Having symptoms and signs of miscarriage at 5 weeks with or without vaginal bleeding can cause anxiety and worry in expecting mothers.
A miscarriage simply means the loss of a pregnancy that occurs before your baby can survive outside the womb. In many countries, including the United States, miscarriage is usually defined as pregnancy loss before 20 weeks, while in the United Kingdom it is usually defined before 23–24 weeks of pregnancy. Survival before about 22–24 weeks is still uncommon even with intensive care. ACOG+1
Commonly, women with miscarriage will experience vaginal bleeding that occurs with or without any pain in your abdomen.
While it’s possible to experience mild spotting when pregnant, heavy or persistent bleeding from your vagina may indicate serious health issues and should be checked by a doctor.
Spotting during pregnancy can occur due to vaginal infections, sexual intercourse, antepartum hemorrhage, ectopic pregnancy or a miscarriage.
The truth is at five weeks, your baby (embryo) is still not well-formed and very small. It’s difficult to see fetal tissue with your spotting.
However, as your baby grows, some women who have a miscarriage later than five weeks will see pregnancy tissue and blood clots coming from their vagina.
From research, more than 80 percent of miscarriages occur in the first three months; and about 10–20 percent of all known pregnancies will end up in a miscarriage. The chances are higher if you are older (especially above 35–40 years), smoking, drinking alcohol heavily, using certain drugs, or taking very high amounts of caffeine.
The main cause of miscarriage at 5 weeks is usually a genetic or chromosomal abnormality when your baby is formed differently. Most of the time, this is a random event and not due to something you did or did not do.
Other possible causes are abnormal hormones, uterine abnormalities and some long-term medical illnesses. Routine, moderate exercise in pregnancy is considered safe and is not known to cause miscarriage; your doctor may only restrict very intense or contact sports in some situations.
This article explains the causes of miscarriage at 5 weeks, symptoms, risk factor and when you should get pregnant after a miscarriage.
Miscarriage at 5 weeks: What to Expect
1. Vaginal bleeding
This is the most common symptom you will experience when you have a miscarriage. In some women, bleeding may be light; while in others it could be heavy resulting in dizziness and body weakness. MedlinePlus+1
At 5 weeks pregnant, your baby is about 1/10th of an inch long. You will not see fetal parts coming out as baby is so small.
While some women may experience light spotting which resolves on its own without any harm to the baby, some women may end up losing their baby.
If you start having bleeding when pregnant, you must inform your doctor immediately or go to the nearest emergency unit, especially if bleeding is heavy, you pass large clots, feel dizzy, faint, or have severe abdominal pain. nhs.uk+1
If you are Rhesus (Rh) negative, your doctor may consider giving you an injection called anti-D (Rh immunoglobulin) after certain types of bleeding, miscarriage or procedures to help prevent your body from making antibodies that could affect a future baby. Guidelines differ by country and by how heavy the bleeding is, so your own doctor or early pregnancy clinic will advise you. NICE+1
Abdominal cramps may not be felt during a miscarriage; some women may just have painless spotting that resolves. However, if you are bleeding with abdominal cramps, the chances are your uterus is contracting to force out the pregnancy tissue.
During your clinic visit, your doctor will examine your cervix through vaginal examinations and request for an ultrasound and other blood tests. MedlinePlus+1
If your pregnancy is viable, it’s important you have a lot of rest, stay hydrated and use only pain relief medications that your doctor or midwife says are safe in pregnancy.
2. Your pregnancy symptoms begin to disappear
Remember that at five weeks into your pregnancy, you are just a week past your period and may start experiencing breast changes, breast pain, breast heaviness, mood swings, body weakness and abdominal cramps.
During a miscarriage at 5 weeks, you may notice your symptoms start to disappear. This happens because pregnancy hormones begin to fall.
After ovulation, if pregnant, the corpus luteum starts to produce estrogen and progesterone that helps thicken uterine endometrium in preparation for gestation. These hormones are responsible for many of your pregnancy symptoms.
If you miscarry, the level of these hormones will fall and make your pregnancy symptoms gradually go away.
It’s important to inform your doctor if you have no symptoms of pregnancy with vaginal bleeding.
3. Your HCG levels begin to fall
After implantation of the embryo into the endometrium, your body starts to secrete a hormone called HCG (human chorionic gonadotropin). This hormone can be detected in urine and blood days before your next menstrual period if you are pregnant.
In fact, for you to get pregnant, HCG levels will usually be higher than about 20–25 mIU/ml; on the other hand, a negative pregnancy test generally means HCG less than 5 mIU/ml (depending on the test used). MedlinePlus
In normal pregnancy and in more than 85 percent of women, your HCG levels will continue to rise in the first 11 weeks of pregnancy, doubling about every 2–3 days. MedlinePlus+1
According to the American Pregnancy Association and other sources, HCG levels at 5 weeks pregnancy can vary widely and ranges given are only rough guides. Some women who have lower than average HCG for gestational age still end up having a normal baby and pregnancy.
Nevertheless, if you have vaginal bleeding or severe cramps during pregnancy, your doctor may request multiple HCG tests to determine if HCG level is rising or not.
During a miscarriage, your HCG hormones begin to fall and in most cases reach pre-pregnancy levels in 4–6 weeks. MedlinePlus
Why did miscarriage happen?
1. Genetic disorders
Normally for your baby to form, genetic material is mixed from both the man’s sperm and your egg. This results in the formation of an embryo that is later implanted into your womb.
In many early miscarriages, especially around 5 weeks, a miscarriage can happen even without you knowing; and in most cases this is due to chromosomal or genetic disorders in the embryo. Wikipedia+1
In fact, most women who have a miscarriage at 5 weeks do so because of these random genetic abnormalities and not because they did something wrong.
2. Low progesterone hormones
Before pregnancy, both estrogen and progesterone help to build up the endometrium. When you have a menstrual period, this thickened endometrium is expelled from the vagina.
Progesterone is more efficient after ovulation and is mostly involved with thickening of the endometrium.
If progesterone is low, you may have a higher chance of miscarriage. In some specific situations (for example, early pregnancy bleeding in women who have had previous miscarriages), your doctor may place you on progesterone treatment during the first trimester based on current guidelines. NICE
Depending on the location of a fibroid, it may reduce your chance of getting pregnant or occasionally cause a miscarriage to occur.
4. Uterine malformations
Abnormalities in the formation of the uterus will also result in recurrent miscarriages or infertility.
In some women, the uterus may be absent. While in others the uterus may be divided by a septum or have another structural problem.
It’s important you inform your doctor if you’ve had three miscarriages in a row so that investigations can be done. Wikipedia+1
Risk factor for miscarriage at 5 weeks
1. Smoking
Women that smoke before getting pregnant have a danger of having a miscarriage during pregnancy. This risk is even higher when you smoke cigarettes during early pregnancy.
Nicotine will interfere with blood circulation to your baby. This will sometimes result in loss of pregnancy or low birth weight babies. Wikipedia
2. Age
Depending on your age, it’s more likely you will miscarry.
The risk of miscarriage increases after 35 years. Women more than 40 or 45 years have a higher likelihood to have a miscarriage.
You should always see a specialist to help monitor your pregnancy and prevent complications. Wikipedia
3. Twin pregnancy
If you have more than one baby coming, you have an increased chance of miscarriage than single mothers.
4. Long-term illnesses
Polycystic ovarian syndrome (PCOS), diabetes, low thyroid hormones and other long-term health problems may increase the risk of miscarriage, especially if they are not well controlled. Also, autoimmune conditions such as antiphospholipid syndrome, where your body makes antibodies that affect blood clotting, may result in a miscarriage. NCBI+1
5. Excessive exercise
It’s important you get enough rest in the first three months of pregnancy. Very strenuous, high-impact or contact exercise may sometimes be restricted by your doctor, but normal everyday physical activity and moderate exercise have not been shown to increase miscarriage risk. ACOG+1
What are miscarriage rates at 5 weeks
The chances you could have a miscarriage is highest in the first few weeks after missing your period and then gradually falls as the pregnancy continues. Among women who already know they are pregnant, about 10–20 percent of pregnancies will end in miscarriage, and most of these happen in the first trimester. MedlinePlus
At around 5 weeks, some studies suggest the risk for many women is around 10–15 percent, but exact numbers vary between different populations and research. The risk is lower if an ultrasound later shows a normal heartbeat. East Africa School Server+1
You should talk to your doctor if you have vaginal spotting, bleeding or notice disappearance of pregnancy symptoms.
The NHS miscarriage page and MedlinePlus miscarriage information have simple explanations of symptoms and when to get urgent help. nhs.uk+1
Miscarriage at 5 weeks, when can I try again?
A miscarriage can have severe psychological effects on women with guilt and also fear of losing your baby during the next pregnancy.
However, this is not true for most women. More than 80 percent of women that had a single miscarriage go on to have a very healthy next pregnancy. ACOG+1
If you’ve already had two miscarriages in a row, there is still hope. Studies reveal more than 70 percent of women with two miscarriages will have a normal healthy next pregnancy, especially when any underlying problems are treated. ACOG+1
On the other hand, if you’ve had 3 or more miscarriages, you should see your doctor or a specialist early pregnancy / recurrent miscarriage clinic for assistance.
Due to the effect of a miscarriage on your health and emotions, it is advisable to wait till you are physically and emotionally ready for next pregnancy. Many guidelines say there is no strict medical need to delay for many months after an early miscarriage, but waiting until bleeding has stopped and you have discussed with your doctor is sensible. ACOG
A new body of research suggests that chances of having a repeat miscarriage are not higher—and may even be lower—if you conceive again within about six months after having a miscarriage. However, you and your partner should only try again when you both feel ready. ScienceDaily+
For more support about pregnancy after loss, you can also read Mayo Clinic’s “Pregnancy after miscarriage” and Tommy’s advice on getting pregnant after miscarriage.
Dr Akatakpo Dunn is a Nigerian medical doctor, sonologist and Medical Director of Verah Clinic & Maternity in Warri, Nigeria. He holds an MBBS from the University of Nigeria, Nsukka, a Postgraduate Diploma in Diagnostic Ultrasound (India) and a Professional Diploma in Obstetrics & Gynaecology (RCPI). Through Medplux, he explains women’s health, pregnancy, fertility and ultrasound in clear, practical language so readers can make informed decisions with their own doctors.
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