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What is a Late Miscarriage?

Barbara Bean-Mellinger
Barbara Bean-Mellinger

A late miscarriage is the loss of a fetus between the 12th and the 20th week of pregnancy. Before the 12th week, the loss is a miscarriage, but not a late one. After the 20th week, the fetus has a reasonable chance of surviving. Therefore, the loss is considered a stillborn birth, rather than a late miscarriage.

Miscarriages in the first trimester — before the 12th week of pregnancy — are common. It is believed that one in four pregnancies end in miscarriage. Some in the medical profession estimate that the rate of miscarriage may actually be closer to 50% because women who are unaware that they are pregnant believe they are having a very heavy, slightly late period when, in fact, they are having a miscarriage.

Smoking cigarettes during pregnancy can cause miscarriages.
Smoking cigarettes during pregnancy can cause miscarriages.

Late miscarriage is much less common, occurring in one or two out of 100 pregnancies. Causes for late miscarriage include fetal abnormalities; maternal difficulties, such as a misshaped uterus or incompetent cervix; genetic abnormalities; problems with the placenta; environmental toxins; or a virus or infection that kills the fetus. With a late miscarriage, there is usually more fetal tissue to examine, which can help doctors determine the reason for the miscarriage and possibly prevent another one in a future pregnancy.

Some women are re-vaccinated for measles in order to prevent miscarriages.
Some women are re-vaccinated for measles in order to prevent miscarriages.

Signs of an impending late miscarriage are similar to the signs of an earlier miscarriage. Very heavy bleeding that does not stop is one of the biggest signs, especially when it is accompanied by severe cramping. A lower backache often precedes or accompanies the cramping. In addition, with a late miscarriage, there is often quite a bit of tissue passed with the bleeding.

Having a late miscarriage is traumatic, and a support system of loved ones can help her through the grieving process.
Having a late miscarriage is traumatic, and a support system of loved ones can help her through the grieving process.

A woman who believes she is having a late miscarriage should call her physician immediately. If heavy bleeding occurs and does not stop, a trip to the emergency room is in order to avoid dangerous complications that could threaten the mother's life. She should save some of the fetal tissue if she can, and if she delivers the baby, she should certainly take the baby to the emergency room with her.

Miscarriages before the twelfth week of pregnancy are common.
Miscarriages before the twelfth week of pregnancy are common.

After the miscarriage and any follow-up procedures that are recommended, the woman will need to heal, and to allow herself time to rest and recover. She is also likely to experience a range of emotions from the loss of her baby as well as the physical trauma she has endured. Many women find emotional healing by talking with other women who have miscarried or by seeking the services of a medical professional.

Discussion Comments

Saraq90

I have never even been pregnant, so I cannot even begin to imagine what that is like and especially what it is like to have a miscarriage and/or late miscarriage.

For those who have miscarriages I pray that people would realize that typically a miscarriage has nothing to do with the mother. It usually is just one of those horrible tragedies that happen to some of the best people, for no reason at all. Or at least not for a reason that could have been helped or prevented.

I truly believe that some horrible things happen to good people and although it sounds trite I also truly believe the saying "That which does not kill us, makes us stronger."

Those that have been through this are strong people for making it through such a terrible tragedy.

aLFredo

I am sure most pregnant women try to treat their bodies as good as possible while pregnant, so I am sure most miscarriages and late miscarriages happen regardless of how healthy and careful the potential mother is.

Here are just a few good reminders to help you focus on being as healthy as you can possibly be during pregnancy:

I would just say to treat your body as good as you possibly can while pregnant. I am sure your doctor or someone will be happy to give you advice on how to stay the healthiest while pregnant.

For example, what foods are healthiest during pregnancy, and what foods to avoid during pregnancy. Also, I am sure your doctor will be glad to inform you about what medicine you can and can not take.

Also, it is always good to stay away from drugs, alcohol, and cigerettes, and any other toxic behavior while pregnant.

Try to remember that everything you do can directly effect your baby in the short or long term or both.

tolleranza

Wow. I did not know that about half of women who get pregnant end up miscarrying. This is so sad. What is even sadder is that although there is less of a chance of having a late miscarriage, the chances are still fairly high, which is very disheartening. My heart goes out to all the women who have had to go through the tragedy of a miscarriage or stillbirth.

These miscarriage and stillbirth statistics make me worried to ever get pregnant. I don't plan on getting pregnant any time soon, as I am not married, but it makes me nervous to even think about. But I do have plenty of friends and family who have had children with little or few complications, so this does give me a little more hope.

ElizaBennett

@MrsWinslow - Once you get pregnant with your first child, you'll be worrying until you die! It just comes with the territory.

But I know what you mean, and here's what I know: hospitals will generally not take any action to save a baby born before 23 weeks. So between 20 and 23 weeks is considered a stillbirth, but a woman who goes into labor at that time has effectively a 0% chance of taking home a baby.

A baby born at 23 weeks has a 50% chance of survival, and a majority of the babies that do survive that early will have long-term effects such as learning disabilities or cerebral palsy (about 30% according to the about.com site on Prematurity).

A friend of mine who is a NICU nurse told me when I was pregnant that the odds of your baby surveying and being healthy long-term go up a lot at 28 weeks. (She waited until I was 28 weeks to tell me, of course.) But *any* preemie can have problems and/or spend weeks in the NICU. Even babies who are technically full-term but on the early side - 37 or 38 weeks - are often not as healthy as babies born at 39 or 40 weeks. Keep the baby cooking!

I'm so sorry for your friend's loss. I used to work with a lady who had miscarried twins at 19 weeks and was at that time pregnant again and obviously really waiting for that 19 week mark. What I didn't understand was that she was still smoking cigarettes. (But then, it is not my place to judge. Maybe it was only 2 or 3 a day and I don't know her personal story.)

MrsWinslow

At what point can a baby really survive outside the womb? Is it really only 20 weeks? I am hoping to be pregnant soon and I know I will be terrified the whole time; I'll feel a twinge of cramps during pregnancy and be convinced I'm in premature labor. A friend of mine had a stillbirth at 21 weeks, so not miscarriage but just absolutely heartbreaking. The hospital dressed her miniature baby in doll clothes and a hand-knitted hat someone had made and donated.

It would be nice to know at what point I could stop worrying!

JessicaLynn

@strawCake - I think any miscarriage can be a difficult experience, but a late one can be especially damaging.

One of the worst parts about having a miscarriage is well meaning people trying to help. A friend of mine had a late miscarriage awhile back, and many of her friends and family members tried to "help" her cope. However, most of the stuff they said just made her feel worse.

I think everyone has to recover from something like this in their own time, and there's really nothing you can say to make them feel better, unfortunately.

strawCake

I think the worst part about a late miscarriage is that everyone usually think they're "safe" after the 12th week. I know most of my friends kept their pregnancies quiet until after the 12th week, because the chance for miscarriage is the highest early on.

However, after the 12th week, most of them announced their pregnancy and relaxed a little bit. They felt like the most "dangerous" part of their pregnancy was over.

I feel like having a miscarriage at this point is even more of a shock than having one early on in the pregnancy period.

orangey03

@lighth0se33 – That is tragic. At least the researchers will know to put a warning on the drug when it comes out on the market. Maybe this will save some babies in the future.

Any medication can be dangerous to a fetus. I have friends who have been in lots of pain and discomfort while pregnant because they gave up their medication in order to protect the baby.

Several drugs actually come with the warning that they can cause damage to a fetus, including a miscarriage. I can't imagine a woman who is several months pregnant taking the risk of a late miscarriage just for some relief from what ails her.

lighth0se33

My sister has always been a little overweight, so she did not realize that she was a little over three months pregnant. She had been taking part in a clinical study drug for her kidney condition, and they had told her to use two forms of birth control during the study, because they did not know what effects the drug might have on an unborn child.

They did a pregnancy test on her every four months, so she must have gotten pregnant right after a visit. Her next appointment was only about a month away when she experienced a lot of bleeding and pain.

She was on birth control pills, so she knew it wasn't time for her period. Even if it had been, her periods were generally light, and this was a heavy flow.

She blames her late miscarriage on the study drug. Had she had any idea that she might be pregnant, she would have stopped taking it.

OeKc05

@seag47 – My mother was thirty-seven when she had me, and I turned out fine. Plenty of people have children in their late thirties without complications.

I do realize that the risk is there for you, but you really just never know what will happen, regardless of statistics. My mother had two miscarriages in her twenties, but the pregnancy of her thirties was the successful one.

All you can do is just keep yourself healthy while pregnant. As long as you eat a nutritious diet and don't smoke or drink, you greatly improve the chances of your baby making it.

seag47

I did not know that you could pass tissue with the blood! That is awful! I cannot imagine seeing something like that coming out of me.

I am ten weeks pregnant, and so far, I haven't had any problems. This article makes me very emotional for the people who have gone through late miscarriages. I only pray that this doesn't happen to me.

I am thirty-eight, which I know is a little old to be having a child for the first time. I have heard that the older you are when you get pregnant, the greater the risk that there will be something wrong with your baby.

andee

I have a niece, who is like a daughter to me, and she has had a hard time keeping a baby full term. She as had two early miscarriages and one late miscarriage, and is very discouraged.

Each time she gets pregnant, she is so afraid she is going to have the same symptoms of early pregnancy bleeding and cramping that she has experienced each time.

She is also almost afraid to keep trying because the emotional stress has been very hard for her.

I know there is counseling and support groups for women who have experienced this, but wonder if there is something they can be a part of while they are pregnant.

Instead of getting the support after something like this has happened, does anyone know of an organization or group that women can be a part of as soon as they know they are pregnant?

LisaLou

@Mae82 - From personal experience I would recommend your sister get some counseling or seek out some time of support system.

I have had more than one late miscarriage so understand all the emotions that go along with this.

Counseling was very helpful, but I think I received the most help from a support group. These other women truly understood what I was going through and we developed some strong bonds of friendship.

It really helped to be able to talk about it and realize that I was not the only one who was struggling with all of these emotions and feelings.

This is a grieving process that needs to be treated like any other major loss in your life. This is also something that takes time and she should not expect to get over in a short amount of time.

Mae82

Can anyone recommend what to do for someone after they have suffered a late miscarriage?

My sister struggled with bleeding during early pregnancy, as well as early pregnancy cramping. We had thought that she was in the clear though when she reached the 12th week, and we believed that things would be better. She recently lost the baby and now our family is having trouble coping.

I am wondering if some sort of family counseling might help my sister to grieve and get the support she needs. She had tried for a baby for a long time so this has been a really hard time for her.

Sara007

@manykitties2 – There are unfortunately many things that can cause a late miscarriage. It could be something such as a biological problem with your uterus, you may have a disease which impacts your ability to carry a pregnancy to term. For example, things like diabetes can cause serious problems if it isn't properly managed. There are even certain viruses and infections you can get that can cause a late miscarriage.

There is a surprisingly high chance of miscarriage in general, so really, the best you can do is take care of yourself and follow your doctor's orders. If you need extra attention while pregnant I am sure your physician will let you know what to do.

manykitties2

My best friend recently suffered from a late miscarriage and it was a very traumatic experience for her to say the least. From what she told me, if you experience pregnancy bleeding beyond what you consider normal, and cramping during pregnancy it can be a sign that something is seriously wrong.

My friend was used to early pregnancy spotting but her doctor told her not to worry about it. Apparently a bit of pregnancy spotting is normal, making it tough to spot if something is going to go wrong later.

Does anyone know some late miscarriage causes? I hope I'll learn from my friend's experience and can hopefully avoid a similar circumstance.

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