Miscarriage symptoms and signs: What could you expect?

If you experience cramping or bleeding in early pregnancy and think you might be having a miscarriage, it can be understandably isolating and frightening. But try to remember that you’re not alone, and if what you’re feeling is pregnancy loss, then it’s never your fault: there’s nothing you can do to prevent a miscarriage. 

Having as much information as possible during this time can be helpful, especially in terms of the signs and symptoms that you could expect. That’s why we’ve asked Dr. Allison Rodgers, an obstetrician and gynecologist, Illinois, US, to talk us through the miscarriage symptoms and signs to be aware of. 

What is a miscarriage?

You might be familiar with the term miscarriage but still not be 100% sure about what it is. Essentially, a miscarriage is the loss of a pregnancy before 20 weeks. A pregnancy loss beyond this point is called a stillbirth. 

Of course, no matter the stage of your pregnancy, pregnancy loss can be incredibly distressing. “It’s normal to be worried, scared, and freaked out,” assures Dr. Rodgers. But it’s important to remember that miscarriages only happen in the minority of pregnancies; around 10% to 20% of known pregnancies will end in miscarriage. It can also be helpful to understand that a miscarriage doesn’t occur because of something you’ve done. “Remember that miscarriage is not your fault,” adds Dr. Rodgers. “There is nothing you can do to prevent a miscarriage or cause a miscarriage.” 

Miscarriage symptoms

It’s completely understandable to worry about changes in your body when you’re pregnant. 

Below, we take a closer look at some of the symptoms of miscarriage; but try to remember that if you’re experiencing any of these symptoms, it doesn’t necessarily mean you are having a miscarriage. 

“lt’s good to educate yourself about the signs and symptoms of miscarriage and trust your instincts if you feel something isn’t right,” says Dr. Rodgers. “But if you are worried or unsure about what your symptoms mean, call your health care provider, who can run tests and give you a professional opinion.” 

Vaginal bleeding 

Vaginal bleeding or spotting is the most common symptom of miscarriage to look out for. “Bleeding in pregnancy can be very scary,” says Dr. Rodgers. However, she adds that it’s important to “remember that not all bleeding is a miscarriage.” For this reason, it’s important not to panic as you may cause yourself more stress than necessary. 

Light bleeding early in pregnancy is not unusual; in fact, bleeding in the first trimester is common and happens in around 15% to 25% of pregnancies. It could simply be due to implantation bleeding, which occurs when the embryo burrows into the lining of your uterus within the first two weeks after conception. If you do experience bleeding during pregnancy, Dr. Rodgers suggests that you monitor it closely. “The only way to know is to see your medical provider to determine if the pregnancy is progressing as it should,” Dr. Rodgers advises. 

She adds that if you’re saturating more than one pad per hour and that flow lasts more than two to three hours, you should call your doctor or go to an emergency room.

If the bleeding is due to a miscarriage, there are some additional signs and symptoms to be aware of. “The bleeding can be heavier than a pad per hour, but this part shouldn’t last too long (no more than 1 to 2 hours),” explains Dr. Rodgers. “[Afterward], you will find the bleeding and pain lightens.” Sometimes, miscarriages can also occur very early on in pregnancy, before the gestational sac has fully formed; these are called chemical pregnancies. In these cases, the bleeding and cramping will be lighter.

Dr. Rodgers also describes what you might expect to see. “The pregnancy tissue and uterine lining are more of a gray or tan color, while the blood clots that follow are dark red, like red wine.” 

Experiencing this can be understandably distressing, so be sure to speak to your doctor and seek as much support from loved ones as you need. And above all, always be kind to yourself, and take as much time as you need to recover both physically and emotionally.

Cramping 

Cramping is another symptom to be aware of. But try to remember that, as with vaginal bleeding, it’s not always a sign of pregnancy loss. In fact, one study found that 85% of women experienced lower abdominal cramping in the first 20 weeks of pregnancy, and of those women, 27% experienced a loss. This shows that in more cases than not, cramping doesn’t necessarily mean you’re having a miscarriage. 

However, it’s important to seek emergency care if you’re experiencing any severe cramping or pain, as this could be a sign of a serious pregnancy complication, such as an ectopic pregnancy. This sounds scary, but try not to panic; make sure you prioritize getting the help you need, and hopefully, a doctor will be able to reassure you.

Loss or reduction of pregnancy symptoms such as nausea and breast tenderness 

In the early stages of pregnancy, often the only “evidence” you have that you’re expecting is a positive pregnancy test and a handful of pregnancy symptoms. But not everyone will experience these, and that can be totally normal. So, as hard as it may be, try not to assume that no pregnancy symptoms equate to a miscarriage.

If the pregnancy symptoms you were previously experiencing stop, however, this may be a sign of miscarriage. Some of the common early signs of pregnancy that you may have experienced include:

• Nausea and vomiting
• Food aversions and cravings
• Breast tenderness
• Mood change
• Fatigue
• Needing to pee more
• Bloating and constipation
• Sensitivity to smells
• Mild cramping

Having said that, as scary as it can be, try to remember that a loss or reduction of these pregnancy symptoms isn’t necessarily a cause for concern. It’s natural for pregnancy symptoms to peak and trough. Every pregnancy is different, and there are a number of different reasons why symptoms may come and go. If you’re concerned about a change in symptoms, always speak to your doctor to put your mind at ease.

How long can a miscarriage last?

“Typical miscarriages last a few hours to a few days,” says Dr. Rodgers. “Sometimes the bleeding continues for a few days or weeks as the uterus heals.” Cramping may also continue for a day or so afterward. This can understandably be a very difficult, distressing, and uncomfortable time, so be kind to yourself and be sure to seek extra support as you need it.

In most cases, a miscarriage won’t last more than two weeks. “It’s important to be evaluated by your health care provider if the bleeding is lasting a long time or if heavy bleeding lasts more than an hour or two,” says Dr. Rogers. “It might mean that the pregnancy is having difficulty detaching, and you may need medication or a medical procedure to help the pregnancy pass.”

Diagnosis of miscarriage: Can you confirm it at home?

You should always speak to your doctor if you think you are experiencing a miscarriage. They will be able to check you over and provide the proper care you need, as well as any reassurance or information that you ask for.

Your doctor may run a number of tests, including a pelvic exam to see if your cervix has dilated, an ultrasound to check for a fetal heartbeat, and a blood test to monitor your levels of the pregnancy hormone, hCG (human chorionic gonadotropin). While this can be a difficult time, remember that professionals who work in this area will understand what you’re going through and will do their best to put you at ease. Be sure to seek support from your loved ones if needed, and speak to your doctor with any concerns or questions you may have.

What’s the treatment after a miscarriage?

The treatment you may be offered after a miscarriage depends on a number of factors, including your health, your age, how far along you were in your pregnancy, the type of miscarriage (you can read more on these below), plus other factors. “With any miscarriage, we typically treat pain with pain medication,” says Dr. Rodgers. 

In cases where there’s still tissue inside the uterus, health care providers will discuss three main treatments with you. Observation is where the tissue is left to pass naturally in time. Dilation & curettage (D&C) is a minor procedure where your doctor dilates your cervix and removes the tissue. Medication that causes your body to pass the tissue is also an option. Always be sure to ask your doctor any questions you might have about these procedures to make sure you fully understand what’s happening, and remember that you can always lean on your loved ones for support during this difficult time. 

What are the symptoms after a miscarriage?

Symptoms experienced after a miscarriage will also depend on the type of miscarriage that occurred, but it’s important to remember they can be emotional as well as physical. Largely, symptoms will be caused by a change in your hormones, so make sure you look after your physical and mental health during those few weeks while your hormones are rebalancing. “That drop in hormones may leave you feeling agitated and anxious,” adds Dr. Rodgers. 

“Losing your baby and pregnancy is devastating,” says Dr. Rodgers. “Patients are experiencing grief alongside the physical pain. Grief is not measured or proportional to how many weeks pregnant you were when you lost your pregnancy, but the loss of the child you were dreaming of holding in your arms.” Remember that however you feel after a miscarriage is always acceptable and that you can seek support if you feel you need it.

Complications of a miscarriage: What’s a septic miscarriage?

Unfortunately, there can also be complications during a miscarriage. “A septic miscarriage is a miscarriage that occurs because of an infection in the uterus,” explains Dr. Rodgers. The symptoms can include fever, chills, tenderness in your lower abdomen, and vaginal discharge that has a foul smell. Concerningly, this can be life-threatening for both you and your baby, so if you experience these symptoms, seek immediate medical care. A septic miscarriage “is treated by a surgical procedure to remove the pregnancy [from the uterus] and with antibiotics.” 

Experiencing a septic miscarriage can be understandably distressing. Emotional healing can take as long, if not longer, than physical healing. If you’re struggling, you can seek further support from organizations like Share in the US or Tommy’s in the UK.

Types of miscarriage and their symptoms

As we’ve seen, there are a number of different types of miscarriages, including chemical miscarriages and septic miscarriages. There are also some other types of early pregnancy losses that can be useful to know about; after all, knowledge is power, and it can be helpful to understand all of the different terms you might hear your doctor discussing. We explain more about these below.

Complete and incomplete miscarriage 

A complete miscarriage is when a pregnancy has completely passed, and all the tissue has left the uterus. In comparison, an incomplete miscarriage means that some of the pregnancy tissue has remained in the uterus. Your doctor can perform an ultrasound to check this; you might need to have any remaining tissue removed to help prevent infection.

Inevitable miscarriage 

An inevitable miscarriage is when the cervix is open, and you experience bleeding and cramping. At this stage, the pregnancy has not yet passed. However, while the miscarriage hasn’t fully happened yet, it can’t be prevented.  

Threatened miscarriage 

A threatened miscarriage is when bleeding occurs in pregnancy while the cervix is closed. While it’s possible that the bleeding could lead to pregnancy loss, remember that there’s also a possibility the pregnancy will continue to develop normally. This can be a scary occurrence, but rest assured you will be closely monitored by your doctor.

Missed miscarriage 

This is a miscarriage that often occurs without any symptoms, although you may experience some pain or bleeding. A missed miscarriage is diagnosed through an ultrasound, which will show the pregnancy is not viable.

Learning that you’ve had a missed miscarriage, as with any miscarriage, can be incredibly difficult news to receive, so be sure to lean on your loved ones for support and be kind and gentle to yourself as you recover.

Miscarriage symptoms and signs: The takeaway

“More people than you think have experienced miscarriages,” says Dr. Rodgers. “It’s something that many people go through and yet feel so alone.” However, it’s important to remember that most people do go on to have a healthy pregnancy after a miscarriage. Figures tell us that only 1% of people will have repeated miscarriages, while between 60% and 80% of women with unexplained repeated miscarriages go on to have healthy pregnancies eventually. “While it is so difficult to go through, it doesn’t mean you can’t carry a pregnancy or that you won’t be successful [in the future],” reassures Dr. Rodgers.