What is a Threatened Miscarriage? (and Why We Don’t Call it That)

Team Peanut4 months ago4 min read

“Threatened miscarriage” is the medical term often used to describe vaginal bleeding during pregnancy while the pregnancy continues.

Threatened Miscarriage

But we believe this is an unhelpful label. Why? Because the majority of women diagnosed with threatened miscarriage will go on to have healthy pregnancies. And while considered “abnormal,” the pregnancy bleeding that leads to this diagnosis doesn’t always mean there’s a serious problem.

Of course, sadly, bleeding in pregnancy sometimes is a sign of pregnancy loss. And the pain of this experience should be discussed more openly. But using an intimidating term like “threatened miscarriage” to describe all pregnancy bleeding can cause needless anxiety for women who aren’t seriously at risk of losing their babies.

That’s why we feel that “threatened miscarriage” could be more helpfully and accurately called pregnancy bleeding. (Take a look at our #RenamingRevolution Glossary for other outdated terms related to fertility and motherhood that we want to see changed.)

But, needless to say, if you do experience any bleeding during pregnancy, it’s best to make an appointment with your healthcare practitioner to get it checked out.
So let’s explore pregnancy bleeding further and find out how you might be diagnosed with a threatened miscarriage.

In this article: 📝

  • What is a threatened miscarriage (pregnancy bleeding)?
  • What are the causes of pregnancy bleeding?
  • How is a threatened miscarriage diagnosed?

What is a threatened miscarriage (pregnancy bleeding)?

About 20% of all mamas-to-be experience vaginal bleeding in the first 20 weeks of pregnancy. This can range from mild spotting to a heavier flow with clots. You might also feel some period-pain-like cramps at the same time.

If you report the bleeding to your healthcare provider, they might decide to carry out some tests (more on that later). And if they find that the embryo in your uterus is alive and well, they may diagnose you with a “threatened miscarriage”. As we’ve seen, not the most helpful term, mainly as your chances of having a healthy pregnancy are still high.

What are the causes of pregnancy bleeding?

There are lots of things that can cause vaginal bleeding in early pregnancy. These can be mild issues that will clear up on their own. But, in more serious cases, bleeding can also be a sign of pregnancy loss.

Common causes of mild spotting include:

  • Increased blood flow to your cervix, which can make it bleed more easily (after sex, for example)
  • Implantation bleeding
  • Bleeding next to the amniotic sac (the membrane holding your growing baby). This is sometimes called a subchorionic hematoma
  • Urine or vaginal infection

More rarely, bleeding may be a sign of pregnancy loss, including:

Get in touch with your healthcare practitioner if you experience pregnancy bleeding or any other unusual symptoms that concern you.

How is a threatened miscarriage diagnosed?

Once you’ve reported your bleeding, your healthcare practitioner may use a number of different tests to check on the progress of your pregnancy. These are:

  • Pelvic exam. Your practitioner will feel the opening of the cervix. If it’s closed, that’s a sign that your pregnancy is continuing normally. If it’s dilated, you may be having a miscarriage (sometimes called an “inevitable miscarriage” – where pregnancy loss has already begun and can’t be stopped).

  • Blood tests. These test the amount of the pregnancy hormone hCG in your bloodstream. You will usually have several tests over several days to see if your hCG levels are rising or falling. It’s normal for them to increase rapidly in early pregnancy, so if they’re falling that could point to a problem.

  • Ultrasound scan. If your baby’s heartbeat is detected, then this could be the point that you’re officially diagnosed with a “threatened miscarriage” (a continuing pregnancy with vaginal bleeding). In fact, when a heartbeat is found, you have an 85% to 97% chance that you will carry your baby to term.

If these tests reveal that your pregnancy is still progressing normally and don’t show a cause for the bleeding, your practitioner might carry out further tests. For example, they might do a urine test to check for a urine infection or take vaginal swabs to check for a vaginal infection. But sometimes, it’s not possible to work out why the bleeding has occurred.