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Miscarriage passing tissue


What Happens After a Miscarriage? An Ob-Gyn Discusses the Options.

Miscarriage, the loss of a pregnancy that’s in the uterus, is common. It happens in about 1 in 10 women who know they’re pregnant. But many people don’t know what to expect afterward.

The vast majority of miscarriages happen in the first trimester, before 13 weeks of pregnancy. Most occur before 10 weeks. In this article, I’ll discuss the treatment options for first-trimester miscarriage, also called early pregnancy loss. Second-trimester miscarriage usually requires different treatments.

Here’s what to know about care and recovery.

There are three main treatments for early pregnancy loss. The goal for all three is to remove any pregnancy tissue left in the uterus. There are two nonsurgical treatments: expectant management (letting the tissue pass on its own) and medication. The third treatment is a surgical procedure called dilation and curettage (also known as D&C or suction curettage).

In many cases, patients can choose the option they prefer.

Expectant management is giving your body time to pass the tissue on its own. This doesn’t involve medication or surgery. Some women choose this because it’s the most natural option, but it is more unpredictable than other treatments.

Most women pass the tissue within 2 weeks of a miscarriage diagnosis, but it can take longer. If it takes too long, your ob-gyn may recommend medication to start the process. (Once the process starts and cramping and bleeding begin, most of the tissue passes within a few hours. More on that below.)

Sometimes, the body doesn’t pass all the tissue. When this happens, another treatment is recommended, usually a D&C. Expectant management is most likely to work when you already have some bleeding and cramping. This means your body has begun the process of passing the tissue.

Medication works faster and is more predictable. Some women choose medication that helps their body remove any leftover tissue. These drugs are absorbed through the cheek in the mouth or through the vagina. Cramping or bleeding usually starts within a few hours. Most women pass the tissue within 48 hours and don’t need any other treatment. (Some women may still not pass all the tissue and may need a surgical procedure.)

Medication gives you more control over the timing of the tissue passing. And it’s often quicker than waiting for the tissue to pass on its own.

Some women like to take the medication in the morning, so the process doesn’t start overnight. And some women like to have a support person, such as a friend or family member, with them when they take the medication.

You’ll have a similar experience whether the tissue passes on its own or you take medication. You’ll have bleeding and cramping that are heavier than your normal period. The pregnancy tissue may look like large blood clots, or it may look white or gray. It does not look like a baby. The process can be painful, and ob-gyns may prescribe medication to help with this discomfort. Your ob-gyn may also suggest over-the-counter pain medication. Talk with your ob-gyn about pain relief options.

Most of the tissue passes within 2 to 4 hours after the cramping and bleeding start. Cramping usually stops within a day. Light bleeding or spotting can go on for 4 to 6 weeks. Two weeks after the tissue passes, your ob-gyn may do an ultrasound exam or other tests to make sure all the tissue has passed.

A D&C is the most predictable treatment. During a D&C, your ob-gyn passes a small tool through the cervix and into the uterus to remove the tissue. Some women choose this option because they want a faster, more certain treatment. And if you’re already bleeding heavily, it’s the safest option.

Some ob-gyns do D&Cs in an operating room using general anesthesia, which means you’ll be asleep. Some offer a form of pain relief called sedation, where you will be awake but comfortable. Others do the procedure in a normal exam room, with an injection of drugs that block pain in a specific area. Women often have some bleeding and intense cramping during a D&C. They usually have little discomfort afterward.

Light spotting or bleeding can last up to a month. An antibiotic is prescribed to prevent infection. Other complications are rare, and most women don’t need any follow-up appointments.

Whichever option you choose, call your ob-gyn if you have very heavy bleeding, a fever, or feel unwell. Dangerous bleeding and infection are a risk of all treatments, but these problems are rare. Call your ob-gyn right away if you have any of these symptoms:

  • Your bleeding soaks through more than two large pads in an hour for 2 hours or more. This much bleeding is dangerous and needs immediate care.

  • You have a temperature higher than 100 °F.

  • You have chills, severe pain, or any other symptoms that concern you.

Physical recovery is usually quick. Most women resume their regular activities a day or two after they pass the tissue or have a D&C. For some, nausea and other pregnancy symptoms stop before their ob-gyn diagnoses a miscarriage. For others, these symptoms go away a few days after the tissue passes.

To keep your infection risk low, don’t put anything into your vagina for a week—no douching (which is never a good idea at any time), vaginal sex, tampons, or menstrual cups. You can use pads to absorb the bleeding. Most women have their first period about 2 weeks after any spotting or light bleeding ends, which is usually about 2 to 3 months after you pass the tissue or have a D&C.

People have different emotional reactions. Some women feel sadness or grief. Others may feel relief. Some may feel a mixture of emotions. All these feelings are normal, and it’s important to allow yourself time to process them.

Talking about these feelings with friends, family, your ob-gyn, or a mental health professional can help. If you feel depressed or are thinking of hurting yourself, tell your ob-gyn or another doctor right away. Support groups and resources, such as Share Pregnancy & Infant Loss Support, may be helpful too.

Miscarriage isn’t your fault. Women often worry that they somehow caused their miscarriage. This is not the case. Physical activity, stress, and sex don’t cause miscarriages. Most happen because the pregnancy wasn’t developing normally. Often, the egg or sperm develops with more or fewer chromosomes than normal, which can lead to miscarriage. This is a random event that you cannot control.

Most women can have a healthy pregnancy after a miscarriage. Talk with your ob-gyn if you have concerns. Your ob-gyn can help ease your fears, answer any questions, and talk about preparing for your next pregnancy.

Published: June 2022

Last reviewed: June 2022

Copyright 2022 by the American College of Obstetricians and Gynecologists. All rights reserved. Read copyright and permissions information.

This information is designed as an educational aid for the public. It offers current information and opinions related to women's health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Read ACOG’s complete disclaimer.

Miscarriage - what you might actually see and feel

Miscarriage - what you might actually see and feel | Pregnancy Birth and Baby beginning of content

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WARNING — This article contains some graphic descriptions of what you might see during a miscarriage.

A miscarriage requires prompt medical care. If you think you are having a miscarriage, call your doctor or midwife for advice and support. Go to the Emergency Department if:

  • you are bleeding very heavily (soaking more than 2 pads per hour or passing clots larger than golf balls)
  • you have severe pain in your tummy or shoulder
  • you have a fever (a temperature above 38 degrees C)
  • you are dizzy, fainting or feel like fainting
  • you notice fluid coming from your vagina that smells bad
  • you have diarrhoea or pain when you have a bowel motion (do a poo)

Miscarriage is a very unfortunate and sad outcome of pregnancy that takes a significant emotional and physical toll on a woman. It also happens more frequently than many people think. It's important to recognise that there's no right or wrong way to feel about a miscarriage.

Despite close to one in 5 pregnancies ending in miscarriage, what actually happens and what a woman needs to know and do when faced with a possible miscarriage are subjects that rarely get discussed.

This article aims to give you an idea of what happens and what a woman needs to know and do at different stages in her pregnancy.

Please call Pregnancy, Birth and Baby on 1800 882 436 if you have any concerns or wish to discuss the topic further.

What might I feel during a miscarriage?

Many women have a miscarriage early in their pregnancy without even realising it. They may just think they are having a heavy period. If this happens to you, you might have cramping, heavier bleeding than normal, pain in the tummy, pelvis or back, and feel weak. If you have started spotting, remember that this is normal in many pregnancies — but talk to your doctor or midwife to be safe and for your own peace of mind.

Later in your pregnancy, you might notice signs like cramping pain, bleeding or passing fluid and blood clots from your vagina. Depending on how many weeks pregnant you are, you may pass tissue that looks more like a fetus, or a fully-formed baby.

In some types of miscarriage, you might not have any symptoms at all — the miscarriage might not be discovered until your next ultrasound. Or you might just notice your morning sickness and breast tenderness have gone.

It is normal to feel very emotional and upset when you realise you’re having a miscarriage. It can take a while to process what is happening. Make sure you have someone with you, for support, and try to be kind to yourself.

What happens during a miscarriage?

Unfortunately, nothing can be done to stop a miscarriage once it has started. Any treatment is to prevent heavy bleeding or an infection.

Your doctor might advise you that no treatment is necessary. This is called 'expectant management', and you just wait to see what will happen. Eventually, the pregnancy tissue (the fetus or baby, pregnancy sac and placenta) will pass naturally. This can take a few days or as long as 3 to 4 weeks.

It can be very hard emotionally to wait for the miscarriage because you don’t know when it will happen. When it starts, you will notice spotting and cramping and then, fairly quickly, you will start bleeding heavily. The cramps will get worse until they feel like contractions, and you will pass the pregnancy tissue.

Some women opt to have medicine to speed up the process. In this case, the pregnancy tissue is likely to pass within a few hours.

If not all the tissue passes naturally or you have signs of infection, you may need to have a small operation called a ‘dilatation and curettage’ (D&C). You may need to wait some time for your hospital appointment. The operation only takes 5 to 10 minutes under general anaesthetic, and you will be able to go home the same day.

While you are waiting for a miscarriage to finish, it’s best to rest at home — but you can go to work if you feel up to it. Do what feels right for you. You can use paracetamol for any pain. If you are bleeding, use sanitary pads rather than tampons.

What might I see during a miscarriage?

In the first month of pregnancy, the developing embryo is the size of a grain of rice so it is very hard to see. You may pass a blood clot or several clots from your vagina, and there may be some white or grey tissue in the clots. The bleeding will settle down in a few days, although it can take up to 2 weeks.

At 6 weeks

Most women can’t see anything recognisable when they have a miscarriage at this time. During the bleeding, you may see clots with a small sac filled with fluid. The embryo, which is about the size of the fingernail on your little finger, and a placenta might be seen inside the sac. You might also notice something that looks like an umbilical cord.

At 8 weeks

The tissue you pass may look dark red and shiny — some women describe it as looking like liver. You might find a sac with an embryo inside, about the size of a small bean. If you look closely, you might be able to see where the eyes, arms and legs were forming.

At 10 weeks

The clots that are passed are dark red and look like jelly. They might have what looks like a membrane inside, which is part of the placenta. The sac will be inside one of the clots. At this time, the developing baby is usually fully formed but still tiny and difficult to see.

At 12 to 16 weeks

If you miscarry now, you might notice water coming out of your vagina first, followed by some bleeding and clots. The fetus will be tiny and fully formed. If you see the baby it might be outside the sac by now. It might also be attached to the umbilical cord and the placenta.

From 16 to 20 weeks

This is often called a 'late miscarriage'. You might pass large shiny red clots that look like liver as well as other pieces of tissue that look and feel like membrane. It might be painful and feel just like labour, and you might need pain relief in hospital. Your baby will be fully formed and can fit on the palm of your hand.

After the miscarriage

You will have some cramping pain and bleeding after the miscarriage, similar to a period. It will gradually get lighter and will usually stop within 2 weeks.

The signs of your pregnancy, such as nausea and tender breasts, will fade in the days after the miscarriage. If you had a late miscarriage, your breasts might produce some milk. You will probably have your next period in 4 to 6 weeks.

Remember, it’ll be normal to feel very emotional and upset at this time.

More information

Read more about miscarriage:

  • What is a miscarriage?
  • What happens after a miscarriage
  • Emotional support after miscarriage
  • Fathers and miscarriage
  • Experiencing a pregnancy loss

Speak to a maternal child health nurse

Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available 7am to midnight (AET), 7 days a week.

Sources:
KidsHealth (Understanding miscarriage), The Royal Women's Hospital (Treating miscarriage), Pink Elephants Support Network (Sorry for your loss), Women’s and Children’s Health Network (Miscarriage), Patient.com (Miscarriage and bleeding in early pregnancy), Pink Elephants Support Network (Treatments and procedures), New Kids Center (Blood Clots of Miscarriage: What It Looks Like?), Babycenter Australia (Understanding late miscarriage)

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: March 2022


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Related pages

  • Fathers and miscarriage
  • Emotional support after miscarriage
  • What happens after miscarriage
  • Miscarriage
  • Experiencing a pregnancy loss

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