Missed miscarriage: what it means and what happens next

A missed miscarriage is when the pregnancy has stopped developing, but your body hasn’t yet passed it, so there may have been few signs or none at all. It’s often found at a scan, which can make the news a real shock. Here’s what it means and what happens next.

What a missed miscarriage is

You may also hear it called a silent or delayed miscarriage. It means the pregnancy has stopped developing, but it’s still in the womb. The physical miscarriage, with bleeding and cramps, might not start until days or several weeks later.

Why there may have been no signs

After some miscarriages, pregnancy hormones take longer to fall. So you may still feel pregnant, sometimes for weeks, and a pregnancy test may still be positive. With no pain or bleeding, it’s natural to assume everything is fine. Some people notice a little spotting or a sense that something has changed, but many notice nothing at all.

There’s often no way you could have known without a scan. Most early miscarriages happen because of a problem with the baby’s genes, and it’s very unlikely that anything you did or didn’t do caused it.

How it’s found

A missed miscarriage is usually found at a scan: a routine one, like the 12-week scan or the 20-week scan, or an early scan you’ve had for another reason. The sonographer measures the pregnancy and looks for a heartbeat. They might see a baby that’s smaller than expected with no heartbeat. Sometimes the pregnancy sac is empty, or no baby can be clearly seen.

Being told at a scan

This news can come as a real shock, especially when you had no idea anything was wrong and still feel pregnant. You might have gone in expecting to see your baby. Many people find it hard to make sense of not having known, and go back over the weeks before. That reaction is very common.

You don’t have to decide anything in the scan room. It’s fine to ask for a moment, to ask questions, and to ask for written information to take home.

Confirming it

Sometimes one scan is enough. If not, NICE guidance sets out when the team should do a second scan, at least 7 days later, or get a second opinion. Some people have their second scan 7 to 14 days after the first.

Waiting for that scan can feel like being in limbo. Your early pregnancy unit should give you a number to call, day or night, if anything changes.

What happens next: your choices

Once a missed miscarriage is confirmed, you’re usually offered 3 options:

Waiting for the miscarriage to happen naturally. This often takes around 2 weeks, sometimes more.
Medicine to help your body pass the pregnancy, at home or in hospital. For a missed miscarriage, this is usually a tablet called mifepristone, then another medicine, misoprostol, 2 days later.
A procedure using gentle suction to remove the pregnancy, under local or general anaesthetic. Many people go home the same day.

All 3 are safe, with a very small risk of infection or other harm. The option you choose won’t change your chances of a healthy pregnancy in future. You can usually take a few days to decide. Our guide to miscarriage treatment options explains each one in more detail.

If you were 14 weeks pregnant or more, your care will usually be different: you may need to give birth, and labour may start on its own or be started with medicine. Your team will talk you through it.

If your blood group is D negative and you were 12 weeks pregnant or more, you may be offered an anti-D injection.

If you wait or take medicine, you may be given a pregnancy test to do at home 3 weeks later. If it’s still positive, contact the team who looked after you.

Support

A missed miscarriage is still a miscarriage, whatever stage you were at, and it’s OK to grieve. Partners can be deeply affected too. If either of you is struggling, talk to your GP.

Miscarriage UK: helpline 0303 003 6464, plus support groups and an online community.
Tommy’s: free midwife helpline 0800 0147 800, Monday to Friday, 9am to 5pm.

For what to expect in your body and your feelings afterwards, see after a miscarriage: your body, your feelings and support.

When to get help

If you’re waiting for a second scan and you start bleeding, or have pain that’s severe, on one side, or not easing after resting for 30 to 60 minutes, or pain in the tip of your shoulder, contact your early pregnancy unit or maternity unit straight away, or NHS 111 if you can’t reach them.

If you’re waiting for the miscarriage to happen, bleeding and cramps are expected. Contact your early pregnancy unit, GP or NHS 111 if you have a high temperature or flu-like symptoms, smelly discharge, pain that painkillers aren’t helping, or bleeding that’s getting heavier or going on longer than expected.

Call 999 if bleeding is heavy (soaking a pad soon after putting it on), or comes with severe tummy or shoulder pain, or with feeling sick, faint or dizzy; and for sudden, severe tummy pain with feeling faint or dizzy, even without bleeding.

Questions people ask

Can you have a missed miscarriage and still have pregnancy symptoms?

Yes. Pregnancy hormones can stay high for a while, so you can still feel pregnant and get a positive test.

Is a silent miscarriage the same as a missed miscarriage?

Yes. Silent, delayed and missed miscarriage are different names for the same thing.

Could the scan be wrong?

One scan can’t always be 100% certain, which is why there are rules for checking. If the pregnancy is very small, there should be a second scan at least 7 days later. If it’s bigger, the team should get a second opinion, do a second scan, or both. It’s fine to ask them to explain what they’ve seen.

How long can a missed miscarriage go unnoticed?

Sometimes for weeks. The bleeding and cramps of a miscarriage can start days or several weeks after the pregnancy has stopped developing, and some people only find out at a routine scan.