Miscarriage (spontaneous abortion) happens when a pregnancy fails to develop before 20 weeks of gestation. How do you know if you had a miscarriage? Miscarriages are a common occurrence, affecting up to 25% of recognized pregnancies, and since some symptoms of a miscarriage also occur in healthy pregnancies, it may be difficult to determine if you had a miscarriage. Not all women may realize that they are miscarrying, and some might not seek medical care when it occurs.

Signs of Miscarriage

If you are pregnant and have any of these symptoms, contact your health care provider immediately:

• Abdominal pain: persistent or severe pain in the lower back or pelvis.
• Vaginal discharge: passage of blood clots, especially with heavy bleeding.
• Tissue discharge: if you pass tissue, your doctor will likely want you to collect the tissue and place it in a clean plastic bag in order to bring it in for medical examination.
• Cramping: for some women, the cramping can be quite strong. For others, it is gentler, and can last for a short time to several hours.
• Early ending of pregnancy symptoms: when women experience the early loss of pregnancy symptoms such as breast tenderness and morning sickness earlier than the second trimester, miscarriage might have occurred.

Click HERE to learn more about miscarriage symptoms.

Types of Miscarriage

How do you know if you had a miscarriage? Other than the common symptoms mentioned above, miscarriages can also be classified into different types according to different manifestations:

• A threatened miscarriage: a threatened miscarriage happens when there is vaginal bleeding during the first 20 weeks of gestation. The cervix is closed and there is still evidence of fetal heart activity. In most of such cases, the pregnancy will turn out to be fine.
• An inevitable miscarriage: an inevitable miscarriage refers to the presence of an open cervix with bleeding during the first 20 weeks of pregnancy. Sometimes a threatened miscarriage may progress to an inevitable miscarriage when cervical dilatation occurs.
• An incomplete miscarriage: this is when a portion of the tissue has passed out of the uterus prior to 20 weeks of pregnancy, but some of the fetus or placenta remains in the uterus.
• A complete miscarriage: A miscarriage is complete if the fetus, all the membranes around the fetus and the placenta are expelled and the cervix closes.
• A missed miscarriage: A missed miscarriage is when the fetus has died or has not developed. However, neither the placenta nor the fetus has been expelled from the uterus.

How Is a Miscarriage Diagnosed and Treated?

How do you know if you had a miscarriage? Your doctor will perform an ultrasound test, pelvic exam, and blood work to confirm a miscarriage. Blood is drawn, and the amount of a pregnancy hormone is measured in order to monitor the progress of the miscarriage. If the uterus is empty, then the miscarriage is complete and no further treatment may be required. If a woman has a history of miscarriages, diagnostic procedures may be ordered to evaluate the cause of repeated miscarriages. These can include a pelvic ultrasound, an x-ray of the uterus and fallopian tubes, and a test in which the physician views the inside of the uterus with a thin, telescope-like device inserted through the vagina and cervix (hysteroscopy).

If the cervix is dilated, you may be diagnosed with an incompetent cervix. An incompetent cervix is a condition that occurs when weak cervical tissue contributes or causes premature birth and the potential loss of an otherwise healthy pregnancy. A procedure to close the cervix may be performed. Depending on your blood type, your physician may give you a blood product that prevents your body from developing antibodies that could harm your baby as well as any future pregnancies.

When the uterus does not completely empty, a dilation and curettage (D&C) procedure could be done. During the D&C, the cervix is dilated and any remaining tissue is gently removed from the uterus. In some instances, certain medications can be administered to cause your body to expel the remaining tissue in the uterus as an alternative to the D&C. This option may be more ideal for a woman whose condition is otherwise stable, but wants to avoid surgery.

What Happens After a Miscarriage?

Miscarriage can leave you with overwhelming feelings of loss and grief. A miscarriage can be tragic whenever it occurs as it removes all the happiness that a pregnancy brings, and you will need to allow yourself some time for grieving and recovery. Over time, you’ll be able to look forward and try again.

It is comforting to know that many women who have miscarried go on to have healthy pregnancies. What’s important to remember is that a miscarriage doesn’t necessarily mean you have fertility problems. Only about 1%-2% of women may have repeated miscarriages. If you've had repeated miscarriages, ask your healthcare provider to perform diagnostic tests to determine the cause.