Late miscarriage

Causes of late miscarriage

Most of the time there’s no clear reason why a miscarriage happens, but it’s unlikely to be caused by anything you did or did not do.

Read more about the causes of a miscarriage

What happens during a late miscarriage

If you’re experiencing a late miscarriage, you may go into very premature labour. If this doesn’t happen, your doctor or midwife might recommend that your labour is induced (started by a midwife or doctor).

If the loss of your baby has been found during a scan or another appointment, you may be offered different options for how you want to proceed. You may be able to:

• choose to have an induction (to have labour started) as soon as possible
• choose to delay induction until you’ve gone home and seen family members
• choose expectant management, where you go home and wait for labour to start naturally

Your doctor or midwife will support you with the information you need to choose what’s right for you.

If you choose expectant management, they’ll make sure you know what to look for and when to attend hospital. They’ll also give you guidance on what to do if labour doesn’t start, and what you can expect your baby to look like when they’re born.

Sometimes, you’ll not be able to choose to wait to deliver your baby. This might be the case if:

• you’re bleeding heavily and continuously
• you’re showing signs of infection
• your waters have broken

Induction of labour

If you’re having an induction you’ll have to go into hospital.

The doctor or midwife caring for you will explain what to expect. They can tell you about pain relief and how long labour might take.

Induction is usually a 2-stage process. First you’ll be a given a medicine called mifepristone. This is a tablet that you swallow. After taking this, you may be able to go home and return 36-48 hours later to start labour. This is because it takes 36-48 hours for the mifepristone to work best.

When you return, you’ll be given prostaglandin tablets every few hours until you have regular contractions. You will then go through labour, and your baby will be born.

Everyone responds differently to induction. For some the labour and birth happens quickly, for others it can take several hours.

Think about what emotional support you’ll need. A partner, friend or family member can stay with you throughout. Your doctor or midwife will discuss this with you.

Memory making

There’s no right or wrong thing to do. It depends on how you (and your partner, if you have one) feel. Your doctor or midwife will discuss your options with you, and can make suggestions about memory making. Take some time to think about it beforehand if you can.

You might be unsure about what your baby will look like. The doctor or midwife looking after you can describe your baby. Depending on how far along in your pregnancy you are, you may be able to see and hold them if you want to. You may also ask medical professionals to take a photo for you to look at later in private.

It may not be possible to tell the sex of your baby. This is something you can talk about with your doctor or midwife. Some people prefer to think of their baby as one sex or the other. There’s no right or wrong way to approach this.

You may also like to invite other family members to spend time with your baby. It is, however, your choice. Whatever you choose, the medical professionals caring for you will support your choices.

There is no formal registration process for babies lost before 24 weeks. However, you can record your loss in the Memorial Book of Pregnancy and Baby Loss Prior to 24 Weeks.

What happens to my baby after a late miscarriage

If you lose your baby before 24 weeks, there’s no legal requirement to have a burial or cremation. The decision about what happens is a very personal one for you and your loved ones. You’ll be guided through this process by the healthcare professionals looking after you.

Some hospitals do offer burials and cremations for babies lost before 24 weeks. This may be a shared cremation, which is when your baby is cremated with other babies rather than alone. You can ask your healthcare professional about the arrangements at your hospital. If you opt for hospital cremation, you’ll be given written information about your options.

You may want to make your own arrangements. Some people choose to use a funeral director or specialist cremation service. Others choose to bury the remains or scatter the ashes at home or somewhere else that is meaningful to them.

You might not be ready to decide right now. There’s no rush and those caring for you will help you make decisions at a pace that feels right for you. They should also give you a person to contact in case you change your mind, and let you know how long you have to make any changes.

You may be offered tests, and your partner may be offered them too. These try to find out why the pregnancy loss happened. Your doctor or midwife will explain what the results mean, including what they mean for a future pregnancy if you want to try again.

Your doctor or midwife may also offer to carry out a post-mortem on your baby. This will only be done with your permission.

In many cases, tests and a post-mortem cannot explain why a miscarriage happened. Still, they may rule out some causes and offer some comfort if you're thinking about trying again in the future.

It's worth remembering that most people go on to have a successful pregnancy afterward, especially when their test results come back normal.

Physical recovery from a late miscarriage

There are physical changes to your body that you may experience after a late miscarriage.

Breastmilk

Your breasts may produce milk in the first few days after your miscarriage. It can make them feel very large, tight, painful and tender.

To help reduce the amount of milk you produce you could try:

• applying ice packs (or a bag of frozen peas) covered in a light cloth to your breasts
• wearing a well-fitting bra
• using pain relief like ibuprofen or paracetamol
• expressing small amounts by hand (just enough to ease the pain, otherwise you’ll encourage the production of more milk)
• taking a warm shower, which may encourage your milk to leak naturally.

You may find it helpful to wear breast pads for the first few days.

You may be able to get medication to suppress your milk, though these are not suitable for everyone. Speak to the doctor or midwife treating you if you’d like further information.

Some people decide to donate their milk to help other babies. Donated breastmilk helps other babies whose mothers are unable to give breastmilk. Some people find some comfort in being able to help others.

Read more about donating breast milk

After-pains/stomach cramps

It’s common to have after-pains after a late miscarriage. They can feel similar to labour contractions, cramps or strong period pains. This is your womb contracting back to its normal size and usual location (down inside your pelvis). Painkillers, like paracetamol, can help with this.

Vaginal bleeding (lochia)

After the miscarriage, you’ll bleed from the vagina. This type of bleeding is called lochia. It’s your body’s way of removing the tissue that formed to help your baby grow. It includes:

• the lining of your womb
• blood from where your placenta was attached

This bleeding is likely to be heavy for around 2 weeks and then lighter for a further 4-6 weeks. It may have some small lumps or clots in it. The colour will change from red, to pink, to brown.

The flow of this bleeding can increase and decrease. Do not worry if you find you have lighter days followed by heavier days. This is normal.

During this time, you should use external period products (like pads) rather than internal period products (like tampons). This can help to avoid infection.

Contact your maternity unit if:

• you’re filling a large sanitary pad in 1 to 2 hours
• you’re passing blood clots larger than a £2 coin

It’s hard to say when your first normal period will happen. It’s likely it will be about 4 to 6 weeks after your miscarriage. It can sometimes be hard to know whether it’s lochia, or your first period.

Sometimes your first period is different than your normal period. This isn’t unusual. There’s no need to be concerned.

You may find that your first period reminds you of your miscarriage. Some people find this upsetting, while others find it a welcome sign that they can try to conceive again.

If you do find it distressing, there’s support available to help you.

Support after a miscarriage

There’s no right or wrong way to feel after a miscarriage. You, your partner (if you have one), and other members of your family, may be feeling grief, shock and sadness. You may find it helpful to look for more support from specialist organisations.

Read more about support after a miscarriage

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