🌸 Men's Health

Miscarriage — Causes, Recovery & Next Steps

Understanding pregnancy loss and how to move forward

A miscarriage (spontaneous abortion) is the loss of a pregnancy before 24 weeks of gestation. It is the most common complication of pregnancy — approximately 10–15% of known pregnancies end in miscarriage, and up to 50% of all fertilised eggs are lost before a pregnancy is even recognised. Despite how common it is, miscarriage remains a taboo subject in Nigeria, leaving many women without information, support, or medical care. Most miscarriages are not preventable and are not caused by anything the mother did.

Signs and Symptoms

✓ Vaginal bleeding — from light spotting to heavy bleeding with clots

✓ Cramping or pain in the lower abdomen (period-like or worse)

✓ Passage of tissue or 'products of conception' from the vagina

✓ Sudden disappearance of pregnancy symptoms (nausea, breast tenderness)

✓ Lower back pain

✓ Missed miscarriage: no symptoms but ultrasound shows no fetal heartbeat

✓ Fever, offensive discharge, or severe pain (suggests infection — emergency)

Risk Factors

Chromosomal abnormalities in the embryo (cause of 50–60% of first-trimester losses)
Age: risk rises from 12% at age 20–30 to 50%+ at age 45
Previous miscarriage (2 losses: 28% risk; 3+ losses: 40%+ risk)
Uncontrolled diabetes or thyroid disease
Uterine abnormalities: fibroids, septum, Asherman's syndrome
Antiphospholipid syndrome (a clotting disorder)
Smoking, alcohol, or drug use during pregnancy
High fever (above 38.5°C) from any infection in early pregnancy
Trauma to the abdomen (less common than believed)

When to Seek Help

Heavy bleeding soaking more than one pad per hourHaemorrhage requires urgent hospital care — can be life-threatening without treatment

Signs of infection: fever, chills, offensive vaginal discharge, severe painSeptic miscarriage is a medical emergency — requires IV antibiotics and evacuation of the uterus

Severe one-sided pelvic pain with bleedingCould be ectopic pregnancy (in the tube, not uterus) — rupture is life-threatening

Confirmed miscarriage at any stageEven if bleeding has stopped, you need assessment for complete vs. incomplete miscarriage and options for management

Emotional support after lossGrief, depression, and anxiety after miscarriage are medically recognised — don't suffer in silence

Tests & Diagnosis

🧪 Ultrasound scan

Confirms whether miscarriage is complete, incomplete, or missed. Detects retained products of conception and rules out ectopic pregnancy

🧪 Beta-hCG (pregnancy hormone)

Serial levels every 48 hours help determine if pregnancy hormone is falling (suggests miscarriage) or rising normally (viable pregnancy or ectopic)

🧪 Full blood count

Checks for anaemia from blood loss and infection (raised white cells)

🧪 Blood group and Rh factor

Rhesus-negative women need anti-D injection after miscarriage to prevent sensitisation in future pregnancies

🧪 Investigations after 3 miscarriages

Blood tests for antiphospholipid antibodies, thyroid function, karyotype (chromosomes) — up to 50% of recurrent miscarriages have an identifiable cause

Treatment Options

Expectant management

Waiting for the miscarriage to complete naturally — takes 1–2 weeks. Appropriate for stable, uncomplicated incomplete miscarriage

Medical management

Misoprostol (Cytotec) tablets — given vaginally or under the tongue — stimulate the uterus to expel remaining tissue. Highly effective, avoids surgery

Surgical management (MVA or D&C)

Manual vacuum aspiration (MVA) or dilation and curettage (D&C) removes tissue under anaesthesia. Preferred for heavy bleeding, infection, or incomplete expulsion

Rh immunoglobulin (Anti-D)

Given to Rhesus-negative women within 72 hours of miscarriage to prevent blood sensitisation

Emotional support and counselling

Grief after miscarriage is real. Allow yourself to mourn. Consider support groups — the Miscarriage Association of Nigeria and similar organisations offer community

Trying again

Most women can try to conceive again after one normal menstrual cycle (4–6 weeks). No medical benefit to waiting longer unless specifically advised

Frequently Asked Questions

Did I cause my miscarriage?

Almost certainly not. The vast majority of miscarriages — especially in the first trimester — are caused by chromosomal abnormalities in the embryo. Routine activities like sex, exercise, working, stress, or a fall in early pregnancy do not cause miscarriage. Feeling guilty is natural but rarely warranted.

Will I miscarry again?

Having one miscarriage does not significantly increase your risk of another (still about 15%). After two miscarriages, the risk rises to 28%, and after three it reaches about 40%. After three consecutive miscarriages (recurrent pregnancy loss), investigations to identify a treatable cause are recommended.

Is it okay to get pregnant soon after a miscarriage?

Medically, yes — there is no evidence that waiting beyond one normal period improves outcomes. WHO recommends waiting at least 6 months, but this is contested by more recent data. Emotionally, take the time you need.

What about traditional medicine (agbo, herbs) after miscarriage?

Many traditional preparations contain compounds that affect uterine contractions or liver function. After a miscarriage, the uterus is sensitive and the risk of haemorrhage or infection from unregulated herbs is real. Always see a doctor first.