Keguguran (miscarriage) is the loss of a pregnancy before 24 weeks, and its main sign is vaginal bleeding, sometimes with cramping pain in the lower tummy. It is common: early miscarriage is estimated to happen in 10 to 20 in every 100 pregnancies, most often in the first 12 weeks. Most early miscarriages are caused by a problem with the baby's chromosomes, and everyday activities such as moderate exercise and sex are not linked to miscarriage. Bleeding in pregnancy is not always a miscarriage, but always get it checked; call 999 if the bleeding is heavy or you have severe pain, shoulder pain or feel faint. Most women who have a miscarriage go on to have a successful pregnancy, and support is available if you are struggling afterwards.
If you are reading this after a loss, we are sorry. Please be gentle with yourself, and reach out for support if you need it (see where to find support).
What is keguguran (miscarriage)?
According to the NHS, a miscarriage is the loss of a pregnancy before 24 weeks. Doctors often describe:
- early miscarriage: before 14 weeks of pregnancy (the charity Tommy's notes most happen in the first 12 weeks);
- late miscarriage: between 14 and 23 weeks;
- missed miscarriage: when there are no symptoms and the loss is only found at a scan;
- recurrent miscarriage: 3 or more miscarriages.
How common is miscarriage?
According to Tommy's, a UK pregnancy and baby charity:
- early miscarriage is estimated to happen in 10 to 20 in every 100 pregnancies;
- late miscarriage (second trimester loss) happens in about 3 to 4 in 100 pregnancies;
- around 1 in 80 pregnancies are ectopic (growing outside the womb);
- the risk of miscarriage goes down a lot after 12 weeks of pregnancy;
- most miscarriages are a one-off, and there is a good chance of a successful pregnancy in the future.
Tanda keguguran: signs and symptoms
According to the NHS, the main symptom of miscarriage is usually vaginal bleeding before 24 weeks. Bleeding in pregnancy may look like:
- spots of pink, red or brown blood on your underwear or toilet paper (spotting);
- larger areas of pink, red or brown blood that may need a pad (light bleeding);
- red blood that soaks through a pad (heavy bleeding).
Other symptoms can include:
- pain and cramping in your lower tummy;
- pink, grey or white lumps coming out of your vagina, which may look or feel stringy;
- fluid suddenly coming out of your vagina.
Sometimes there are no symptoms, and the loss is only found at a pregnancy scan (a missed miscarriage).
The NHS also notes that vaginal bleeding and tummy pain in pregnancy can be caused by other things and are not always serious. Many people search for pictures of darah keguguran, but bleeding varies so much that you cannot tell from a picture whether you are miscarrying; an examination and scan are needed. For early pregnancy symptoms, see our guide to tanda-tanda mengandung.
When to get help
According to the NHS, get urgent medical help (at a hospital, your antenatal clinic or a klinik kesihatan) if you are pregnant and have:
- light vaginal bleeding or spotting, with no or only mild tummy pain;
- vaginal discharge that is unusual for you, or fluid leaking from your vagina.
Call 999 if you are pregnant, have vaginal bleeding and:
- you have severe pain in your tummy (you cannot do daily tasks or focus because of the pain);
- you have pain in your shoulder;
- you feel sick, faint, dizzy or lose consciousness;
- the bleeding is heavy (soaking a pad soon after putting it on).
These can be signs you need immediate treatment, for example for an ectopic pregnancy; see our guide to sakit perut for more on pain low in the tummy in women.
Punca keguguran: what causes miscarriage?
According to the NHS, it is not always known what causes a miscarriage, but it is often because there is a problem with the way the pregnancy develops. Tommy's explains that most early miscarriages (before 12 weeks) are caused by a problem with the baby's chromosomes or genes, which means the baby cannot develop properly and the pregnancy cannot continue.
The NHS lists things that may increase the chance of a miscarriage:
- being aged 35 or over, or the baby's father being 45 or over;
- being from a Black African or Black Caribbean background;
- conditions such as diabetes, a blood clotting condition, a thyroid condition such as an underactive thyroid, or polycystic ovaries (now also called polyendocrine metabolic ovarian syndrome, PMOS);
- a problem with your womb (see our guide to fibroids);
- low levels of the hormone progesterone, or vitamin D deficiency;
- smoking, drinking alcohol, or drinking a lot of caffeine;
- living with obesity or being underweight;
- exposure to harmful chemicals or high levels of air pollution.
Things that do not cause miscarriage
Many women blame themselves after a miscarriage. According to Tommy's, the following are not linked to an increased risk of miscarriage:
- moderate exercise in an uncomplicated pregnancy; babies are secure inside the womb;
- having sex in a normal pregnancy, unless your doctor has told you not to;
- flying during an uncomplicated pregnancy;
- a previous abortion.
Tommy's adds that research has found a link between persistent, high levels of stress and miscarriage, but more studies are needed. If stress feels too much, talk to your doctor or midwife.
How is a miscarriage diagnosed?
According to the NHS, if doctors think you might be having a miscarriage, they will ask about your pregnancy, any previous pregnancies and your general health, and may offer:
- blood or urine tests;
- an internal (trans-vaginal) ultrasound scan.
What happens during a miscarriage?
According to the NHS, a miscarriage cannot be stopped once it has started. Your options depend on your symptoms and how many weeks pregnant you are.
| Stage | Options (NHS) |
|---|---|
| Early miscarriage (before 14 weeks) | Waiting for it to pass naturally (usually about 2 weeks, sometimes longer); medicine to help pass the pregnancy; or a procedure using gentle suction to remove the pregnancy, under general or local anaesthetic, often with a same-day discharge |
| Late miscarriage (14 to 23 weeks) | Your care team will discuss options; you may need to give birth, sometimes with medicine to start labour, with support throughout |
If your blood type is RhD-negative and you were at least 12 weeks pregnant, you may be offered an anti-D injection to help protect future pregnancies.
There is no ubat keguguran that can stop a miscarriage. Do not use herbal or traditional remedies to speed it up without medical advice, and follow your doctor's instructions about any medicine you are given.
Selepas keguguran: recovery and emotions
According to the NHS, everyone experiences miscarriage differently. You may feel physically better within days or weeks, but it can take longer. Afterwards you may:
- have tummy pain for a few days;
- have vaginal bleeding or spotting for up to 2 weeks;
- feel many different emotions, including anxiety and sadness.
To help your recovery, the NHS suggests:
- rest if you need to;
- take paracetamol for pain;
- talk to your partner, family or friends about how you feel;
- do not have sex until your symptoms have gone, because of the risk of infection.
Contact a doctor if you are worried about any of your symptoms. It can take longer to come to terms with a miscarriage emotionally, and partners can be affected too. Counselling is available; ask your doctor or clinic.
Trying for a baby again
According to the NHS:
- you can try to get pregnant again when you feel ready, after your symptoms have gone;
- it can take up to 8 weeks for your period to return, and a few months for it to settle (see our guide to period lambat);
- most women who have a miscarriage go on to have a successful pregnancy;
- talk to a doctor if you have had 3 or more miscarriages; you will usually be referred for tests to look for a treatable cause.
Before trying again, it may help to stop smoking, avoid alcohol, limit caffeine and keep long-term conditions such as diabetes or thyroid problems well controlled, as these are among the risk factors listed by the NHS.
Where to find support in Malaysia
Losing a pregnancy can be very hard, whatever stage it happens. You do not have to cope alone:
- talk to your doctor or the hospital team, who can arrange counselling;
- Talian Kasih 15999 (or WhatsApp 019-261 5999), a 24-hour government helpline that offers counselling and support;
- Befrienders Kuala Lumpur, +603-7627 2929, a free, confidential 24-hour emotional support line;
- in an emergency, or if you are thinking of harming yourself, call 999.
Frequently asked questions (FAQ)
What are the signs of keguguran (miscarriage)?
According to the NHS, the main sign is vaginal bleeding before 24 weeks of pregnancy, which can range from spotting to heavy bleeding. Other signs include cramping pain in the lower tummy, tissue (pink, grey or white lumps) coming out of the vagina, and fluid suddenly leaking from the vagina. Some miscarriages cause no symptoms and are only found at a scan.
Does bleeding in early pregnancy always mean a miscarriage?
No. The NHS says vaginal bleeding and tummy pain in pregnancy can be caused by other things and are not always serious. But you should get urgent medical help if you are pregnant and have any bleeding or spotting, and call 999 if the bleeding is heavy or you have severe pain.
What does darah keguguran look like?
Bleeding from a miscarriage can be pink, red or brown, and may range from spots on your underwear to heavy bleeding that soaks a pad. You may also pass pink, grey or white tissue. Because the appearance varies so much, it is not possible to tell from pictures alone whether you are miscarrying; see a doctor for an examination and scan.
What causes a miscarriage?
It is not always known. According to the charity Tommy's, most early miscarriages (before 12 weeks) are caused by a problem with the baby's chromosomes or genes, which means the pregnancy cannot develop. Things linked to a higher risk include being 35 or older, smoking, alcohol, a lot of caffeine, obesity or being underweight, and conditions such as diabetes or thyroid problems.
Did I cause my miscarriage?
According to Tommy's, most early miscarriages are caused by a problem with the baby's chromosomes or genes. Miscarriage is not linked to everyday activities such as moderate exercise, having sex in an uncomplicated pregnancy, or flying.
Is there an ubat to stop or treat a miscarriage?
According to the NHS, a miscarriage cannot be stopped once it has started. Depending on how far along you are and your symptoms, you may wait for it to pass naturally, take medicine to help pass the pregnancy, or have a small procedure. Your doctor will explain the options. Do not take herbal or traditional remedies to speed it up without medical advice.
When can I try for a baby again after a miscarriage?
The NHS says you can try again when you feel ready, after your symptoms have gone. It can take up to 8 weeks for your period to return. Most women who have a miscarriage go on to have a successful pregnancy. See a doctor if you have had 3 or more miscarriages, as tests may find a treatable cause.
Disclaimer
This article is for general information only and is not a substitute for advice, diagnosis or treatment from a doctor. If you are pregnant and have bleeding or pain, get medical help. Health supplements are not intended to diagnose, treat, cure or prevent any disease.
