Experiencing a miscarriage can be one of the most difficult moments in a pregnancy journey. It can come with emotional hurt, physical discomfort, and lots of unanswered questions. You’re not alone. Miscarriage is common, in that it affects up to one in four known pregnancies. Many people will know someone who has walked this path.

In this blog, we’ll explain: what miscarriage is; common causes; how it’s diagnosed and managed; and what support and care options are available — helping you make sense of a deeply personal experience, with compassion and clarity.

What Is a Miscarriage?

A miscarriage is when an embryo (early pregnancy) stops developing and growing. The pregnancy tissue is then either expelled (a ‘complete miscarriage’), or remains in the uterus (a ‘missed miscarriage’). Most miscarriages occur in the first 12 weeks of pregnancy, though they can happen up to 20 weeks’ gestation.

Sometimes people experience a miscarriage after recognising the pregnancy; at other times, it can happen before anyone knows they are pregnant. Because of this, the actual rate of early pregnancy loss is likely to be much higher than statistics suggest.

Why Do Miscarriages Happen?

In most cases, no easily preventable cause is found, and nothing you did caused the pregnancy loss. Women are very good at blaming themselves after a miscarriage, but the vast majority of the time, your miscarriage wasn’t caused by anything you did (or didn’t do): it was simply nature’s way of admitting that, for whatever reason, this wasn’t going to be a happy and health baby.

The most common diagnosed underlying reason for a miscarriage is chromosomal (or genetic) abnormalities in the embryo. Perhaps the genetics in your egg and the man’s sperm just didn’t align correctly: the resultant miscarriage is nature’s way of stopping a pregnancy that cannot progress healthily.

Other factors that are associated with a higher chance of miscarriage include:

• Increasing maternal age, with miscarriage risk rising as women get older (esp. over 35 years old)
• Smoking and alcohol use in early pregnancy
• High caffeine intake (some evidence suggests higher risk with > 200 mg caffeine/day, which is approximately 1 – 2 cups of espresso-style coffee, of 3 cups of instant coffee)
• Uncontrolled medical conditions such as diabetes or thyroid disorders
• Certain clotting disorders (in rare cases)

It’s important to know that even the healthiest people can experience miscarriage — and that often there is nothing that could have been done differently to prevent it.

Common Symptoms of Miscarriage

Symptoms can vary, and not all miscarriages present the same way. Some of the common signs include:

• Vaginal bleeding, which may look like spotting or heavier bleeding
• Cramping or pain in the lower abdomen, often described like strong period cramps
• Passing tissue (often pink / grey) from the vagina
• Feelings of dizziness or faintness might occur if there has been significant blood loss or if you’re particularly anxious or distressed.

Every woman’s experience is different, and symptoms can be physically and emotionally confusing.

How Miscarriage Is Diagnosed

When you go to your GP or early pregnancy care clinic with symptoms, the clinician will typically use a combination of history, examination, blood tests, and ultrasounds to work out what’s going on.

Medical history and symptoms

Listening to your story is often the first step. Questions are likely to include:

• When you most recent period started
• When your symptoms (e.g. vaginal bleeding and / or pelvic cramps) started, and how they’ve changed over time
• Whether or not you’ve had any pregnancy symptoms (e.g. nausea)

Physical examination

A gentle examination helps assess bleeding and uterine size, and to determine the urgency of ongoing care. This may include a speculum examination.

Blood tests

Apart from confirming pregnancy, blood tests (including serial BhCG levels) can help determine whether the pregnancy is progressing or stalling.

Ultrasound scan

A transvaginal ultrasound scan is the most useful test to confirm whether the pregnancy is developing normally or has stopped growing. It can often also distinguish miscarriage from an ectopic pregnancy (where the pregnancy implants outside the uterus), which needs immediate care.

From this information, your clinician can usually tell whether the miscarriage is a:

• Missed miscarriage: the embryo or fetus has stopped developing, but you don’t have any vaginal bleeding or pelvic cramps. The pregnancy tissue is still inside your uterus.
• Incomplete miscarriage: some pregnancy tissue has passed, but some remains inside the uterus
• Complete miscarriage: all the pregnancy tissue has passed spontaneously

What Happens Next: management and options

Once miscarriage has been diagnosed, there are several care pathways. They all aim to help you safely complete the miscarriage, manage symptoms, and avoid complications such as infection or heavy bleeding. Your health professional will discuss which option is most appropriate based on your clinical situation and personal preferences.

Expectant Management (aka. ‘watch and wait’)

In many cases, miscarriage tissue will pass naturally without medical intervention. This approach avoids surgery or medication, but can take days to weeks depending on the type of miscarriage.

Medical Management

Medications such as misoprostol may be recommended to help the uterus expel the remaining pregnancy tissue more quickly. This can often be done at home with appropriate follow-up.

Surgical Management

If there’s heavy bleeding, infection, or if tissue isn’t passing naturally, a surgical procedure (such as a ‘dilation and curettage’ or ‘suction evacuation’) may be advised to remove the tissue safely.

Emotional Impact and Support

Miscarriage is not just a physical event — it carries emotional weight too. Even when it happens early, many women and their partners feel deep sadness, grief, and loss, which is completely understandable.

Support is available from multiple sources, such as:

• Your GP or women’s health GP can help with emotional coping strategies and medical care
• Miscarriage Australia provides evidence-based fact sheets and emotional support resources
• Support services such as Pink Elephants, the Early Pregnancy Loss Coalition, and local counselling services can offer confidential help

You might feel anxious about future pregnancies, second-guess what happened, or simply need time to process. All of these reactions are valid and worthy of support.

When to Seek Urgent Help

Certain symptoms should prompt immediate medical review or a visit to the emergency department:

• Very heavy bleeding, e.g. soaking through a pad in under an hour
• Severe pain not relieved by simple pain relief (e.g. paracetamol)
• Fever or signs of infection (such as smelly vaginal discharge, or feeling unwell)
• Dizziness or fainting

These can be signs of complications such as incomplete miscarriage or infection, which need timely care.

Recurrent Miscarriage: when to investigate further

If you have had two or more miscarriages, your clinician may recommend further testing to look for possible contributing factors — such as immune issues, hormonal imbalances, clotting disorders or uterine anomalies.

However, for most women who miscarry once or twice, extensive testing isn’t routinely offered because the cause is often not identifiable, and often doesn’t change management for future pregnancies.

Planning Ahead After a Miscarriage

After a miscarriage, your body needs time to heal physically and emotionally. Many women are advised to wait until after their first period before trying to conceive again – this is simply so that, should you fall pregnant straight away, we can ‘date’ your next pregnancy from the first day of your most recent period.

Emotionally, many women need more time to process and recover from a miscarriage, before considering falling pregnant again. This is perfectly normal…

Maintaining a healthy lifestyle — avoiding smoking, limiting alcohol and caffeine, and addressing underlying health conditions — supports future pregnancies, and may decrease the risk of having another miscarriage in future.

Final Thoughts

Miscarriage is common, and it can feel deeply personal and painful. Even when the cause isn’t something that could have been prevented, the experience can still leave emotional and physical echoes that deserve care and attention.

If you think you might be miscarrying, or if you’ve already had a loss and have questions about your symptoms, management options, or future pregnancies, please consider booking an appointment with one of our women’s health GPs (Dr Amy Sinclair-Thomson or Dr Phillippa Wootton). At Maven Centre, we aim to provide compassionate, evidence-based care to support you through this experience — in body, mind, and spirit.