Late miscarriage: Common signs and the way forward

Miscarriage

Having an early or a late miscarriage can be devastating for a pregnant woman. Unfortunately, miscarriages happen to a good number of women, even today. 

A miscarriage is the unexpected loss of a baby before the 20th week of pregnancy. There are two kinds of miscarriages: late miscarriage and early miscarriage. 

Most women experience an early miscarriage, before the 13th week of their pregnancy. But a few lose their pregnancy afterward. Loss of fetus after the 13th week is commonly known as a late miscarriage. 

If you have stayed up late thinking about the signs of a late miscarriage, its causes, and so on, you are in the right place. In this article we’ll answer all such questions and more. 

What does late miscarriage mean?

A late miscarriage refers to the loss of fetus during the second trimester. Late miscarriages are rare as they only affect 1-2% of pregnancies.

Early miscarriages happen when the baby doesn’t develop properly. They commonly happen before your 13th week of pregnancy. In fact, 80% of pregnant women experience early miscarriages. 

If you lose your baby after the 20th week of pregnancy, it is called a stillbirth. 

What causes a late miscarriage?

One of the key factors that determine a successful pregnancy is the way the baby develops in your womb. Abnormal implantation can cause miscarriage, as well as trauma. Also, any malfunction with your cervix during pregnancy can affect your baby too.

Some other factors that contribute to a late miscarriage include:

  • High blood pressure (hypertension)
  • Thyroid disorders (hypothyroidism & hyperthyroidism)
  • Diabetes
  • Preeclampsia
  • Past history of miscarriages
  • Late pregnancy (above 35 years of age)
  • Being overweight or underweight
  • Taking hard drinks or drugs like alcohol, caffeinated substances, tobacco, and cocaine

These factors are a few of the many things that can increase your chances of a miscarriage. However, they don’t entirely determine whether you can have a healthy pregnancy or not. 

Nevertheless, it is always better to be safe than sorry. Taking care of your health would really help you and your baby. 

What are the symptoms of a late miscarriage?

Late miscarriage can be devastating for expecting parents, we can all agree on that. But how do we know when there’s a miscarriage?  

Not all women experience symptoms prior to a miscarriage. However, some do and we have listed a few common ones below. 

Symptoms of a late miscarriage include:

  • No movement of your baby
  • Vaginal spotting 
  • Pain in your abdomen

Spotting is a sign of miscarriage. Some women experience spotting during a healthy pregnancy. This is normal too. To be on the safe side, reach out to a doctor to confirm if the spotting is normal. 

What are my chances of having a late miscarriage?

Having a late miscarriage is not common. Only 1-2% of pregnancies are affected. A woman’s age at the time of conception can affect her pregnancy. The older a woman, higher are the chances of a late miscarriage.  

Chances of having a miscarriage are as follows:

  • You have a 20% risk of getting a miscarriage if you’re 35.   
  • Women aged above 35 have a high risk of miscarriage. 
  • Your risk increases to 40% at the age of 40
  • At age 45, it’s now 80%.

Do you have to deliver after a late miscarriage?

You may need to go through labor if you have a miscarriage after the 13th week of pregnancy. 

Sometimes, the labor could be induced. However, your doctor would want you to wait to see if it would begin naturally. 

What happens during a late miscarriage delivery?

If it doesn’t begin naturally, then you may have to undergo induced labor. Some people opt for induced labor if they don’t want to wait for labor to begin naturally. 

To induce labor, your doctor will give you medications which you may have to ingest or insert in your vagina. The medicine will aid in softening your cervix to ensure the baby easily evacuates your womb. 

Some people are given medicine intravenously (through the vein). This helps to increase their contractions especially if their water has broken. However, you should note that it may take a while for the infusion to work. 

Going into labor can be a very painful process and can vary from woman to woman. Your doctor will recommend certain painkillers to help you relieve pain. 

What to do after a late miscarriage?

Having a late miscarriage can be a painful experience to go through. And it can leave you physically as well as emotionally drained. Having an open conversation with your doctor and family or friends helps. Have a support group to help you heal. Also, here are a few other things you can do to help yourself heal: 

Taking care of yourself physically:

Your body may recover quickly after a miscarriage. It depends on how far along you were in your pregnancy before the miscarriage happened. If you had a late miscarriage, it may take longer than others to recover physically. 

Avoid strenuous activities for a while because your body is still recovering. You may experience bleeding, cramps, and fatigue, all common after a late miscarriage. 

Eat a balanced diet to help your body recover from excessive blood loss. Meals that contain iron are red meat, shellfish, eggs, beans, and leafy green vegetables. 

Generally, these side effects from your pregnancy loss should not be excessive. But if that happens, don’t hesitate to get in touch with your doctor. 

Taking care of yourself emotionally:

You experience excitement and joy when you learn that you are pregnant. So, hearing the news of a miscarriage can be depressing, it’s only natural. As hard as it may sound, you should not skip the emotional support that your body needs after a late miscarriage. 

Remember that the way you deal with pain can be different from that of another woman. Some prefer talking about the experience while others don’t. Either way, it is important that you discover what works for you. 

Your doctor can also recommend a few support groups that can help you manage your emotions.

Joining these support groups can help you find a shoulder to lean on in these trying times. It helps if you know that someone understands what you’re going through and cares about you. 

When is it safe to get pregnant after a late miscarriage?

The trauma that follows a miscarriage can scar a woman from trying to get pregnant again. You may be unsure of when to start trying again or the necessary steps to take. 

Before trying to get pregnant again, you and your partner should self-evaluate yourselves. Understand if you are emotionally as well as physically ready to get pregnant. 

It is advised to avoid having sex during the first 2 weeks after a miscarriage to prevent a chance of an infection.

You need to wait till all of the pregnancy tissue and hormones are cleared from your body.

Vaginal bleeding, or a period, is an unreliable way to figure out when the pregnancy is completely out of your system. You should measure your human chorionic gonadotropin (hCG) levels after your miscarriage to understand when you can start trying again.

When the female egg meets the male sperm, the egg gets fertilized. The fertilized egg then travels to the uterus and gets attached to the uterine wall. This is known as implantation.

The placenta or the pregnancy tissue releases the pregnancy hormone – human chorionic gonadotropin (hCG) which doubles every 3-4 days after implantation. 

After a late miscarriage, the pregnancy tissue is expelled and you will experience vaginal bleeding lasting for several days. At that point, the hCG levels will start dropping and ultimately clear from your system.

If you have a D&C (dilatation & curettage) to remove the pregnancy tissue from the uterus, you will generally see the remaining hCG go away more quickly.

When you decide to deliver the pregnancy tissue on your own without a D&C, your hCG levels drop slower.

Hence it is recommended that women follow their hCG levels after a miscarriage using blood tests every week or two. This is to make sure that everything is resolving as it is supposed to.

Can a late miscarriage happen again?

Recurrent miscarriage or repeated pregnancy loss (RPL) is not common. Only 1-2% of women experience it. This means that the chance of delivering a healthy baby at full term is high. 

Regardless, this only applies if you don’t have some underlying health conditions. 

Summary

  • Having a late miscarriage is not common amongst pregnant women.
  • About 2 out of every 100 pregnancies go through a late miscarriage.
  • The way a baby develops contributes greatly to the chances of a miscarriage.
  • Contact your doctor if there are no signs of movement in your womb as it is a symptom of miscarriage.
  • Sometimes you may have to deliver a baby during a late miscarriage. But ensure you take proper rest afterwards. It’s all part of the healing process.
  • Miscarriages do not normally reoccur after the first time. However, this applies to people without any underlying health conditions.

Was this article helpful?

  1. Dugas C, Slane VH. Miscarriage. In: StatPearls. StatPearls Publishing; 2022.
  2. Miscarriage: medlineplus medical encyclopedia.
  3. Spotting during pregnancy. American Pregnancy Association.
  4. Hennessy M, Dennehy R, Meaney S, et al. Clinical practice guidelines for recurrent miscarriage in high-income countries: a systematic review. Reproductive BioMedicine Online. 2021;42(6):1146-1171.
  5. Miscarriage, stillbirth and ectopic pregnancy | nidirect.

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