The journey of pregnancy doesn’t always go as planned, and when miscarriages happen, it can feel like the ground has been pulled out from under you. Although miscarriages are more common than many people realise, affecting roughly 1 in 4 pregnancies, they’re still not talked about enough. While it can be a sensitive and difficult topic, it's important to understand what miscarriage is, why it happens, and what to expect. Our Repromed Fertility Specialist, Dr Karen Buckingham answers some of the most commonly asked questions about miscarriage, including why they happen and what you can do if you experience one.
What is a miscarriage and how common is it?
A miscarriage is a pregnancy that ends on its own within the first 20 weeks. Most miscarriages—over 95%—happen during the first trimester, typically between 12 to 14 weeks. In Aotearoa, it’s estimated that between 13,000 and 15,000 people experience miscarriages each year.
Why do miscarriages happen?
Despite how common miscarriages are, many parents feel a deep sense of loss and confusion as to why one happened in the first place.
There isn’t always a clear answer, but miscarriages often occur due to complications in the early stages of a baby’s development. Sometimes, there might be an issue with cell formation or genetic abnormalities during conception. In other cases, health factors such as infections or problems with the placenta, can contribute.
Whatever the reason, it’s important not to blame yourself as most miscarriages have absolutely nothing to do with something you did or didn’t do during pregnancy.
What actually happens during a miscarriage?
Every miscarriage is different, and the physical experience can vary depending on how advanced the pregnancy was. Some common symptoms may include:
- Vaginal bleeding, from light spotting to heavy bleeding
- Passing fluid, blood clots, or tissue
- Abdominal pain or cramping
- Lower back pain
- Fever and chills, which could indicate infection
It’s important to know that bleeding in early pregnancy doesn’t always lead to a miscarriage—in fact, less than half the cases of bleeding, or ‘threatened miscarriages’ go on to actual miscarriages. Sometimes, it can be a sign of less common complications of early pregnancy like ectopic pregnancy, molar pregnancy or pregnancy of unknown location, so it’s good to seek medical help early.
However, the heavier the bleeding and the more intense the pain, the more likely it may be that a miscarriage is happening.
If you suspect you’re having a miscarriage, contact your lead maternity carer (your midwife, GP, or obstetrician). If you are experiencing very heavy bleeding, passing blood clots, or feeling extreme pain, head to the emergency department at your local hospital immediately.
What happens after a miscarriage?
In some cases, a miscarriage happens spontaneously and is complete without the need for further medical treatment. However, sometimes tests such as blood work or an ultrasound are needed to check if the pregnancy tissue has fully passed. If not, medical intervention or a procedure known as Evacuation of Retained Products of Conception (ERPOC) may be necessary.
How can miscarriages affect your mental health?
Understandably, a miscarriage can be emotionally overwhelming. It’s normal to feel a deep sense of grief, confusion, and even guilt—though it’s important to remember that miscarriages are rarely anyone’s fault. It’s very common for the emotional recovery from a miscarriage to take longer than the physical healing.
Many people struggle to talk about their loss, especially if they hadn’t yet shared the news of their pregnancy with others, but opening up about your experience can often bring comfort. Through sharing your story, you might find that others around you have been through a similar experience, and this can create a strong support network.
Some suggestions for self-care after a miscarriage include:
- Take care of your body. Eat well, rest, and get some gentle exercise
- Check in with your healthcare provider. A follow-up appointment can help reassure you that your body is healing
- Seek emotional support. Whether from friends, whānau, a counsellor, or support groups, talking to a compassionate listener can be incredibly healing
You can visit Sands New Zealand or Miscarriage Support to find support groups in your area.
How can you support someone going through pregnancy loss?
If someone close to you, like a friend or member of your whānau, has experienced a miscarriage, it can be difficult to know how to offer support. Many people often worry about saying the wrong thing or feel that silence is safer. However, simply acknowledging the loss can be incredibly meaningful.
A few simple words like, “I’m sorry for your loss,” or “I can’t imagine how hard this must be for you,” can offer comfort. Sometimes, it’s not about finding the perfect words, but just about showing that you care—even saying, “I don’t know what to say, but I’m here for you,” can help.
Actions often speak louder than words. You could offer to bring a meal, help with errands, or simply sit with the person and listen. If you can’t be there in person, a heartfelt message to let them know you’re thinking of them can make a world of difference.
When can you try again for a baby after a miscarriage?
Most people who experience a miscarriage go on to have healthy pregnancies and babies, but the specific timing of when to try again can vary. In general, it’s best to take the advice of your GP or health provider.
Ultimately, the best time to try again is when both you and your partner (if applicable) feel physically healed and emotionally ready to begin your next pregnancy journey.
If you or someone you know has experienced a miscarriage, know that you’re not alone. It’s normal to feel a range of emotions, including grief, sadness, anger, and guilt, and it’s important to give yourself time to process your feelings. Our Repromed counsellors are here to support you. If you conceived via IVF, please know that free counselling is included with your cycle and we are here to help.