Miscarriage Explained: Causes, Early Signs, NHS Support & What Every Woman Should Know
Miscarriage is common, yet many women feel unprepared for it — medically and emotionally. In the UK, around one in four pregnancies ends in miscarriage, most often in the first 12 weeks. Understanding why miscarriage happens, how to recognise early signs, and where to find NHS support can help women feel less isolated and more informed during a deeply difficult time.
Editor’s note: This article is medically aligned with NHS guidance and written for information purposes only. It does not replace advice from your GP, midwife, or specialist.
What Is a Miscarriage?
A miscarriage is the loss of a pregnancy before 24 weeks. Most miscarriages occur in the first trimester, often before a woman even realises she is pregnant.
According to the NHS, miscarriage usually happens because the pregnancy is not developing as it should, and in most cases, it cannot be prevented.
What Causes Miscarriage?
Chromosomal abnormalities (most common cause)
The NHS states that most miscarriages are caused by chromosomal problems, where the embryo has missing or extra chromosomes. This prevents normal development and is not caused by anything the woman did or didn’t do.
Hormonal and medical conditions
Certain conditions can increase risk, including:
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Thyroid disorders
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Poorly controlled diabetes
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Autoimmune conditions
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Hormonal imbalances such as low progesterone
Infections
Severe infections during pregnancy may raise the risk, particularly if untreated.
Uterine or cervical issues
Fibroids, structural differences in the uterus, or cervical weakness can contribute, especially in later losses.
Lifestyle factors
Smoking, alcohol, recreational drugs, and exposure to harmful chemicals are recognised risk factors.
Important reassurance: Stress, work pressure, exercise, sex, or everyday activities do not cause miscarriage, according to NHS guidance.
Early Signs and Symptoms of Miscarriage
What are the first signs of miscarriage?
Common symptoms include:
Vaginal bleeding (light spotting can be normal)
Cramping or lower abdominal pain
Lower back pain
Passing clots or tissue
Sudden loss of pregnancy symptoms such as nausea or breast tenderness
Is bleeding always a miscarriage?
No. The NHS confirms that bleeding in early pregnancy is common and does not always mean miscarriage. However, heavy bleeding, bleeding with pain, or passing tissue should always be checked urgently.
How Is a Miscarriage Diagnosed?
Diagnosis may include:
Ultrasound scans
Blood tests measuring pregnancy hormone (hCG) levels
Physical examination
Some women experience a missed miscarriage, where the pregnancy has stopped developing but symptoms are minimal or absent.
What Happens After a Miscarriage?
The NHS offers three main management options, depending on medical need and personal preference:
Expectant management – allowing the miscarriage to happen naturally
Medical management – medication to help the body pass pregnancy tissue
Surgical management – a minor procedure if needed
Your healthcare team will explain the safest option for your situation.
Emotional Impact and Mental Health Support
Miscarriage is both a physical and emotional loss. Many women experience:
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Grief and sadness
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Guilt or self-blame
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Anxiety about future pregnancies
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Depression or trauma symptoms
The NHS recognises miscarriage as a significant life event. If emotional symptoms persist or feel overwhelming, your GP can refer you to:
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NHS counselling services
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Perinatal mental health teams
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Specialist pregnancy-loss charities and support groups
Seeking help is a sign of strength, not weakness.
Trying Again After Miscarriage
When can you try to conceive again?
Medically, the NHS advises that women can try again once bleeding has stopped and they feel ready. There is no medical need to delay, unless advised otherwise.
Emotionally, readiness varies. There is no “correct” timeline — only what feels right for you.
Recurrent miscarriage
The NHS defines recurrent miscarriage as two or more pregnancy losses. In these cases, referral to a specialist clinic and further testing may be offered.
Final Thoughts
Miscarriage is common, complex, and deeply personal. Understanding the causes, recognising symptoms early, and knowing where to access NHS support can make a difficult experience feel less frightening and isolating.
Most importantly, miscarriage is not a failure, and many women go on to have healthy pregnancies in the future. If you are struggling physically or emotionally, speaking to a healthcare professional is the most important first step.
