A miscarriage, or spontaneous abortion, is a pregnancy that suddenly ends before the fetus can survive, and occurs in about 20 percent of all known pregnancies. Any vaginal bleeding is thought to be a potential miscarriage; however, vaginal bleeding in early pregnancy is common, and nearly one out of every four pregnant women has some bleeding in the first few months. About one half of women stop bleeding and complete their pregnancy.

A miscarriage is inevitable when there is severe bleeding along with opening of the cervix, and typically, cramping and abdominal pain. Incomplete miscarriage occurs before the twentieth week of pregnancy and bleeding is heavier, usually with abdominal pain and expulsion of some, but not all, of the products of conception; an ultrasound will show some matter still remaining in the womb. Complete miscarriage, or spontaneous abortion, is the expulsion of all products of conception, including fetus and placental tissues from the womb. Typically, abdominal pain and bleeding occur, but the discomfort and bleeding stop after the tissues and fetus have been expelled.

Causes of Miscarriage

The most common reason for miscarriages during the first three months of pregnancy (or first trimester) is an abnormal fetus, usually due to genetic problems (chromosomal abnormality), which are found in up to 70 percent of miscarried fetuses. Other reasons for miscarriage include:

• Chronic illnesses, including severe high blood pressure, lupus, and diabetes

• Thyroid problems

• Kidney disease

• Acute infections such as CMV (cytomegalovirus), mycoplasma (walking pneumonia), and German measles

• Extreme emotional shock

• Abnormal uterus

• Fibroids

• Poor muscle tone in the cervix (incompetent cervix)

• Abnormal growth of the placenta

• Multiple gestations

• Certain drugs, including alcohol, tobacco, cocaine, and possibly caffeine

First Aid for Miscarriage

Call your doctor or provider if you know or think you may be pregnant and you have any of the following symptoms:

• Vaginal bleeding

• Abdominal or back pain or cramping

• Weakness or dizziness

• Severe nausea or vomiting

• Heavy bleeding

• Severe dizziness or loss of consciousness

• A fever greater than 100.4°F

• You pass tissue

• You've had prior ectopic pregnancies

Any tissue you expel should be placed in a container and brought to the hospital. Although a miscarriage may be frightening and extremely difficult, most women are successful at completing subsequent pregnancies. You need to wait until you have recovered fully, usually a few weeks to a few months, after a miscarriage before attempting to conceive again. Many doctors recommend waiting until you've had several subsequent menstrual cycles. Take the time to work through your emotions regarding your loss, and get any professional help that you may need to help you recover.