The majority of miscarriages occur in the first trimester (first 12 weeks) of pregnancy, so most mums-to-be breath a sign of relief as they reach their second trimester. Occasionally, miscarriage can happen after this point and is termed a "late" miscarriage or, if after 20 weeks, a stillbirth.
Late miscarriages are rare, especially if there are no medical reasons for the pregnancy to be considered high risk. Only about a quarter of all miscarriages happen after week 12.
What are the symptoms of late miscarriage
Signs you might be having a late miscarriage are similar to those in the early stages.
• Heavy bleeding and clots
• Cramps and stomach pain
• Feeling that your waters have broken
• Feeling your baby's movements stop
It is also possible that you will not notice any miscarriage signs and will only discover that your baby has died during a routine appointment. This can come as a big shock if you had no idea anything was wrong. If this is the case you may need to be induced or your doctors may give you a few days for labour to start naturally. A late miscarriage can be painful, as with a normal labour and you will be offered pain relief.
Why does a late miscarriage happen?
Miscarriages later in pregnancy are usually associated either with the placenta or with the health of the mother rather than the developing foetus as in miscarriages before 12 weeks.
There is plenty of advice on how to keep yourself healthy with diet and exercice, bad habits to give up such as smoking, alcohol and too much caffeine and mums-to-be are regularly monitored to ensure their babies are safe, which helps keep late miscarriage numbers low.
Although you will no doubt worry, accidental falls and knocks do not tend to bring on miscarriage in healthy pregnancies. However, serious infection, existing tumours and other serious illnesses contracted during pregnancy do need to be treated with urgent care to protect the foetus.
Problems with the placenta can also cause late miscarriage. If it becomes detached or cannot supply enough nutrients to the baby, miscarriage may occur. Other things to consider are placenta praevia, placental insufficiency, or an incompetent cervix.
After a late miscarriage
Once a miscarriage has happened it is not possible to save the baby, but medical treatment is urgently needed to make sure you are well, and to ensure that no long term damage has been done which may affect another pregnancy.
If possible, your doctors will try to determine why you have miscarried in the hope of preventing a future loss.
Medical staff are often more sympathetic to women who have suffered a late miscarriage than at an earlier stage and you should be offered support. There is no right or wrong way to react to this trauma. If you are having trouble getting over a miscarriage, you may find these steps may help you cope.