What should I do if I think I'm having a miscarriage?

Pregnancy loss is when a pregnancy ends naturally before the baby can survive outside the uterus. When it happens before 20 weeks of pregnancy, it is called a miscarriage.

Early miscarriage happens in the first trimester of pregnancy, up to 14 weeks. It is the most common type.

Late miscarriage happens in the second trimester, up to 20 weeks.

Pregnancy loss is common. Some people may experience more than one loss.

Most miscarriages aren't caused by anything you did or didn't do. They usually happen because the baby doesn't develop properly, often due to a genetic issue.

Sometimes a miscarriage may happen if you have:

• a health condition
• a different uterus shape
• an infection

If you are having a miscarriage, you will probably have vaginal bleeding. This could range from light spotting to heavy bleeding with blood clots. You may also have cramping or lower abdominal pain.

Some people don't have any symptoms and find out that they've had a miscarriage at a routine pregnancy check-up.

Pain and bleeding are common in early pregnancy and do not always mean you are having a miscarriage.

If you have begun pregnancy care, contact your doctor, obstetrician or midwife. If it is very early in your pregnancy and you have not yet begun pregnancy care, you can contact your family doctor (GP).

In major cities you may be referred to an early pregnancy assessment service (EPAS). This is a specialised clinic where people with non-urgent bleeding or pain in early pregnancy can be assessed and treated. If you live in a rural or regional area, an EPAS may not be accessible — ask your doctor or midwife where to get care.

Your doctor or hospital team will arrange a blood test and an ultrasound to check what is going on:

• If there are signs that the pregnancy has stopped growing, they will diagnose a miscarriage.
• If the pregnancy is too early to know what is going on, your doctor will arrange for you to have another blood test and ultrasound in a few days.
• If the pregnancy is growing outside your uterus, they will diagnose an ectopic pregnancy.

Sadly, nothing can be done to prevent or stop miscarriage from happening if a pregnancy is developing abnormally.

Options to manage a miscarriage include:

• expectant management — waiting for the pregnancy tissue to pass by itself
• medical management — taking medicines to help your body pass the pregnancy tissue
• surgical management — a surgical procedure to empty your uterus

If you have miscarried at home, see your doctor or EPAS clinic to check that all the pregnancy tissue has passed.

If you have a negative blood type, check with your doctor whether you need a dose of anti-D after your miscarriage. Read more on blood types in pregnancy.

Go to your nearest emergency department if:

• your bleeding is heavy
• you have pain in your shoulder tip
• your bleeding had become lighter but is now getting heavier again
• your bleeding continues for longer than 2 weeks
• you have severe pain that doesn't get better with paracetamol (Opens in new tab)
• you feel faint or dizzy
• you have a fever (Opens in new tab) or chills
• you have vaginal discharge with an unpleasant smell

How can I care for myself at home?

Get plenty of rest in the comfort of your home.

You can take paracetamol for pain and use a heat pack on your tummy.

It's best to use sanitary pads rather than tampons to avoid infection.

If you are alone, consider calling your partner or a friend to be with you for support.

Consider contacting one of the support services listed below.

You might prefer to have a planned surgical procedure in hospital, rather than wait at home and possibly need emergency surgery later. If you go to hospital, the treating team will arrange tests and give you anti-D if you need it.

Be sure to tell your treating team if you have cultural beliefs or preferences about what you'd prefer to do with the pregnancy tissue.

After a miscarriage, your bleeding will get lighter over time and will usually stop within 2 weeks. Pregnancy symptoms, such as nausea and tender breasts, will go away. If you had a miscarriage close to 20 weeks of pregnancy, your breasts might produce some milk.

See your doctor within 6 weeks. They may ask you to do another pregnancy test to confirm that all the pregnancy tissue has passed.

If you feel ready, it's safe to get pregnant right after a miscarriage. If you don't feel ready, talk to your doctor about contraception.

If you have had 2 or more miscarriages, your doctor may suggest seeing a fertility specialist.

Miscarriage can lead to many different emotions, such as sadness, grief, guilt, numbness or anger. Some people may develop depression or anxiety.

You and your partner, if you have one, may react in different ways. This can sometimes affect your relationship.

Read more on experiencing a pregnancy loss.

It may help to talk to loved ones or others who have experienced pregnancy loss. You can also talk to your doctor or midwife.

If you have cultural or spiritual beliefs about pregnancy loss that affect how you feel, you may want to talk to an elder or religious leader.

If your strong feelings last for a long time or you think you might have depression (Opens in new tab), reach out to a counsellor or mental health professional. For advice and to get connected to local mental health services, call Medicare Mental Health (Opens in new tab) on 1800 595 212. Check the operating times.

There are many support groups (Opens in new tab) that provide online and telephone support services and are accessible throughout Australia, including in rural and remote areas.

If you have experienced a miscarriage or pregnancy loss, there are many support services available to help you, your partner and your family.