While less common than in the first trimester, a miscarriage is still possible at 14 weeks of pregnancy. Understanding the possibilities at this stage is important for expectant parents. Awareness of the signs and factors involved can help in seeking timely medical attention.
Understanding Second Trimester Miscarriage
A second-trimester miscarriage refers to a pregnancy loss that occurs between 14 and 24 weeks of gestation. The risk of miscarriage significantly decreases after the first trimester, which typically ends around 12 to 13 weeks. Most pregnancy losses happen in the initial 12 weeks of gestation. Research from 2025 indicates that miscarriage rates between 14 and 19 weeks are estimated to be between 1% and 5% in the United States. This contrasts with an overall miscarriage risk of about 15% across all known pregnancies, highlighting the reduced, though still present, risk in the second trimester.
Signs to Watch For
Vaginal bleeding is often the earliest symptom. This bleeding can range from light spotting to a heavier, continuous flow, and it may include passing blood clots or fluid. Bleeding is more concerning if it is heavy, increases over time, or occurs alongside intense cramping.
Increased belly pain or cramping, which can feel similar to or more severe than menstrual cramps, is another sign. These cramps might progress to strong, labor-like contractions in the abdomen or back.
A loss of previously experienced pregnancy symptoms, such as breast tenderness or nausea, can also be an indicator. It is also possible for a miscarriage to occur without any bleeding, a condition sometimes called a “missed miscarriage.” In such cases, the loss might only be discovered during a routine ultrasound where fetal cardiac activity has ceased. Any of these symptoms warrant immediate medical attention to determine the cause and receive appropriate care.
Common Contributing Factors
Miscarriages in the second trimester, including at 14 weeks, often stem from different causes than those in the first trimester. While early miscarriages are frequently due to chromosomal abnormalities, losses at 14 weeks and beyond are more commonly linked to maternal or placental issues.
Common factors include cervical insufficiency, where the cervix begins to open prematurely without contractions, unable to hold the growing pregnancy. This can lead to very early labor. Uterine abnormalities, such as an unusually shaped uterus or the presence of fibroids or polyps, can also contribute to a miscarriage.
Infections, whether bacterial vaginosis, or other systemic infections like parvovirus, cytomegalovirus, or toxoplasmosis, can lead to pregnancy loss. Certain chronic health conditions in the mother, such as poorly controlled diabetes, high blood pressure, thyroid disorders, or autoimmune conditions like lupus and antiphospholipid syndrome (APS), increase the risk. APS, sometimes called “sticky blood syndrome,” can cause blood clots in the placenta.
Seeking Medical Help and Support
If any of the aforementioned signs appear, contacting a healthcare provider immediately is recommended. While not all symptoms indicate a miscarriage, prompt medical evaluation is necessary to assess the situation and receive appropriate guidance.
In cases of heavy bleeding (soaking more than one sanitary pad per hour for two hours) or feeling very sick, heading to an emergency department is advisable.
Medical management after a miscarriage diagnosis can involve various procedures. Expectant management, where the body passes the tissue naturally, may be an option. Medications like misoprostol, sometimes in combination with mifepristone, can be administered to induce uterine contractions and help expel pregnancy tissue. Surgical procedures such as dilation and curettage (D&C) or dilation and evacuation (D&E) may be performed to remove any remaining tissue, which can help prevent heavy bleeding and infection.
Emotional support is also important, and resources are available to help individuals and couples cope with loss.