This type of loss occurs when a fertilised egg implants in the uterus, however the embryo doesn’t develop. A gestational sac may form and grow, and so pregnancy symptoms and positive pregnancy tests commonly occur. Eventually, the body recognises the pregnancy isn’t viable and is usually detected upon a scan showing an empty sac. This diagnosis can affect the ability to process and mourn the loss.

A chemical pregnancy is an early loss, typically before the 5th week of pregnancy (shortly after implantation). Importantly, the perception of the pregnancy dictates the attachment and not the gestational week. Hormone levels briefly rise, often giving a positive test result, but then falls again. Some people never realise they were pregnant; others find out because they test early or have been undergoing fertility treatment.

An ectopic pregnancy occurs when an embryo implants outside the womb, usually in a fallopian tube. It affects about 1 in 80 pregnancies and can be life-threatening if not treated promptly. The fallopian tube can’t stretch to accommodate the growing embryo, which can cause it to rupture. Some ectopic pregnancies show no early signs. When symptoms do appear, they might include unusual vaginal bleeding, shoulder tip pain, one-sided abdominal pain and feeling faint/collapsing. Immediate treatment is required for any of these symptoms – treatment typically involves surgery, but sometimes medical management.

A missed miscarriage (also called a silent miscarriage) occurs when a baby has died, but the body hasn’t yet recognised this. There may be no signs – no pain or bleeding – and so the discovery, usually during a scan, can be a huge shock. Pregnancy hormones may remain elevated for a time, so women can still feel pregnant and have a positive test result. An ultrasound may show no heartbeat, or that the baby is smaller than expected.

A molar pregnancy (hydatidiform mole) occurs when the cells that would normally form the placenta develop abnormally, and so the embryo doesn’t form or cannot survive. There are two types:
Partial mole: Two sperm fertilise one egg. Too much genetic material prevents normal development.
Complete mole: An empty egg is fertilised, usually by one sperm. There’s no baby/fetus, just rapidly dividing placental cells.

Molar pregnancies cannot continue and are usually diagnosed after miscarriage surgery, though they can sometimes be suspected earlier by scan or unusual symptoms. Molar tissue may rarely lead to a type of cancer called choriocarcinoma. It is highly treatable, however can be very a distressing diagnosis, and women cannot try again while undergoing treatment and testing.

Defined as two or more losses, usually in-a-row (depending on NHS Trust), recurrent miscarriage affects about 1% of couples. If you’ve experienced multiple losses, you should be referred to a recurrent miscarriage clinic for testing and support. Investigations may reveal causes such as blood clotting disorders, uterine issues or thyroid problems – but sometimes no cause is found. Recurrent miscarriage is often deeply distressing and anxiety-provoking.

Sometimes, a pregnancy is ended due to a diagnosis affecting the health of the baby or mother. Though it’s a deliberate medical decision, it is still experienced as a pregnancy loss, often filled with grief and complexity. TFMR can be isolating due to stigma and misunderstanding.

Sometimes no cause is found, however, it may be that you are diagnosed with:

• A blood clotting disorder

• Thyroid problems

• Thyroid antibodies

• Uterine problems

• Genetic cause