How can you tell whether you have had a miscarriage?

—Bleeding at the wrong time?

Dear Bleeding at the wrong time?,

The most common sign of a miscarriage is spotting or vaginal bleeding. If the miscarriage occurs later in pregnancy, women may also experience abdominal cramps and pass fluid or tissue from the vagina. A previous positive pregnancy test is the only way to know for sure if you have had a miscarriage. Since there may be other explanations for your irregular bleeding, you may want to make an appointment with a health care provider.

About 10 to 20 percent of pregnancies result in miscarriage, also known as spontaneous abortion. Miscarriage usually occurs in the first trimester or first twelve weeks of pregnancy as a result of genetic or physical defects in the fetus. In many early miscarriages, the woman does not even know that she is pregnant, since the miscarriage may often seem like a heavier than usual menstrual flow. Other causes of miscarriage include infection, hormonal factors, or a physical condition in the mother such as diabetes or thyroid disease. One miscarriage does not mean that later pregnancies will be unsuccessful.

There may be another reason that you are bleeding at the wrong time, so it's a good idea to make an appointment with a health care provider. Other explanations for irregular vaginal bleeding include fluctuating hormone levels; a sexually transmitted infection like chlamydia, gonorrhea, or genital warts; a tumor, polyp, or fibroids in the reproductive system; cervical disorders; or an ectopic pregnancy. A health care provider will be able to determine the cause of your bleeding. In the case of a miscarriage, the clinician can perform a pelvic exam to make sure that all the products of the pregnancy have been expelled safely.

A miscarriage may bring on mixed emotions ranging from relief to confusion to sadness or guilt. In addition to leaning on friends and family members for support, you may find it helpful to talk with a professional counselor about the loss of your pregnancy.

The Mayo Clinic and the American College of Obstetricians and Gynecologists offer more information about miscarriage and irregular menstrual bleeding, or see the related questions below. Take care.


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