What Are Miscarriage & Stillbirth?

According to the American College of Obstetricians and Gynecologists (ACOG), chemical pregnancies may account for 50 to 75% of all early pregnancy losses. This occurs when a pregnancy is lost shortly after implantation, resulting in bleeding that occurs around the time of your expected period. You may not realize that you ever conceived when you experience a chemical pregnancy.

A blighted ovum occurs when a fertilized egg implants in the uterus but doesn't develop into an embryo. It is also referred to as an embryonic (no embryo) pregnancy and is a leading cause of early pregnancy loss. This often occurs before pregnancy is detected, but it’s also not uncommon to see your doctor after a positive pregnancy test only to find an empty gestational sac, often labeled a blighted ovum.

A missed miscarriage is when a pregnancy loss is detected during a routine ultrasound. This can be particularly upsetting since it does not accompany any symptoms that indicate a pregnancy loss. At a routine check up, a doctor may say you’ve had a missed miscarriage if they see the sac with the embryo (called the “fetal pole”) but hear no heartbeat. You may not have symptoms of miscarriage because your body simply hasn’t started the process of cramping and bleeding, which happens when it recognizes that the pregnancy is no longer active. Know that if this happens, your doctor will discuss your options with you, and together you can decide how to proceed. Learn more about pregnancy loss treatment options and what to expect here.

Ectopic pregnancy, also called extrauterine pregnancy, is when a fertilized egg grows outside your uterus, most often in the fallopian tube. An ectopic pregnancy can cause life-threatening bleeding and needs medical care right away. If you have any spotting, bleeding, or pain on either side (aside from mild, period-like cramps), you should call your doctor and be evaluated — even if you notice these symptoms as early as the first day you’ve missed your period.

A molar pregnancy is a non-cancerous tumor that develops in the uterus as a result of a nonviable pregnancy. It’s very rare, occurring in just 1 out of 1,000 pregnancies. The pregnancy may seem normal at first, but when symptoms develop, they include dark brown to bright red vaginal bleeding during the first trimester along with severe nausea and vomiting. The tumor must be removed to avoid complications and requires close consultation with your doctor as each case can be different.

This term is typically used when you have vaginal bleeding early in pregnancy but no other signs of a problem (for example, a heartbeat is detected). In many people with a “threatened miscarriage,” the bleeding subsides and the pregnancy continues to term. In others, the bleeding becomes heavier and pregnancy loss occurs. If you experience this, your doctor will discuss options for monitoring your pregnancy closely moving forward. While there is no evidence to support this, some doctors may consider progesterone supplementation in this case. It’s important to be aware that the term “threatened miscarriage” may appear on billing statements from your insurance company when your doctor sees you for an episode of bleeding; this can be triggering for many people.

An inevitable miscarriage means a pregnancy loss cannot be avoided. Your doctor will use this term if your cervix is open, bleeding is heavy or increasing, and abdominal cramping is present. Know that if this happens to you, you will likely have a choice to either allow the loss to occur on its own or opt to take medication or undergo a procedure that will move the process along. See our article on Pregnancy Loss: Treatment Options and What to Expect.

An incomplete miscarriage means that only part of the pregnancy tissue has passed and some remains in the uterus. Typically, the fetus has been passed, but bits of the placenta remain. The cervix remains open, and bleeding may be heavy. Options are to either have a D&C (dilation and curettage), where the cervix is dilated and uterine lining is scraped, or try medical management (i.e. misoprostol) to help the uterus contract and expel what remains inside.

This term is used when a person passes all of the pregnancy tissue. This is common in miscarriages that occur before 12 weeks of pregnancy. After the pregnancy loss, there is a period of bleeding and cramping which resolves without treatment. On examination, the clinician typically finds that the cervix is closed, and there is no sign of a pregnancy sac in the uterus. An ultrasound examination may need to be performed to confirm the diagnosis.

It’s rare, but sometimes a pregnancy loss can also be accompanied by an infection in the uterus. This is known as a septic miscarriage and is the leading cause of death related to pregnancy loss. Symptoms include fever, chills, flu-like aches, abdominal pain, vaginal bleeding, and vaginal discharge which may be thick and may have an odor. If you experience any of these symptoms, particularly a fever, call your doctor.