Types of Pregnancy Loss: A Comprehensive Guide

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Growing up, the only thing I knew I wanted to be was a mother. I was the girliest of girls – long hair, ponytails, pink everything, and dolls galore. I have a photograph of myself at around five or six years old, asleep with my arm over about 12 dolls lying under my blanket in my bed. I played with dolls well into my tweens and remember pretending to be pregnant as a teenager. I was so sure that my role in life was to be a mother. 

In 2000, I fell pregnant for the first time. Everything about the timing was wrong. I was living my best life as a young South African in London. At the time of seeing the two pink lines, I was living in a youth hostel between rentals and was working as a door-to-door salesperson for gas and electricity. I felt that I was in no position to bring a child into the world. I chose to terminate that pregnancy. So in June 2000, I had an abortion. My first experience with pregnancy loss. 

Over my eight pregnancies, I experienced multiple types of pregnancy loss. Here’s what I learned about the different types and why the type doesn’t actually matter when it comes to grief.

My Types of Pregnancy Loss

Abortion or Termination

Definition: The medical term for a pregnancy that ends before 24 weeks of gestation, whether spontaneously (miscarriage) or by choice. Your medical file may refer to a miscarriage as a “spontaneous abortion.”

Outside of medical definitions, the word “abortion” is used when someone chooses to end a pregnancy. “Termination” is used when there’s less of a choice involved – often related to termination for medical reasons, TFMR (see below). Both words are interchangeable, though. 

My fertility journey started with an abortion and ended with a termination. 

There are so many types of pregnancy loss, but the type of loss doesn’t change how you process the emotions around that pregnancy loss. Grief is allowed for an abortion. Sadness is allowed for an abortion. Just because you chose to end a pregnancy doesn’t negate the love you felt for that baby. 

Your choice to end a pregnancy is yours alone. You get to experience any and all emotions related to that. You get to seek support in processing all those emotions. 

So often, society clouds our experience with feelings and emotions we should feel and shame often means we don’t share our experience. Whether your abortion was recent or years ago, you are allowed to seek support in processing your feelings around it. 

I didn’t spend a lot of time thinking about that abortion until years later, when I experienced my first miscarriage and then recurrent, unexplained miscarriage. 

Miscarriage

Definition: When a pregnancy ends spontaneously in utero before 20 weeks of gestation. It can happen at any point during a pregnancy, but it is most common in the first trimester (first 12 weeks). Often identified by bleeding as the pregnancy leaves the uterus.

Statistics tell us that this is the most common type of pregnancy loss. Approximately one in four known pregnancies end in miscarriage. It’s thought that even more pregnancies end spontaneously before the pregnant person realises they could be pregnant. 

My first miscarriage happened on the day I confirmed my pregnancy with the doctor. I worked in a mall, and we had offices linked to the mall. My GP was in those offices. So on my lunch break, I went in for my appointment to confirm the pregnancy. I had already taken a home pregnancy test and seen the two pink lines. On my way back down to the office, I was on the phone with my sister, letting her know that I was pregnant. I had my first cramp while I was on the phone with her. I stopped at the loo on my way back to the office, and I had some spotting. I knew that this could happen in early pregnancy. It was six weeks after my last period. 

I finished my day at work and headed home. By this time, the spotting had become heavier and the cramping was getting worse. I tried to ease the pain with a bath, but it was an uncomfortable evening. By the morning, my cramping had stopped, and the bleeding was like a regular cycle. I realised that I had lost the pregnancy. 

I went back to the GP, and he told me that “these things happen”. He was the first one to mention the “1 in 4” statistic to me. I was told to wait a cycle and then try again. No one seemed very surprised or concerned. 

We were sad, but even I thought that at least I could get pregnant, and we could try again. So we waited the one cycle, I took extra supplements and worked at improving my health, and we tried again. 

Miscarriage may be one of the most common types of pregnancy loss, but that doesn’t make it any less devastating. So many people speak about letting friends and family know they’ve had a miscarriage, and are surprised at the number of people who say they have also experienced one or more. It’s often mind-boggling to realise how many people it has affected, and yet it still feels like no one speaks about it much. 

Recurrent Miscarriage

Definition: The painful and often baffling experience of enduring three or more consecutive pregnancy losses (miscarriages) before 20 weeks of pregnancy. This diagnosis involves repeated grief and often requires specialised testing to identify underlying causes. 

And then I lost my next pregnancy at five weeks after my last period. I started spotting the same day I got the positive home pregnancy test. I didn’t even get a chance to confirm that one with a doctor. The only reason I knew that I was pregnant was because I was tracking my cycles so accurately. We were in full “Trying to Conceive” mode. 

Again, my GP told me to just wait one cycle and then we could try again. Not the most compassionate or caring advice. I know it was practical and accurate, but that didn’t change the fact that I felt that I was failing at the one thing I knew I wanted to me. 

I spent more time researching ways to improve our chances, and I started seeing multiple alternative health professionals to help me improve. 

A few weeks later, I had another positive home pregnancy test. When I saw the two pink lines, there was no longer the immediate joy and excitement. I was apprehensive and concerned. When we passed the 6-week mark, I started to feel a little hopeful. This was the longest pregnancy I had had. I had also managed to secure an appointment with a new obstetrician and was looking forward to getting some answers. 

I started spotting a few days before my scheduled appointment. Again, the cramping escalated, and I passed the pregnancy before my appointment, which had been moved forward. By the time the doctor scanned me, half my uterus was already clean. 

We were unable to get any testing done with the tissue that was available. The doctor did a thorough medical history with me, sent me for a barrage of blood tests and declared that I had unexplained recurrent miscarriage. 

Recurrent miscarriage can be such a devastating experience for the parents. Especially when it is unexplained. For me, that was the hardest part: none of the tests came back giving any indication of what the issue could have been. 

We took a few months off, and then I fell pregnant and my son was born. We didn’t even have a chance to start more extensive testing on Brian and me. Parenting after pregnancy loss is a whole different ball game, but I’ll chat about that soon. 

Missed Miscarriage

Definition: When a miscarriage occurs without awareness from the pregnant parent or the uterus shedding the stopped pregnancy. Sometimes, due to medication that prevents the bleeding

When my son was just over a year, I found out I was pregnant again. My OB saw me at just over 6 weeks and confirmed the pregnancy with a scan. I got to see a very early heartbeat flutter on the screen. As my husband says, “just a few moving pixels”. I was put on a bunch of additional medications to try and support the pregnancy. 

At my 10-week scan, there was no longer a heartbeat. I was devastated. The baby had stopped growing at 8 weeks, but the medications that I was on stopped my body from realising what had happened. I walked around for the weekend knowing that I was carrying a dead baby inside me. This was the first of my pregnancy losses for which we were able to get genetic testing. Knowing that she had been a girl and had a genetic disorder was of little relief. A pregnancy loss is a pregnancy loss, no matter the type. 

Missed miscarriages come with so many additional levels of trauma. Sometimes it means the parent needs to walk around for days or even weeks, knowing that they have a dead baby inside them. Often it could require having to go under anaesthesia for surgery. There is the level of grief of realising that you didn’t know your baby was dead. 

Missed miscarriage is the type of pregnancy loss that often requires the most amount of support for the loss parents. Especially when needing to parent siblings as well. 

Almost two years later, I had another successful pregnancy and gave birth to my daughter. That, however, wasn’t the end of my journey. 

TFMR – Termination for Medical Reasons

Definition: The difficult, compassionate decision to end a pregnancy following a diagnosis that indicates the baby cannot survive or will have a very poor quality of life, or when continuing the pregnancy poses a significant risk to the pregnant parent’s health. TFMR can happen at any time during a pregnancy. 

In January 2019, I realised that I was pregnant again. We hadn’t been actively trying to conceive, but we also weren’t not trying. We were apprehensively excited. I had an early doctor’s appointment and saw a heart flutter again. At my 12-week scan, the baby was diagnosed with cystic hygroma. The nuchal fold was much thicker than it should be. The next two weeks were a flurry of doctors’ appointments, hurry up and wait moments, boring days in hospital and a lot of deep thinking and wrestling with my mind. When we found out that the baby had Down Syndrome and was unlikely to make it to birth, we chose to terminate the pregnancy. It was a traumatic experience for me that wasn’t handled well by the hospital staff. 

Termination for medical reasons is absolutely a type of pregnancy loss. Just because the parents made a choice to end the pregnancy doesn’t change the fact that they lost a baby. Making a choice to save a child from pain doesn’t negate the love felt for that child. Choosing to save a mother’s health doesn’t change the love felt for the unborn child. 

I am passionate about supporting this community of loss parents. I started my Baby Bryce Foundation to advocate for parents experiencing all types of pregnancy loss, including choosing to end a pregnancy. 

Other Types of Pregnancy Loss

Although these are the pregnancy loss types I have experienced, there are so many other loss types that are included in our community. 

Stillbirth

Definition: The devastating loss of a baby who dies in the womb, typically after 20 weeks of pregnancy, or dies during labour and birth.

The pain and anguish of having to deliver a baby who has died can be especially devastating. Often, these are parents who already have everything ready to bring their baby home. It’s heartbreaking to think of parents who have to walk out of a hospital without their baby, or return home to a house set up to welcome a baby, only to have to pack it all away. 

Stillbirth can often be one of the most unexpected types of pregnancy loss. One of the hardest things to carry and to have to show up in life after. 

Ectopic Pregnancy

Definition: A life-threatening pregnancy loss where the fertilised egg implants and grows outside the main cavity of the uterus, most commonly in a fallopian tube. It is very rare for these pregnancies to survive. 

 My mother had two ectopic pregnancies when I was a child. The first was between my sister and me, and the other was after my sister, each in a fallopian tube. I don’t remember much from that time; I was four and seven when they occurred.  I do know that my mother seldom had time to express her grief over those losses. Because these pregnancies are often life-threatening to the parent, they are almost always treated as medical emergencies, and the parents seldom receive the support they need to process their grief. 

Ectopic pregnancy, although a medical emergency, is still a type of pregnancy loss. Anyone who has experienced an ectopic pregnancy deserves to grieve, deserves to get support and deserves to have their loss recognised. 

Molar Pregnancy

Definition: A rare, abnormal growth in the uterus that forms instead of a healthy pregnancy/placenta due to a genetic error at fertilisation. It cannot develop into a baby and results in the loss of the pregnancy.

Molar pregnancies can be devastating and are often life-threatening to the pregnant parent. Much like an ectopic pregnancy, they are often treated only as a medical emergency. A molar pregnancy can also affect a pregnant parent’s ability to carry future pregnancies and can really affect the whole fertility journey. Not factoring in the emotional aspects of these types of pregnancy losses can add additional trauma to an already difficult experience. 

Blighted Ovum

Definition: A type of miscarriage where a fertilised egg implants in the uterus, but the embryo doesn’t develop.

As I talk about in my book, an entire lifetime is imagined in the seconds following seeing a positive pregnancy test. A blighted ovum can be as devastating as any other pregnancy loss. An embryo may not have formed in the pregnancy, but a whole life had been imagined. The pregnancy may not have been medically relevant, but it was emotionally relevant. 

I have spoken with so many parents who were dismissed in feeling loss about a blighted ovum or talked down to by medical professionals for becoming emotional about this type of pregnancy loss. 

Why the Type of Pregnancy Loss Doesn’t Matter

Loss is loss. 

Knowing you were pregnant meant that a life was imagined. 

Your grief matters!

Your emotions deserve recognition and support!

Journaling Prompts

Processing your pregnancy loss through writing can be incredibly healing. Here are some prompts to explore your feelings:

1. Write about your loss(es): What type of pregnancy loss did you experience? How did medical professionals describe it to you? How would you describe it?

2. Permission letter: Write yourself a letter giving yourself permission to grieve your loss exactly as you need to – regardless of the type, timing, or what others might think.

3. What you wish people understood: If you could help one person understand your type of pregnancy loss better, what would you want them to know?

For more guided journaling exercises specifically designed for loss parents, check out the Companion Journal to All of These Lines – it includes prompts from every chapter plus space to write your own story.

You Are Not Alone

The type of pregnancy loss you experienced doesn’t determine the depth of your grief. Whether it was an early miscarriage, a TFMR, a stillbirth, or any other type – your loss matters. Your grief is valid. Your baby was real and loved.

You deserve support, compassion, and space to grieve in whatever way feels right for you. There’s no timeline, no “right way” to do this. You’re doing it exactly right simply by showing up and surviving each day.

If my story resonates with you, I’d love to connect. Download my free guide “Finding Your Words” with seven journaling prompts to help you process your loss. Or grab a copy of All of These Lines to read the full story of my journey through eight pregnancies and find the tools that helped me heal.

You’ve survived 100% of your worst days already. 🦋