This information explains what to do if you think you are having a miscarriage. If your symptoms are severe, go to the Accident and Emergency department (A&E).
Vaginal bleeding
Stomach pain or cramping
Other miscarriage symptoms
Symptoms of an ectopic pregnancy
Seeking urgent help
What happens at the hospital or Early Pregnancy Unit?
If you are employed
Bleeding and miscarriage
Light bleeding during early pregnancy (in the first 12 weeks) can be quite common. It's not always a sign of miscarriage. But if you have any bleeding at any point in your pregnancy you should contact your GP or your midwife (if you have started your antenatal care) straight away.
Bleeding from your vagina can be a symptom of miscarriage. This varies from light spotting or brown discharge to a bleed that may be heavier than your normal period. You can read more about bleeding and spotting in pregnancy here.
Use a clean sanitary pad or period pants. Do not use tampons, menstrual cups or anything you put inside your vagina. This can increase the risk of infection.
If you can, make a note of what the bleeding is like so you can tell your doctor, nurse or midwife. Think about how much there is, and whether there are any big lumps or clots.
If you are bleeding heavily, and/or in pain, call NHS 111 or go straight to your nearest Early Pregnancy Unit (EPU).
Taking progesterone in early pregnancy
Research has shown that taking progesterone may prevent a miscarriage if you:
- are bleeding in early pregnancy (before 12 weeks) and
- you have had 1 or more miscarriages before.
If this is what has happened to you, you should be given information about progesterone before you leave the hospital or Early Pregnancy Unit. There are no guarantees, but this treatment may help prevent a miscarriage.
Find out more about taking progesterone in early pregnancy.
Miscarriage cramps vs pregnancy cramps
It's not unusual to have some pain and light cramps in the stomach area in early pregnancy. You may experience mild stomach pain as your womb expands and your bump grows. Hormones, constipation and trapped wind can also cause discomfort.
However, cramping and pain in your lower stomach or back may also be a sign of miscarriage. If you have any concerns about any pains, or if you just feel something is wrong, contact your GP, midwife or nearest EPU straight away. You can also call NHS 111 any time.
Don't worry about wasting anyone’s time. It’s always best to get things checked out.
Find out more about stomach pain in pregnancy.
Other miscarriage symptoms
Other signs or symptoms of miscarriage are:
- a gush of fluid from your vagina
- tissue coming from your vagina (this may look lumpy or stringy)
- a sudden loss of pregnancy symptoms, such as feeling sick and tender breasts (although these symptoms may also lessen or go away after the first trimester).
Symptoms of an ectopic pregnancy
- An ectopic pregnancy is when a fertilised egg implants outside the womb – for example, in the fallopian tube. This needs to be treated urgently because your health is at risk if the pregnancy continues. Sadly, an ectopic pregnancy cannot survive.
- Tell your GP or local GP walk in centre, your nearest EPU or 111 urgently if you have symptoms of an ectopic pregnancy. These may include:
- tummy pain low down which may be on one side. This may happen suddenly and then settle
- vaginal bleeding or a brown, watery discharge
- pain in the tip of your shoulder
- discomfort when peeing or pooing.
- If you have severe symptoms or continuous pain, go straight to A&E.
- Symptoms of an ectopic pregnancy tend to develop between the 4th and 12th week of pregnancy. But you can tell your GP (or midwife if you have one) at any time if you have any concerns.
Seeking urgent help
Call 999 for an ambulance or visit your nearest A&E department if you:
- you have severe bleeding – such as soaking through your pad every half an hour to an hour and losing large clots
- feel very dizzy or faint
You should seek urgent help from NHS 111 or your GP or midwife if you have any of the following symptoms:
- severe stomach (tummy) pain
- vaginal bleeding or a brown watery discharge at the same time as pain
- pain in your shoulder tip (where your shoulder meets your arm)
- diarrhoea and vomiting
- feeling very faint and lightheaded, or fainting.
What happens at the hospital or Early Pregnancy Unit?
Your healthcare professional will talk to you about your symptoms and explain what will happen next. They will also carry out tests.
Ultrasound scan
You should have an ultrasound scan to check that the pregnancy is in the womb and if there is a heartbeat. Different things will then happen depending on what the scans show.
If your pregnancy is in the right place, and your baby seems well, you will be discharged back into your GP’s care (or midwives, if you have one).
It may be too early in the pregnancy to know what is happening. For example, the sonographer may be able to see a pregnancy on a scan, but it might be too early to detect a heartbeat. You may be asked to return for a second scan in 7 or 14 days.
Sometimes a pregnancy can’t be seen on the ultrasound scan, even if you have had a positive pregnancy test. This is called a ‘pregnancy of unknown location’ (PUL). The pregnancy could be:
- in the right place but very small
- ectopic
- or you may have had a miscarriage already.
To find out what has happened, further tests are carried out. Blood tests may be done 48 hours apart to look for changes in pregnancy hormones. These can help tell if the pregnancy is ectopic, but it can be difficult to get a definite diagnosis. You may be offered further transvaginal ultrasound scans and blood tests.
Sadly, it is possible the scan will show that you have had a miscarriage. If so, the health professionals looking after you will look after you and explain more about what happens next. There are different types of miscarriage – some will need ongoing care and some will not. You can read more about your options here. We also have a lot of support after miscarriage here.
Before you leave the hospital or Early Pregnancy Unit, make sure you know exactly when you need to come back and that you have their contact / out of hours numbers. You should also be told if there’s any reason why you should come back earlier. For example, if you develop any new symptoms or if your symptoms get worse.
Waiting to find out more
In some cases, you may have to go home without knowing exactly what is happening. This can be very difficult. You are likely to feel very anxious and upset, and may need good support from a friend, partner or family while you wait. Your EPU will also be able to help and give any advice needed. If you haven’t told anyone about your pregnancy, this may be a good time to talk to someone close to you who can help you. They can also come back to the hospital with you for moral support.
You can also talk to one of our Tommy’s midwives for free. You can call them Monday-Friday, 9am-5pm on 0800 0147 800 or you can email them at [email protected]. They will be able to talk to you about everything you are going through. If you are Black or Black Mixed-heritage you can also contact our specialist helpline which supports Black and Black Mixed-Heritage women and birthing people in the UK with any aspect of your pregnancy journey.
If you are employed
Legally, you do not have to tell your employer that you are pregnant until the 15th week before your baby is due. But you are entitled to take paid time off work for antenatal appointments your doctor, nurse or midwife recommends, so it may be helpful to tell them what is happening. They may also be able to offer you other support, such as flexible working or time off if needed.
If you do miscarry, you will need to time to recover, physically and emotionally. We have more information about work after a miscarriage.
