A Guide to Early Pregnancy Loss
Miscarriage, Missed Miscarriage,
Ectopic Pregnancy, and Molar Pregnancy
We are deeply sorry for your loss.
Pregnancy loss can be devastating, regardless of how early it occurs. You have the right to grieve the loss of a pregnancy at any gestational age.
Please know that there is no right way to handle pregnancy loss. Your choices and grieving process are your own. Be kind to yourself and allow yourself to do what feels helpful.
This guide offers information about early pregnancy loss, medical care, physical and emotional experiences, and ways to find support. You do not have to read everything at once. Take what feels helpful and return to the information when you need it.
Understanding Early Pregnancy Loss
Early pregnancy loss can happen in different ways. Understanding the type of loss you have experienced may help you make sense of what happened and what medical care may be needed.
Miscarriage: The loss of a pregnancy before 20 weeks. Miscarriage may involve bleeding and cramping, or it may be discovered during an ultrasound.
Missed Miscarriage: A pregnancy loss in which the embryo or fetus has stopped developing, but the body has not yet begun the process of miscarriage. There may be no noticeable symptoms.
Ectopic Pregnancy: A pregnancy that develops outside the uterus, most commonly in a fallopian tube. An ectopic pregnancy cannot continue and can become life-threatening without treatment.
Molar Pregnancy: A rare pregnancy complication involving abnormal growth of placental tissue. Molar pregnancies require medical care and follow-up monitoring.
Every experience is different. Your healthcare team can help explain your diagnosis, what to expect, and which care options are appropriate for your circumstances.
Understanding Your Medical Care Options
Your options will depend on several factors, including the type of pregnancy loss, how far along you are in your pregnancy, and your individual medical circumstances.
You may have already received treatment, or you may still be considering your options. The information below describes approaches that may be available. Your healthcare provider can help you understand which options are safe and appropriate for you.
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You may be able to let the process of miscarriage occur naturally if you're in the first trimester of your pregnancy and this option is safe for you. This process can often happen at home.
Here are examples of what you may experience:
No defined timeline; the process could take days or weeks.
Bleeding and cramping that may be heavier or more painful than a menstrual period.
You may see pregnancy tissue, depending on how far along you are. Ask your medical provider if they have a collection kit for you to use at home, if this is something you would like.
Follow-up care may be needed to confirm that the miscarriage is complete.
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Vaginal or oral medication may be an option, depending on how far along you are in your pregnancy and your medical circumstances.
If you're in the first trimester, medication causes the uterus to contract and pass the pregnancy tissue. This may happen at home or in an outpatient setting. You may experience bleeding and cramping that are heavier or more painful than a menstrual period.
For pregnancy loss later in pregnancy, medication may be used to start labor and lead to vaginal delivery.
Your healthcare provider can explain what to expect, pain management options, and any follow-up care you may need.
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Depending on your circumstances, a procedure may be recommended or may be an option you choose.
D&C (Dilation and Curettage): A procedure commonly performed in the first trimester. During the procedure, your cervix is dilated or opened, and pregnancy tissue is removed from the uterus, often using suction.
D&E (Dilation and Evacuation): A procedure generally performed later in pregnancy. The cervix is dilated, and pregnancy tissue is removed from the uterus using suction and specialized instruments.
Your healthcare provider can explain the procedure, anesthesia or pain management options, and what to expect during recovery.
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An ectopic pregnancy requires medical treatment because it cannot continue safely and may cause life-threatening internal bleeding.
Methotrexate injection(s) may be given in certain circumstances if you're early in your pregnancy and medically stable. The medication stops pregnancy cells from growing, and your body gradually absorbs the pregnancy tissue.
Sometimes, surgery is needed to remove the pregnancy or repair or remove the affected fallopian tube.
Your healthcare provider will discuss the safest treatment based on your symptoms, test results, and medical circumstances. Follow-up monitoring is important, including after medication treatment.
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A molar pregnancy requires medical treatment and follow-up monitoring.
Treatment usually involves a procedure to remove the abnormal pregnancy tissue from the uterus.
After treatment, your healthcare provider will monitor your pregnancy hormone (hCG) levels to make sure the abnormal tissue has resolved. Additional treatment is sometimes needed if the tissue persists.
Your healthcare provider can explain the recommended follow-up schedule and when it may be safe to consider another pregnancy.
When to seek immediate medical attention
Seek emergency medical care if you experience severe or worsening abdominal pain, shoulder-tip pain, fainting, severe dizziness, or very heavy bleeding. Contact your healthcare provider promptly if you develop a fever, worsening pain, or other concerning symptoms. These may be signs of complications that require medical attention.
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When receiving care for pregnancy loss, it can be difficult to know what to ask for or what options may be available.
This is a suggested list of requests to make or topics to discuss when you are in the hospital or clinic. Not every option will be available or appropriate for every type of loss, but you have the right to ask questions and share what matters to you.
An ultrasound before the procedure, if available, to have a keepsake image.
Pain management options that are available during the procedure (e.g., medication, anesthesia).
Handprints and footprints of your baby, if possible, depending on gestational age and circumstances.
Request what you need to feel comfortable, including having a support person present, if permitted.
A room away from other patients to have a quiet, private space, when available.
Options for handling pregnancy remains, including further testing, cremation, or burial, when applicable.
Information about what to expect afterward, including physical recovery, follow-up appointments, and when to contact your healthcare provider.
You do not have to make every decision immediately or ask every question on this list. If possible, consider having a partner, family member, friend, or other support person help you communicate your wishes and remember information.
Physical and Emotional Responses After Early Pregnancy Loss
Pregnancy loss can affect you physically and emotionally. Your experience will depend on your circumstances, and you may experience some, all, or none of the responses below.
Physical Responses
Bleeding and uterine cramping
Breast tenderness or milk production
Hormonal changes, including night sweats
Fatigue and changes in sleep
Changes in appetite or digestion
Emotional Responses
Sadness, anger, guilt, or anxiety
Feeling numb, disconnected, or overwhelmed
Difficulty concentrating or feeling in a mental fog
Changes in sleep or appetite
Feeling isolated or misunderstood by others
There is no right or wrong way to respond to pregnancy loss. Your physical recovery and emotional grief may unfold differently, and both deserve care and support.
If your symptoms are concerning or your emotional distress feels overwhelming, reach out to a healthcare professional for additional support.
Caring for Yourself After Early Pregnancy Loss
There is no timeline for grief or recovery after pregnancy loss. What feels helpful in the days immediately following your loss may be different from what you need weeks or months later.
Some suggestions that may be helpful:
Allow yourself time to rest and recover, both physically and emotionally.
Ask for help from family members or friends with meals, household responsibilities, or other daily tasks.
Share your feelings with people you trust, if and when you feel comfortable.
Consider ways to remember or honor your baby or pregnancy, if that feels meaningful to you.
Be gentle with yourself around pregnancy announcements, baby showers, holidays, and other potentially difficult experiences.
Consider connecting with others who have experienced pregnancy loss through a support group or online community.
Seek additional support from a mental health professional if you feel you would benefit from it.
You do not need to do all of these things. Take what feels helpful and leave the rest.
You Don't Have to Navigate This Alone
Pregnancy loss can feel isolating, especially when others may not understand the depth of your grief. Whether your loss happened recently or many years ago, you deserve support and a space where your experience is acknowledged.
At Return to Zero: HOPE, we offer compassionate support for individuals and families navigating pregnancy loss, including miscarriage, ectopic pregnancy, and molar pregnancy.
Our support groups, workshops, and community gatherings provide opportunities to connect with others who understand. There is no right time to seek support, and you are welcome wherever you are in your grief.