A late miscarriage is the loss of a fetus between the 12th and the 20th week of pregnancy. Before the 12th week, the loss is a miscarriage, but not a late one. After the 20th week, the fetus has a reasonable chance of surviving. Therefore, the loss is considered a stillborn birth, rather than a late miscarriage.
Miscarriages in the first trimester — before the 12th week of pregnancy — are common. It is believed that one in four pregnancies end in miscarriage. Some in the medical profession estimate that the rate of miscarriage may actually be closer to 50% because women who are unaware that they are pregnant believe they are having a very heavy, slightly late period when, in fact, they are having a miscarriage.
Late miscarriage is much less common, occurring in one or two out of 100 pregnancies. Causes for late miscarriage include fetal abnormalities; maternal difficulties, such as a misshaped uterus or incompetent cervix; genetic abnormalities; problems with the placenta; environmental toxins; or a virus or infection that kills the fetus. With a late miscarriage, there is usually more fetal tissue to examine, which can help doctors determine the reason for the miscarriage and possibly prevent another one in a future pregnancy.
Signs of an impending late miscarriage are similar to the signs of an earlier miscarriage. Very heavy bleeding that does not stop is one of the biggest signs, especially when it is accompanied by severe cramping. A lower backache often precedes or accompanies the cramping. In addition, with a late miscarriage, there is often quite a bit of tissue passed with the bleeding.
A woman who believes she is having a late miscarriage should call her physician immediately. If heavy bleeding occurs and does not stop, a trip to the emergency room is in order to avoid dangerous complications that could threaten the mother's life. She should save some of the fetal tissue if she can, and if she delivers the baby, she should certainly take the baby to the emergency room with her.
After the miscarriage and any follow-up procedures that are recommended, the woman will need to heal, and to allow herself time to rest and recover. She is also likely to experience a range of emotions from the loss of her baby as well as the physical trauma she has endured. Many women find emotional healing by talking with other women who have miscarried or by seeking the services of a medical professional.