Miscarriage 2025: Causes, Warning Signs, and Modern Support

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Zappelphilipp Marx•
Two hands offering comfort after a miscarriage

A miscarriage is one of the most common, and at the same time one of the most stigmatized, losses in pregnancy. Many people affected feel guilty or isolated, even though medically they did nothing wrong. This guide explains in clear terms 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 spontaneous abortion, refers to the loss of a pregnancy before the point at which a baby would be viable outside the uterus. Many guidelines place this limit between 20 and 24 weeks of gestation. Losses later in pregnancy 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 fetus without cardiac activity, without bleeding or expulsion occurring

Important: Most miscarriages are not caused by diet, exercise, or a single stressful event. The most common cause is random errors in early development, which are beyond the control of the person affected.

Numbers and frequency

Estimates suggest that about 10 to 20 percent of clinically recognized 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 rarely discussed openly.

Risk changes with age. Miscarriage is less common in younger people and becomes more likely with increasing age, particularly from the mid-30s onward. Still, many individuals over 35 have completely uneventful pregnancies.

Causes and risk factors

After a miscarriage many people ask: why us? Often no single cause can be clearly 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 undiagnosed 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, significant underweight or overweight, and severe sleep deprivation.
  • Parental age: As maternal age increases, the risk of genetic errors rises; advanced 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. No one can change their age or random genetic errors. At the same time, it is worthwhile to investigate treatable causes, especially after recurrent miscarriages.

Warning signs and diagnosis

Not every bleed means a miscarriage, but all concerning symptoms should be taken seriously. Seek medical care promptly if you experience any of the following signs:

  • 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 prominent pregnancy symptoms
  • Fever, chills, or foul-smelling discharge

Diagnosis is usually made by combining ultrasound examination and blood tests. Ultrasound assesses fetal heartbeat, the size of the gestational sac and embryo, and the location. Serial measurements of the pregnancy hormone hCG help evaluate the course. National health services such as the NHS in the UK recommend that any 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 ideal conditions. Still, there are strategies that can reduce risk and support overall pregnancy health:

  • Good preparation: take folic acid, check vaccination status, and have chronic conditions optimally 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 abstain already during preconception planning.
  • Review medications: have regularly taken medicines checked for safety in pregnancy.
  • Reduce stress: prolonged severe stress can amplify existing risks. Breaks, good sleep hygiene, and relaxation techniques help ease the nervous system.

If you have already had a miscarriage, discuss with your OB/GYN practice or a fertility clinic whether thyroid screening, clotting diagnostics, or other investigations are appropriate. International professional societies such as ESHRE publish regularly updated recommendations on these topics.

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 spontaneously. This can take several days to a few weeks and is followed 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, especially with heavy bleeding, signs of infection, or retained tissue.

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

Clinical guidelines and recommendations on miscarriage and preterm birth can be found in guideline collections such as the AWMF guideline repository and from national professional societies like the American College of Obstetricians and Gynecologists (ACOG).

Planning the 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 somewhat longer interval may be sensible to allow the uterine lining to regenerate fully.

The emotional aspect is just as important. Some people feel ready for another attempt relatively quickly, others need much more time. A detailed follow-up conversation with your treating clinician helps clarify open questions, understand findings, and jointly decide whether genetic or hormonal tests are appropriate.

Mental health and support

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

  • Psychotherapy and counseling: grief counseling or cognitive behavioral 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: differing mourning reactions can strain relationships. Open communication helps avoid misunderstandings.
  • Rituals and farewells: memorial rituals, letters, or keepsakes can help give the baby a place in your life.

You can get support through OB/GYN practices, midwives, psychosocial pregnancy counseling centers, or specialized bereavement services. Many of these offers are free or supported by health insurance.

Outlook 2025: Research and innovation

Intensive research worldwide aims to better understand miscarriage risks and to provide more targeted support to affected couples. Some focal 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 in the genital tract influence inflammation, implantation, and early pregnancy courses.
  • Digital tools and artificial intelligence: apps and analysis algorithms may in the future help identify individual risk profiles and refer people earlier to specialized centers.

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 if any of the following applies:

  • Very heavy bleeding, for example when pads or sanitary towels are soaked hourly over several hours
  • Severe, persistent pain in the lower abdomen or in the shoulder
  • Pronounced 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 OB/GYN practices, early pregnancy clinics, midwives, or the on-call medical service.

Conclusion

A miscarriage is a profound event that affects both body and mind and yet occurs very frequently. No one is to blame when a pregnancy does not continue. Clear information, secure medical care, and feelings 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 about 10 to 20 percent of clinically recognized pregnancies end in miscarriage, most of them in the first trimester. Many very early losses go unnoticed, so the actual 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 problems. With such signs, those affected 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 well-being 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 egg quality declines on average and genetic changes become more frequent. As a result, miscarriage risk gradually increases, particularly from the mid-30s and more markedly after 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 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 it is generally associated with a lower risk of scarring and a faster recovery compared with classical sharp curettage.

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

Often it is sufficient to wait for one natural menstrual cycle before trying for a new pregnancy. After surgical procedures or complicated courses, a somewhat longer interval may be sensible. In addition to medical assessment, your physical and emotional recovery also plays an important role.

In most cases it remains a single event and the next pregnancy proceeds uneventfully. Only after two or more consecutive miscarriages is further investigation typically recommended to uncover 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 in its early stages, and specific routine therapies based on the microbiome are still under investigation.

In many regions there are support groups, bereavement circles, and initiatives for parents who have lost a baby during pregnancy or shortly after birth. Affected people can get information through hospitals, counseling centers, midwives, or local search portals.

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