Second trimester loss (late miscarriage)

A second trimester loss (also called a late miscarriage) is one that happens after 13 weeks and before 24 weeks of pregnancy. 

This can be confusing as the second trimester actually ends at 28 weeks. But if your baby dies during pregnancy or birth after 24 weeks of pregnancy, it is called a stillbirth. If your baby is born alive at any time, and then dies, this is called a neonatal death. 

If you have had a second trimester loss (late miscarriage), we're so very sorry. You and your partner (if you have one) may be feeling grief, shock and sadness, possibly for a long time afterwards. It’s very normal to need time and space to slowly begin to process all that has happened. 

You may feel the word ‘miscarriage’ doesn't describe your loss at all. Our information on stillbirth may help you more.

We know that many people search for ‘late miscarriage’ to find out more information about what is happening to them and we want them to find this page. We also know many other people find this description very upsetting and prefer to use 'second trimester loss' or 'mid-trimester loss'. 

We have used the phrase ‘second trimester loss’ as well as ‘late miscarriage’ here. If neither of these phrases feel right to you, we are very sorry. We hope you can still find the help and support you need here. 

On this page:

Symptoms of second trimester loss

Causes of second trimester loss

What happens during a second trimester loss

Tests and treatments after second trimester loss

Support after a second trimester loss

Telling other people about your loss

We also have a page on what happens after a second trimester loss which may be helpful for you.

Symptoms of second trimester loss (late miscarriage)

The most common signs of second trimester loss are:  

• vaginal bleeding  
• stomach/abdominal pain – cramping pains, that come and go  
• a gush or trickle of clear liquid from the vagina – this may happen if your waters break early  
• your baby’s movements stop, slow down or change.  

Contact your midwife or maternity unit immediately if you have any of the symptoms above.  

Some women or birthing people only find out they have had a second trimester loss when they go to an antenatal appointment or have an ultrasound scan.  

Causes of second trimester loss (late miscarriage)

Problems with the placenta  

The placenta is the organ that provides baby with oxygen and nutrients. It’s attached to the lining of the womb and is connected to your baby by the umbilical cord. Problems with the placenta can happen at any stage of pregnancy and can lead to loss.  

Antiphospholipid syndrome (APS)  

Antiphospholipid syndrome (APS) is a syndrome that makes your blood more likely to clot. This is not common, but it can cause recurrent, early miscarriage and second trimester loss.  

Abnormal chromosomes  

Chromosomes are blocks of DNA that contain instructions for your baby’s development. They can sometimes develop abnormally, and your baby gets too many or not enough chromosomes. This can affect their development and can sometimes lead to second trimester loss. In most cases, this happens even though the parents themselves have normal chromosomes.  

Cervical insufficiency (weak cervix)  

The cervix is the entrance to the womb. Sometimes, if the cervix is weak or damaged, it opens too soon in the pregnancy and causes either a second trimester loss or a preterm birth.  

Developmental problems with the baby  

If the baby has not developed properly, this may lead to a second trimester loss.  

Infection  

Some infections can cause a loss in the second trimester. The baby might get the infection or the amniotic fluid (the liquid around the baby) could be infected. These include parvovirus, cytomegalovirus (CMV), listeria and toxoplasmosis.  

Food poisoning  

Food poisoning is caused by eating food that contains bacteria, viruses or parasites. This can increase the risk of miscarriage and second trimester loss. For example, pâté may contain listeria. These are bacteria that can cause an infection called listeriosis. Listeriosis can harm a baby during pregnancy or cause severe illness in a newborn.  

Other risk factors  

There are some other things that are linked to second trimester loss. You can read more about them on our causes of miscarriage page.  

What happens during a second trimester loss (late miscarriage)

In some cases with a second trimester loss, you will go into premature labour and give birth spontaneously - without any medical intervention.  

If this doesn’t happen and your baby has died in the womb but you have not gone into labour, you will probably need to give birth to your baby. This may come as an extra shock during what can be a very distressing time.  

Read more about what happens during a second trimester loss (late miscarriage) here.  

Tests and treatments after second trimester loss (late miscarriage)

Sometimes doctors can offer tests to try to find out what happened and what this means for any future pregnancies.  

After a second trimester loss, most hospitals will offer to carry out some tests to try and find a reason for your loss. You may also be offered a post-mortem. Tests, investigations and post-mortems are only done if you give your consent (say it is ok for them to do it).

You may have lots of questions about how and where the post-mortem is performed, and what the results might tell you. Talk to the midwife and doctor caring for you about your concerns and questions. You will have care from a clinician who will talk you through all the sensitive details. Your baby will be treated with respect and dignity at all times.

It may be several weeks or months before the results of your baby’s post-mortem are ready. You will be invited to a follow-up appointment to talk about the results.  

A post-mortem doesn’t often provide a reason for a miscarriage, so you may not find out why your baby died. But it may help rule out some possibilities and perhaps reassure you if you want to try to get pregnant again in the future.  

Support after a second trimester loss (late miscarriage)

It’s likely to take you some time to recover, physically and emotionally after a second trimester loss. There is no ‘right’ way to feel. You and your partner (if you have one) may be feeling grief, shock and sadness, possibly for a long time afterwards. It’s very normal to need time and space to slowly begin to process all that has happened.

Depression and anxiety following loss is not unusual. If you are struggling to cope, talk to your GP, who can help you get more support. You might find it helpful to look at our page on mental health after pregnancy loss.  

Your hospital may be able to offer a bereavement support midwife, specialist screening midwife or counsellor who can provide support from diagnosis of your loss until well into the postnatal period.  

They may also be able to offer support in a next pregnancy if you choose to try again. They may be able to refer you to a specialist pregnancy after loss team or rainbow clinic if your hospital has one.  

You should be offered contact with the spiritual care/chaplaincy team if this would be of comfort to you. 

You can find more information here about support after the loss of a baby.  

Telling other people about your loss

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

You may find it too hard to tell everyone individually. If so, you could ask your partner, a family member or friend to tell people for you.  

Take care of yourself as you go through this process. You don’t need to explain any details about what happened if you prefer not to - or tell people that everything is ok. Your priority is you and your partner right now.  

If you have any live children, you may find it helpful to have a look at our information on talking to children about pregnancy loss. You may also want to share our information on supporting someone after baby loss with friends and family.