Only after two or more consecutive miscarriages is further investigation commonly recommended to identify possible genetic, hormonal or anatomical causes.

Early studies suggest that an imbalance of the bacteria in the genital tract can promote inflammation and thus influence early pregnancy courses. Research is still in its early stages and routine therapies based on the microbiome are under investigation.

In many areas there are support groups, bereavement circles and initiatives for parents who have lost a baby during pregnancy or shortly after birth. Information is available from hospitals, counselling centres, midwives or local search portals.

A mostly plant-based, Mediterranean-style diet rich in vegetables, fruit, whole grains, healthy fats, adequate protein, folic acid and vitamin D supports overall health and may have a positive effect on hormonal balance and fertility.