I think I'm having a miscarriage
Most of this information is for women or birthing people who think they are having a miscarriage in early pregnancy (in the first 12 weeks)
If you are more than 12 weeks pregnant
If you are more than 12 weeks pregnant and you are having any miscarriage symptoms, including vaginal bleeding, you should have urgent medical attention. Call your GP or midwife. You can also call NHS 111 at any time or go to the accident and emergency department.
If you are 20 weeks pregnant or more, call your local maternity unit at the hospital you are planning to give birth in straight away.
What should I do if I think I'm having a miscarriage before 12 weeks of pregnancy?
If you notice any miscarriage symptoms, especially vaginal bleeding or stomach pain, contact your GP surgery or local GP walk-in service.
You can also contact your nearest Early Pregnancy Unit if they offer a self-referral or walk in service. You can also contact NHS 111 at any time of day.
If you are seen by your GP, they may refer you to an Early Pregnancy Unit if needed.
Vaginal bleeding in early pregnancy
Bleeding in early pregnancy is common and does not always mean there is a problem. But bleeding, with or without pain, should always get checked out.
Use a clean sanitary pad for the bleeding, if you can. Do not use tampons, because they can increase the risk of infection. It’s a good idea to monitor the bleeding and make a note of what it looks like. For example:
- if you are losing clots
- how big any clots are
- what the colour the blood is.
This will help your healthcare professional assess your bleeding and get you the right care you need.
Take your sanitary pad to show your healthcare professional or take pictures on your mobile phone. It may also help to tell them if you feel any changes from your usual pregnancy symptoms. You can make a note of these if it helps.
When to seek urgent help
You should seek medical help urgently by attending A&E straight away or calling 999 if:
- you have severe bleeding – such as soaking through your pad every half an hour to an hour and losing large clots
- you have severe stomach pain or feel dizzy and faint.
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.
Call 111 or a local GP walk-in centre 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.
Symptoms of an ectopic pregnancy tend to develop between the 4th and 12th week of pregnancy. But you can call your GP (or midwife if you have one) at any time if you have any concerns.
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.
You should have an ultrasound scan to check that the pregnancy is in the womb and if there is a heartbeat. If everything is OK, you will be discharged back into your GP’s care (or midwives, if you have one).
Your healthcare professional should talk to you about progesterone before you are discharged (see below).
Unfortunately, sometimes the scan department may be closed (for example, if it’s the middle of the night) or it may be too early in the pregnancy to know what is happening. For example, they may be able to see a pregnancy on a scan, but it might be too early to detect a heartbeat.
If this is the case, you may be asked to come back for another scan after having blood tests.
You may also need a repeat scan if your healthcare professional suspects that you have a Pregnancy of Unknown Location (PUL). This is when a person has had a positive pregnancy test, but the pregnancy cannot be seen either inside or outside the womb on an ultrasound scan.
You may also be offered blood tests to measure whether the pregnancy hormone (hCG) is rising or falling. You will usually have 2 tests 48 hours apart. If your hCG level is falling, this may indicate that you are no longer pregnant. However, your healthcare professional may still not know whether you have miscarried straight away.
If the blood tests suggest that you are pregnant, your healthcare professional may ask you to have more blood tests and have an ultrasound scan again in 1 or 2 weeks.
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.
If you have miscarried before, 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 progesterone.
Waiting to find out more
Going home without knowing what’s happening can be very difficult. You are likely to feel very anxious and upset, and will need good support from a friend, partner or family. Your EPU will also be able to help and give any advice needed. We realise that this is a very uncertain time in your life and you may need extra support through this.
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 need to come back for more appointments
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.
If you are having a miscarriage
This can be a very upsetting and difficult time and the health care professional will talk you through what will happen next.
There are different types of miscarriage and some will need treatment and some do not. Often you will need ongoing care to ensure that a miscarriage is ‘complete’.
A complete miscarriage
A complete miscarriage is when all of the pregnancy tissue comes away from the womb naturally and you won't need any treatment. Read more about what a complete miscarriage feels like and ways to deal with it.
An incomplete miscarriage
An incomplete miscarriage is when a miscarriage begins, but some pregnancy tissue stays in the womb. If this happens, you will need some treatment.
Making choices at such a distressing time can be very difficult. You should be given some time to think about the diagnosis and what you want to do.
Find out more about how your miscarriage will be managed or treated.
NHS. Vaginal bleeding. https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/vaginal-bleeding/ (Page last reviewed: 10 March 2021 Next review due: 2024)
NHS. Ectopic pregnancy. https://www.nhs.uk/conditions/ectopic-pregnancy/ (Page last reviewed: 23 August 2022 Next review due 23 August 2025)
West Suffolk NHS Foundation Trust. Management of pregnancy of unknown location (PUL). https://www.wsh.nhs.uk/CMS-Documents/Patient-leaflets/Gynaecology/5753-2ManagementofPregnancyofUnknownLocation(PUL).pdf
NICE (2021). Ectopic pregnancy and miscarriage: diagnosis and initial management. National Institute for health and care excellence Overview | Ectopic pregnancy and miscarriage: diagnosis and initial management | Guidance | NICE
Maternity Action. Time off for antenatal care. https://maternityaction.org.uk/advice/time-off-for-antenatal-care/