Miscarriage 2025: Causes, Warning Signs and Modern Support

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Zappelphilipp Marx•
Two hands comforting each other after a miscarriage

A miscarriage is one of the most common — and at the same time one of the most stigmatised — losses in pregnancy. Many people affected feel guilty or isolated, even though medically they did nothing wrong. This guide explains in plain terms what a miscarriage is, which warning signs you should take seriously, what treatment options exist and how you can recover physically and emotionally.

What is a miscarriage?

A miscarriage, medically a spontaneous abortion, is the loss of a pregnancy before the stage at which a baby would be viable outside the uterus. Many guidelines set this boundary between the 20th and 24th week of pregnancy. Later losses are classified as stillbirths.

Clinicians distinguish, among other categories:

  • 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 cardiac activity, without bleeding or expulsion starting

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

Numbers 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 true rate is likely higher. The World Health Organization (WHO) notes that pregnancy loss affects millions of families worldwide each year and is still rarely talked about openly.

Risk changes with age. Miscarriage is less common among younger people; as age increases, especially from the mid-30s onwards, the likelihood rises. Nevertheless, many people have uncomplicated pregnancies even beyond age 35.

Causes and risk factors

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

  • Chromosomal abnormalities: a large proportion of early miscarriages are due to random errors in chromosome division. These usually originate in the egg or at fertilisation.
  • Hormonal disorders: thyroid disease, poorly controlled diabetes, luteal phase deficiency or polycystic ovary syndrome (PCOS) can affect implantation and early development.
  • Anatomical causes: fibroids, uterine malformations, adhesions or undiagnosed cervical incompetence can increase the risk.
  • Infections: for example bacterial vaginosis or certain pathogens such as listeria, chlamydia or rubella.
  • Lifestyle: smoking, heavy alcohol use, certain drugs, severe underweight or overweight and pronounced sleep deprivation.
  • Parental age: with increasing maternal age the risk of genetic errors rises; higher paternal age may also contribute.
  • Clotting and autoimmune disorders: for example antiphospholipid syndrome or other coagulation disorders.

It is important to distinguish between modifiable and non-modifiable factors. No one can change their age or random genetic errors. At the same time it is worthwhile to assess treatable causes, especially after recurrent miscarriages.

Warning signs and diagnosis

Not every bleeding means a miscarriage, but any noticeable symptoms should be taken seriously. Immediate medical attention is important 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 pronounced pregnancy symptoms
  • Fever, chills or foul-smelling discharge

Diagnosis usually combines ultrasound examination and blood tests. Ultrasound assesses cardiac activity, size of the gestational sac and embryo, and the location. Serial measurements of the pregnancy hormone hCG help to evaluate the course. National health services such as India's Ministry of Health and Family Welfare or the UK's NHS recommend that any bleeding in pregnancy be medically assessed.

Reducing risk: What you can do yourself

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

  • Good preparation: take folic acid, check immunisation status, and stabilise chronic conditions before conception.
  • Weight and nutrition: a normal body mass index (BMI) and a Mediterranean-style, mostly plant-based diet support hormonal balance and circulation.
  • Quit smoking and alcohol: ideally avoid these from the preconception period onwards.
  • Review medications: have regularly taken medicines checked for safety in pregnancy.
  • Reduce stress deliberately: prolonged severe stress can worsen other risk factors. Breaks, sleep hygiene and relaxation techniques help to relieve the nervous system.

If you have already had a miscarriage, discuss with your gynaecologist or a fertility centre whether, for example, thyroid screening, clotting tests or further 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 strategies:

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

After a miscarriage follow-up checks are important to ensure the uterus is fully evacuated and no infection remains. For Rh-negative women, anti-D prophylaxis is generally recommended to prevent complications in future pregnancies.

National clinical guideline collections, for example from the Ministry of Health and Family Welfare or the Indian Council of Medical Research, provide evidence-based recommendations for healthcare professionals and those affected.

Planning your next pregnancy

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

The emotional side is just as important. Some feel ready for another attempt relatively quickly, others need much more time. A detailed follow-up discussion with your treating clinician helps to clarify questions, understand findings and decide together whether genetic or hormonal tests are advisable.

Mental health and support

A miscarriage is not only a medical event but also a farewell to a hoped-for future. Sadness, anger, anxiety or guilt are normal reactions. The WHO, in its spotlight on pregnancy loss, calls for breaking shame and silence and for respectful, continuous support for those affected.

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

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

Outlook 2025: Research and innovation

Intensive research worldwide aims to better understand miscarriage risks and to provide targeted support for affected couples. Key areas include:

  • Improved genetic diagnostics: less invasive analyses of embryos and pregnancy tissue help to 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 may in future help identify individual risk profiles and refer people earlier to specialised 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 sanitary pads or dressings soaked through each hour over several hours
  • Severe, persistent pain in the lower abdomen or pain in the shoulder
  • Marked dizziness, loss of consciousness or feeling faint
  • Fever, chills or foul-smelling discharge after a suspected or confirmed miscarriage

Even for 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 on-call medical service.

Conclusion

A miscarriage is a profound event that affects body and mind and is nonetheless very common. No one is to blame when a pregnancy does not continue. Clear information, safe medical care and validated emotional responses can help to 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 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 decrease in previously strong pregnancy symptoms, as well as dizziness or circulatory complaints. With such signs people should seek medical advice promptly.

Current evidence does not support that short-term everyday stress alone causes miscarriage. However, prolonged, very severe stress can affect general wellbeing and other risk factors such as high blood pressure, sleep loss or unhealthy habits and should therefore be taken seriously.

Yes, with increasing maternal age average egg quality declines and genetic abnormalities become more frequent. This gradually raises miscarriage risk, particularly from the mid-30s and more noticeably after 40, although many pregnancies in these age groups proceed without problems.

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

Both procedures aim to remove remaining pregnancy tissue from the uterus. Today a gentle vacuum aspiration is often preferred because compared with sharp curettage it is usually associated with a lower risk of scarring and faster 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 from forming antibodies that could endanger a later pregnancy.

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

In most cases it is an isolated event 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 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 areas there are support groups, bereavement circles and initiatives for parents who have lost a baby during pregnancy or shortly after birth. Affected people can find information via hospitals, counselling centres, midwives or local search portals.

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