"Doctor, when I was 10 weeks pregnant, I suddenly started having lower abdominal pain and bleeding. When the lab did a scan, they said the baby's heartbeat had stopped. Is this my fault, doctor? Did this happen because I did heavy work?" 28-year-old Niranjala came to our clinic crying and asked that question, Dr. Priya answered her question by reassuring her.

"Niranjala, this is not your fault at all. More than 50% of miscarriages are caused by genetic or chromosomal abnormalities that occur during the formation of the embryo. Lifting weights or doing normal chores will not cause a miscarriage."

A miscarriage is an experience that brings deep emotional and physical pain that cannot be put into words. Many women try to isolate themselves in such a situation by blaming themselves. Here, we will simply talk about the medical causes of miscarriage, its types, and how to recover physically and mentally afterwards.

The true story behind the word "abortion"

In medical terms, this is called a "spontaneous abortion." This means that the pregnancy ends spontaneously, without any external intervention, before the developing fetus is developed enough to survive on its own in the outside world - usually before 20 weeks of pregnancy. If a pregnancy is lost after 20 weeks, it is medically known as a stillbirth.

#### Types of Miscarriage:

• Threatened Miscarriage: Early in pregnancy, there may be some vaginal bleeding and lower abdominal pain. However, the cervix remains closed and the pregnancy can often continue successfully.
• Inevitable Miscarriage: The cervix remains open with bleeding and severe abdominal pain. In this case, the miscarriage cannot be prevented.
• Incomplete Miscarriage: Some parts of the fetus or placenta are expelled from the uterus, while other parts remain in the uterus.
• Complete Miscarriage: All of the pregnancy tissue, including the fetus and placenta, is completely expelled from the uterus.
• Missed Miscarriage: The fetus has died but there are no external signs such as bleeding or abdominal pain. The cervix remains closed and this can only be detected by an ultrasound scan.
• Recurrent Miscarriage: Three or more consecutive pregnancies end in miscarriage. This requires separate testing to determine the cause.
• Blighted Ovum: A fertilized egg implants in the uterine wall and forms a gestational sac, but an embryo does not develop.

Miscarriages are something that really happens to a lot of people.

When you experience this pain, you may wonder, "Why is this happening to me?" But statistics show that between 10% and 20% of confirmed pregnancies end in miscarriage. Most miscarriages occur within the first 12 weeks of pregnancy (the first trimester). Sometimes, miscarriages occur very early, before a woman even knows she is pregnant, and they may feel like a normal period.

Your Body Tells You: Signs and Diagnosis of Miscarriage

When a miscarriage occurs, the body experiences the following symptoms:

• Vaginal bleeding (ranging from light red spotting to heavy blood clots).
• Severe pain in the lower abdomen or back and cramping pain in the stomach.
• Tissue or fluid discharge from the vagina.
• Pregnancy symptoms such as morning sickness and breast tenderness suddenly disappear.

#### How the doctor confirms the disease:

• Pelvic Exam: Checking whether the cervix is ​​open.
• Ultrasound scan: Checking the fetal heartbeat and the condition of the uterus.
• Blood tests: Measuring the level of the pregnancy hormone hCG (Human Chorionic Gonadotropin) in the blood over several days.

The heart-wrenching question of "Why?": Factors that can influence a miscarriage

Most miscarriages occur through no fault of the mother or father. The main reasons are:

• Genetic or chromosomal abnormalities: Random errors in chromosome division during embryo formation cause the embryo to naturally stop developing.
• Maternal age: The risk of miscarriage gradually increases after the age of 35.
• Uncontrolled chronic diseases: Uncontrolled diabetes, thyroid disease, high blood pressure, or immune system diseases such as lupus (SLE).
• Uterine problems: Congenital changes in the shape of the uterus or growths on the uterine wall, such as fibroids.
• Hormonal imbalance: Low production of the hormone progesterone, which is essential for maintaining pregnancy.
• Types of infections: Infections such as rubella, toxoplasmosis, or listeria.
• Harmful lifestyle: smoking, alcohol consumption, and drug use.

🚨 Red Flags That Need Immediate Medical Attention

The following complications that occur during or after a miscarriage can be fatal and require immediate hospitalization:

• Heavy bleeding: Bleeding that completely wets more than 2 sanitary pads per hour.
• Signs of severe infection (Sepsis): High fever, chills, foul-smelling vaginal discharge, and severe stomach cramps.
• Severe dizziness and fatigue: Shock caused by excessive blood loss.

🛠️ Action Steps to Recover Physically and Mentally After a Miscarriage

• Step 1: If there is tissue remaining in the uterus from a miscarriage, remove it using medication or a D&C (Dilation and Curettage) surgery as directed by your doctor.
• Step Two: If your blood type is Rh-negative, get the Anti-D Immunoglobulin vaccine immediately to prevent possible problems in future pregnancies.
• Step Three: Avoid inserting tampons, douching, and having sex for the first two weeks after the abortion to prevent infection.
• Step Four: Talk openly about your feelings with your partner, family, or a qualified counselor to help you overcome the trauma.
• Step Five: Give your body a break for at least 2-3 months and take folic acid tablets daily before planning another pregnancy.

📊 Comparison of Treatment Options (Management Options)

📖 Sources and Scientific References

• NHS (UK) Guidance on Miscarriage: NHS Miscarriage Information (Accessed 2026)
• NCBI Bookshelf Review: Spontaneous Abortion and Early Pregnancy Loss (StatPearls - NBK560521)