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What to Do If You Think You're Miscarrying

If you think you're miscarrying, it is completely understandable to feel frightened and overwhelmed. This guide explains exactly what to do, step by step — who to contact, what to expect, and how to take care of yourself in a very difficult situation.

Step 1: Don't Panic

Bleeding in early pregnancy is more common than many people realise. Not every bleed leads to miscarriage. Spotting and light bleeding can be caused by implantation, cervical sensitivity, a small bleed behind the placenta (subchorionic haematoma), or simply the increased blood supply to the cervix during pregnancy. Many people who bleed in early pregnancy go on to have healthy babies.

That said, any bleeding in pregnancy deserves to be checked by a healthcare professional. Try to stay as calm as you can and follow the steps below.

Step 2: Contact the Right Service

In the UK, the right place to contact depends on your symptoms and the time of day:

  • Your GP (during surgery hours): Call your GP practice first thing. They can refer you to the Early Pregnancy Unit (EPU) or arrange an urgent assessment.
  • Your midwife: If you already have a named midwife, they can advise and help you access the EPU directly.
  • Early Pregnancy Unit (EPU): Many EPUs accept self-referrals. You can find your nearest EPU through your GP or hospital's website. EPUs specialise in exactly this situation and are the right place for early pregnancy concerns.
  • NHS 111: If it is out of hours and you are not sure what to do, call 111. They can direct you to the right service and arrange urgent care if needed.
  • A&E or call 999: Go to A&E — or call 999 — if you are soaking through a pad in an hour or less, if the pain is severe and not controlled by paracetamol, if you feel faint or collapse, or if you have one-sided severe pain (which could indicate an ectopic pregnancy). These are emergency situations.

Step 3: What Will Happen at the EPU

When you are seen at the EPU, the team will aim to find out what is happening as quickly as possible. Depending on your symptoms and how many weeks pregnant you are, they are likely to:

  • Perform an ultrasound scan — usually a transvaginal (internal) scan for best visibility in early pregnancy. This will check whether a heartbeat is present and whether the pregnancy is in the right place.
  • Take blood tests to measure your hCG (pregnancy hormone) levels. If the situation is uncertain, they may ask you to return 48 hours later for a repeat test to see whether levels are rising or falling.
  • Give you a diagnosis and a management plan. If a miscarriage is confirmed, the team will talk through your options — natural management, medical management (tablets), or surgical management — and support you in making the right choice for you.

Step 4: Look After Yourself

Whatever is happening, you are going through something extremely hard. While you are waiting for an appointment or scan:

  • Use a sanitary pad rather than a tampon so that any bleeding can be monitored.
  • Take paracetamol if you have pain (check the packet instructions and avoid ibuprofen without medical advice in pregnancy).
  • Let someone you trust know what is happening so you are not alone.
  • Avoid strenuous activity.

There is nothing you could have done to cause a miscarriage in early pregnancy, and nothing you could have done differently to prevent one. The vast majority of early miscarriages are caused by chromosomal differences in the developing embryo — they are not caused by stress, exercise, sex, or anything you ate or did.

What Happens After a Miscarriage

If the worst happens and your pregnancy has ended, your care does not stop at the EPU. You will be given follow-up information, and you should receive a phone call or follow-up appointment. If you feel you are not coping — physically or emotionally — contact your GP. Organisations like the Miscarriage Association (miscarriageassociation.org.uk) offer free support and helplines for anyone affected by pregnancy loss.

Frequently Asked Questions

Should I go to A&E if I'm bleeding in pregnancy?

For light bleeding or spotting, call your GP or EPU rather than going straight to A&E. A&E is the right choice if you are soaking through a pad in an hour or less, if the pain is severe, if you feel faint or collapse, or if you have sharp one-sided pain (which could signal an ectopic pregnancy). If in doubt out of hours, call 111 for guidance.

What should I bring to the EPU?

Bring your maternity notes if you have them, a sanitary pad rather than a tampon so the team can assess blood loss, and a support person if you would like one. The EPU team are experienced in supporting people through this, and you will not be judged or rushed.

How soon will I be seen at the EPU?

Most EPUs aim to see urgent cases the same day or within 24 hours. If you are told there is a wait and your symptoms are getting worse — heavier bleeding, worsening pain, faintness — do not wait. Go to A&E or call 999.

Further reading:

Always speak to your midwife or GP for personal advice about your pregnancy and any symptoms you are experiencing.

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