I think I'm having a miscarriage

This information is for you if you think you might be having a miscarriage in early pregnancy (in the first 12 weeks).

If you are more than 12 weeks pregnant and you are having any miscarriage symptoms, including vaginal bleeding, you should get urgent medical attention. Call your GP, midwife or local Early Pregnancy Unit (EPU). You can also call NHS 111 at any time.

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 or menstrual cups, 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:  

• how often you need to change your sanitary pad,
• what colour the blood is,
• if you are losing any clots, and how big they are

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 your GP or local GP walk in centre, contact your nearest EPAU or call 111 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.

If you have severe symptoms or continuous pain, go straight to A& E.

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.

Ultrasound scan

You should have an ultrasound scan to check that the pregnancy is in the womb and if there is a heartbeat. Different things will then happen depending on what the scans show.

• If your pregnancy is in the right place, and your baby seems well, you will be discharged back into your GP’s care (or midwife, if you have one).
• It may be too early in the pregnancy to know what is happening. For example, the sonographer may be able to see a pregnancy on a scan, but it might be too early to find a heartbeat. You may be asked to return for a second scan in 7 or 14 days.

• Sometimes a pregnancy can’t be seen on the ultrasound scan, even if you have had a positive pregnancy test. This is called a ‘pregnancy of unknown location’ (PUL). The pregnancy could be:  

  • in the right place but very small
  • ectopic
  • or you may have had a miscarriage already.

  To find out what has happened, further tests are carried out. Blood tests may be done 48 hours apart to look for changes in pregnancy hormones. These can help tell if the pregnancy is ectopic, but it can be difficult to get a definite diagnosis.  You may be offered further transvaginal ultrasound scans and blood tests. 

• Sadly, it's possible the scan will show that you have had, or are having, a miscarriage. If so, the health professionals looking after you will look after you and explain more about what happens next. There are different types of miscarriage – some will need ongoing care and some will not. You can read more about your options here.   We also have a lot of support after miscarriage here.

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.

Progesterone treatment

Research has shown that taking progesterone may prevent a miscarriage if you:

• are bleeding in early pregnancy (before 12 weeks) and
• you have had 1 or more miscarriages before.

If this is what has happened to you, 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. Read more about progesterone treatment.

Waiting to find out more

In some cases, you may have to go home without knowing exactly what is happening. This can be very difficult. You are likely to feel very anxious and upset, and may need good support from a friend, partner or family while you wait. Your EPU will also be able to help and give any advice needed. 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 are employed

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.