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Missed miscarriage

A missed (or silent) miscarriage is one where the baby has died or not developed, but has not been physically miscarried.  In many cases, there has been no sign that anything was wrong, so the news can come as a complete shock.

Why does it happen?

It’s not at all clear why some miscarriages happen within days of a baby dying and others take much longer before the pregnancy hormone levels drop and the physical miscarriage begins.  Sometimes that delay may be a matter of days, but it might take several weeks.

Why didn’t I know?

While many miscarriages begin with symptoms of pain and bleeding, there are often no such signs with a missed miscarriage.  Pregnancy hormones may continue to be high for some time after the baby has died, so you may continue to feel pregnant and a pregnancy test may well still show positive.

In the first few weeks of the second trimester, it may be too early to feel the baby kick so without any bleeding or pain, you are likely to assume all is well.

There often is no way you could know, except by having an ultrasound scan.

Nurses told me the baby probably died around seven weeks, four weeks before I realised anything was wrong. Four weeks in which I was marching around with a big smile on my face.

The scan

A missed miscarriage is often diagnosed at a routine ultrasound scan, whether around 12 weeks or at the 20 week ‘anomaly’ scan.  However it might also be seen at a non-routine scan, NHS or private, whether or not there are any symptoms.

With a missed miscarriage, the scan picture usually shows a pregnancy sac with a baby (or fetus or embryo) inside, but there is no heartbeat and the pregnancy looks smaller than it should be at this stage.

After taking lots of pictures I was told ‘I’m sorry there is no heartbeat, the baby died at 9.5 weeks’, so it was a missed miscarriage and my body thought I was still pregnant.  It hit me hard.

In some cases, the scan shows an empty pregnancy sac or no clear sac at all.  The embryo has either not developed or it stopped developing at a very early stage and been reabsorbed by the body. You might hear that called ‘early embryonic demise’ or the old-fashioned term ‘blighted ovum’.

Your feelings

The diagnosis of a missed miscarriage can be very shocking, especially if you had no indication at all that anything was wrong.

You might have been full of excitement about seeing your baby and looking forward to sharing your news, as Tina was:

As we got to the 12 week scan, I was looking forward to it.  I wanted that to be the benchmark when I could tell everybody.

Perhaps you had an early or additional scan because of spotting, pain or bleeding, or just a sense that something wasn’t right.  The diagnosis might have confirmed your worst fears but it might still have come as a real shock, perhaps especially if it was some time since the baby had died.

On the other hand, you may have had several scans before the miscarriage was confirmed, and this can be a very stressful time.

The scan showed the “baby” was only the size of a 5 week pregnancy and there was no heartbeat. We were told we would have to wait a week to see if there was any growth and if there had been, then the baby might be big enough to have a detectable heartbeat.  That was one of the longest weeks of my life.

This period of waiting can feel like you’re ‘in limbo’, whether you try to be positive, as in this story, or you prepare for the worst.  You might move between the two.

Being faced with decisions

At the same time as dealing with the news that you have a missed miscarriage, you may also be asked to make some difficult decisions about how to manage the miscarriage process.  (We write about this here.)

You might feel ready to make that decision very quickly, or you might need a few days to take everything in before making a decision.  You are very welcome to contact us if you’d like to talk things through.

Helping you through

You might also find it helpful to read some of the following stories:

Our animation ‘Helping people through’ shares one couple’s experience of a missed miscarriage:

You might also want to talk with others who have been through something similar:

You don’t need to go through this alone.