Managing a late miscarriage

A late miscarriage is one that happens during your second trimester, which is after the first 3 months of pregnancy, but before 24 weeks. If a baby dies at or after 24 weeks of pregnancy, this is called a stillbirth.

It can be very hard to understand why a very late loss is called a miscarriage rather than a stillbirth. This is because, from a legal point of view, a baby is thought to have a good chance of surviving if they are born alive at 24 weeks. 

This distinction can be upsetting for some women who have a late miscarriage because they may also give birth to their baby and, understandably, feel that it should be called a stillbirth.

How will I know if I’m having a late miscarriage?

The most common signs of miscarriage are vaginal bleeding and strong, labour-like cramping pains. Sometimes, your waters may break and your baby may be born very quickly.

Some women have no signs at all that their baby has died and sadly only discover the loss when they attend a routine antenatal appointment for an ultrasound scan.

Other women may notice that their baby's movements have stopped, slowed down or changed. Contact your midwife or maternity unit immediately if you are worried about your baby’s movements.

Read more about the common symptoms of miscarriage.

Your treatment for a late miscarriage

If you have a late miscarriage, you will need to go through labour to give birth to your baby. This can be a very distressing time and you may be in shock. The staff caring for you at the hospital will understand this and will explain what your options are clearly so you can make a decision about your treatment. Ask as many questions as you need to so you feel as comfortable as possible.

Your doctor may suggest that you can go home and wait to see if labour starts naturally. If you want to do that, try to have someone stay with you for support.

Your doctor may advise you to be induced, which means starting labour artificially. You may also choose to be induced as soon as possible if you don’t want to wait for labour to start naturally.

You will have to go into hospital to have an induction, where you should be given your own room or quiet area.

You may want to start having the labour induced as soon as possible. If so, you will be given medication to swallow, or pessaries to insert in your vagina, to induce labour. When this will happen may depend on when a private room is free.

You will be offered a medicine to help soften the cervix (the entrance to the womb), to allow the pregnancy to pass out of the womb. This medicine might be given as an oral tablet or a vaginal pessary.

You may also be given Oxytocin. This happens if your waters have broken and they need to encourage contractions if they haven’t started naturally. Oxytocin can also be used to make contractions regular and stronger.

It may take several hours for the medicine to be effective, and, depending on your stage of pregnancy, the labour can be very painful. You will be offered a range of pain relief to help with this. Sometimes the birth comes quickly. Sometimes it can take several more hours.

There will be a nurse or midwife with you, who can answer any questions about what is happening.

Seeing and holding your baby after a miscarriage

You can talk to the hospital staff about whether you want to see your baby and hold them after they are born.

The staff may also be able to do things like:

• help you create hand and footprints
• dress the baby in clothes you have chosen
• take a photograph and save it for in case you want to see it later.

There is no right or wrong thing to do. It depends on what the hospital staff may be able to do and how you and your partner feel. You should be able to take some time to think about it.

“When we were asked if I wanted to see our baby, Arthur, our feelings were all over the place. Did we want to see him? Would he look ok? We decided to see him and he was bought to us on the ward. The hospital took pictures of him, which are good, but I do wish I had taken my own. I think I felt a bit self-conscious about it. Was this a normal thing to do? Looking back, there is nothing more normal than taking a picture of your own child. We made the decision to make our own funeral arrangements as I wanted to keep Arthur’s ashes. We did have a little funeral for him. This was very small and private between me and my husband. My advice, and this is something I wish I had done, is even if you think you are handling everything OK, is go find a group or someone to talk to. Looking back, I really could have done with additional help to process my feelings. Even though I thought I was fine, I was actually in a pretty bad place."

Jennifer

What will happen to my baby after a miscarriage?

Some hospitals offer burials or cremations for miscarried babies. Unfortunately, some hospitals are still not able to offer this service.

You may want to make your own arrangements for burial or cremation, whether you use a funeral director or specialist cremation service.

Find out more about what happens to your baby after a miscarriage.

There are lots of ways to commemorate your loss. Find out more about remembering your baby after miscarriage.

What will happen to my body during a miscarriage?

Your body will go through some changes as your pregnancy hormones begin to fall. Find out more about what happens to your body during a miscarriage.

Tests and treatments after a late miscarriage

Sometimes doctors can do tests to try to find out why you had a miscarriage and what this means for any future pregnancies.

You may also be offered a post-mortem examination of your baby to find out why they died. This will not happen without your permission (consent).

After this, your doctor will talk to you about your test results and what this might mean for your chances of having another miscarriage and successful pregnancy, if you want to get pregnant again.

Be aware that doctors may not be able to find out why you miscarried, which can be difficult and frustrating. But most couples are likely to have a successful pregnancy in the future, particularly if test results are normal.

Find out more about tests after miscarriage.

Your emotional health after a miscarriage

Losing a baby can be heart breaking and a late miscarriage may be particularly difficult for many parents. Your feelings and emotions are your own and no-one can tell you how you should or shouldn’t be feeling. There is no right or wrong way to feel about pregnancy loss. 

It may take some time to recover, physically and emotionally. It’s important to take the time you need to grieve. In time, you may start thinking about the possibility of trying again, if that’s what you want to do.

Having a miscarriage can impact your mental health. If you or someone you love feel that you need help, there is support available.

Telling other people about your miscarriage

If you’ve had a late miscarriage, you’ve probably already told friends and family about your pregnancy. Sharing the news that you’ve now lost the baby can be very upsetting and emotionally draining.

There's no one right way to tell people about your loss. You even may want to do it in different ways, depending on who you are speaking to. You may find the idea of telling everyone individually a bit daunting. If so, you could ask your partner, a family member or friend to tell people for you.

Make sure you take care of yourself as you go through this process. You don’t need to explain any details about what happened or tell people that everything is ok. You and your partner will be processing your own feelings and emotions about what has happened, so try not to worry too much about how other people take the news. Hopefully, you have friends and family who can support you and your partner during this difficult time and help you move through your grief.