Miscarriage is the end of a pregnancy before the baby is able to survive outside the uterus. Miscarriage can occur during the first or second trimester, before 20 weeks. Most happen in the first 12 weeks of pregnancy. They often are unexpected and isolated events.

Fetus in First Trimester
Nucleus image
Copyright © Nucleus Medical Media, Inc.


For some, the cause of miscarriage is unknown. Miscarriages can also occur for the following reasons:

  • Problems in the chromosomes (common cause)
  • Abnormal structure or issues in the uterine tract, such as fibroids
  • Problem with hormones, such as not having enough hormone (progesterone) to support pregnancy
  • Immune system-related problems, such as blood-clotting problems or rejection of the fetus
  • Trauma

Risk Factors

Miscarriages are more common in women 35 years and older. Other things that may increase the chance of a miscarriage are:

  • Infection
  • Smoking, drinking alcohol, or using drugs during pregnancy
  • Certain medicine
  • Exposure to certain environmental toxins
  • Autoimmune disorders, such as systemic lupus erythematosus
  • High-dose radiation therapy on the ovaries, uterus, or the pituitary gland during treatment of childhood cancers



Miscarriage may cause:

  • Vaginal bleeding
  • Pink or brown discharge
  • Cramping
  • Passing the fetus, placenta, and surrounding membranes through the vagina
  • Fever

Recurrent Miscarriage

Miscarriage is often a one-time occurrence. Couples who have 2 or more miscarriages should have a complete medical exam. It may help to understand the cause. This may prevent another miscarriage.


The doctor will ask about symptoms, length of pregnancy, and when changes happened. Physical and pelvic exams will be done. Passed tissue may be examined. The uterus may also be examined with:

  • Ultrasound
  • Hysteroscopy—to examine the inside of the uterus



Early or first trimester miscarriages may only need observation. Medicine may be needed if there is heavy bleeding or cramping.

A dilation and evacuation (D&E) may be needed if all tissue does not pass through the vagina. The doctor will remove remaining tissue.

Support Services

Miscarriage carries emotional challenges as well. Many women have grief, anger, guilt, and more. A counselor or support group may help.


Treatment may help prevent future miscarriages if a specific cause was found.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.

a (Spontaneous Abortion)


The American Congress of Obstetricians and Gynecologists http://www.acog.org 

March of Dimes http://www.marchofdimes.org 


The Society of Obstetricians and Gynaecologists of Canada https://sogc.org 

Women's Health Matters http://www.womenshealthmatters.ca 


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Miscarriage. March of Dimes website. Available at: http://www.marchofdimes.com/loss/miscarriage.aspx. Updated July 2012. Accessed March 19, 2020.

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