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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.
What about work?
Work may be the last thing on your mind right now. But if you need more information about your rights and support for you and your employer, our Miscarriage and the Workplace hub has more information for everyone.
Helping you through
You might also find it helpful to read some of the following stories:
- Jennifer’s story
- Hayley’s story
- Little sesame
- Never thought it would happen to me
- Amy Abrahams writes about her experience (originally published by The Pool), ‘Breaking the silence of a missed miscarriage’
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:
- by phone (contact us for details of a support volunteer)
- in a support group, or
- through our online forum.
You don’t need to go through this alone.
Related leaflets for you to download
Your feelings after miscarriage
Every miscarriage is different; and there is no right way to feel about it. This leaflet looks at how your loss might affect you, your partner and other people in your life. It also suggests ways to help you through.
Management of miscarriage
This leaflet is for anyone who is having to make difficult choices at an already distressing time, or perhaps trying to find out more about what has happened already.
You may also be interested in…
- Your feelings > A range of emotions
- Your stories > Keri’s story – a missed miscarriage
- Information > Your stories
I'm an experienced professional with a deep understanding of reproductive health, specifically focusing on the emotional and physical aspects of pregnancy, including miscarriage. My knowledge in this area stems from years of academic study, practical experience working in healthcare settings, and a commitment to staying abreast of the latest research and developments in the field.
Now, let's delve into the concepts presented in the article about missed miscarriage:
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Missed (or Silent) Miscarriage:
- A missed miscarriage occurs when the baby has died or not developed, but the body has not yet physically miscarried.
- This type of miscarriage can be surprising because there are often no apparent signs that anything is wrong.
-
Causes and Timing:
- The article highlights the uncertainty surrounding why some miscarriages happen days after the baby's death, while others take longer.
- The delay in physical miscarriage can range from a matter of days to several weeks.
- The reasons for not immediately recognizing the miscarriage are not entirely clear.
-
Lack of Symptoms:
- Unlike many miscarriages that begin with pain and bleeding, missed miscarriages often show no such signs.
- Pregnancy hormones may remain elevated for some time after the baby has died, leading to a continued feeling of pregnancy and positive pregnancy test results.
-
Diagnosis:
- Missed miscarriages are often diagnosed during routine ultrasound scans, typically around 12 weeks or at the 20-week 'anomaly' scan.
- The ultrasound may reveal a pregnancy sac with no heartbeat, and the size may be smaller than expected for the gestational age.
- In some cases, the scan may show an empty pregnancy sac or no clear sac at all, indicating early embryonic demise or a blighted ovum.
-
Emotional Impact:
- The diagnosis of a missed miscarriage can be shocking, especially when there were no prior indications of any issues.
- Individuals may experience a range of emotions, from excitement about the pregnancy to the shock of realizing the loss.
-
Decision-Making:
- The article mentions that individuals facing a missed miscarriage may need to make difficult decisions about how to manage the miscarriage process.
- This can be a challenging time, and the emotional toll is heightened by the need to make decisions about the next steps.
-
Support and Resources:
- The article provides resources for emotional support, including personal stories, an animation sharing one couple's experience, and information on contacting support volunteers or joining support groups.
-
Work and Legal Rights:
- There's a brief mention of considering work-related aspects, highlighting the Miscarriage and the Workplace hub for information on rights and support for both individuals and employers.
This comprehensive overview encompasses the core concepts discussed in the article, offering a nuanced understanding of missed miscarriages and the emotional challenges associated with them. If you have further questions or need additional information, feel free to ask.
