Process of early miscarriage
Miscarriage - What happens - NHS
If there's no pregnancy tissue left in your womb, no treatment is required.
However, if there's still some pregnancy tissue in your womb, your options are:
- expectant management – wait for the tissue to pass out of your womb naturally
- medical management – take medicine that causes the tissue to pass out of your womb
- surgical management – have the tissue surgically removed
The risk of complications is very small for all these options. It's important to discuss them all with the doctor in charge of your care.
Expectant management
If you have a miscarriage in your first trimester, you may choose to wait 7 to 14 days after a miscarriage for the tissue to pass out naturally. This is called expectant management.
If the pain and bleeding have lessened or stopped completely during this time, this usually means the miscarriage has finished. You should be advised to take a home pregnancy test after 3 weeks.
If the test shows you're still pregnant, you may need to have further tests.
If the pain and bleeding have not started within 7 to 14 days or are continuing or getting worse, this could mean the miscarriage has not begun or has not finished. In this case, you should be offered another scan.
After this scan, you may decide to either continue waiting for the miscarriage to occur naturally, or have drug treatment or surgery. If you choose to continue to wait, your healthcare professional should check your condition again up to 14 days later.
Contact your hospital immediately if the bleeding becomes particularly heavy, you develop a high temperature (fever) or you experience severe pain.
Medicine
You may choose to have medicine to remove the tissue if you do not want to wait, or if it does not pass out naturally within 2 weeks. This involves taking tablets that cause the cervix to open, allowing the tissue to pass out.
In most cases, you'll be offered tablets called pessaries that are inserted directly into your vagina, where they dissolve.
The tablets usually begin to work within a few hours. You'll experience symptoms similar to a heavy period, such as cramping and heavy vaginal bleeding. You may also experience vaginal bleeding for up to 3 weeks.
In most units, you'll be sent home for the miscarriage to complete. This is safe, but ring your hospital if the bleeding becomes very heavy.
You should be advised to take a home pregnancy test 3 weeks after taking this medicine.
If the pregnancy test shows you're still pregnant, you may need to have further tests.
You may be advised to contact your healthcare professional to discuss your options if bleeding has not started within 24 hours of taking the medicine.
Surgery
In some cases, surgery is used to remove any remaining pregnancy tissue. You may be advised to have immediate surgery if:
- you experience continuous heavy bleeding
- there's evidence the pregnancy tissue has become infected
- medicine or waiting for the tissue to pass out naturally has been unsuccessful
Surgery involves removing any remaining tissue in your womb with a suction device. You should be offered a choice of general anaesthetic or local anaesthetic if both are suitable.
After a miscarriage
A miscarriage can be very upsetting, and you and your partner may need counselling or support.
You may also have questions about trying for another baby and what happens to the miscarried foetus.
For more information, read what happens after a miscarriage.
Page last reviewed: 09 March 2022
Next review due: 09 March 2025
Miscarriage - what you might actually see and feel
Miscarriage - what you might actually see and feel | Pregnancy Birth and Baby beginning of content7-minute read
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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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Help with early miscarriage
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A miscarriage occurs when the fetus is shed from the endometrium, the inner lining of the uterus.
According to experts, two out of 10 clinically established pregnancies end in spontaneous abortion. It is necessary to understand in more detail the causes, symptoms and methods of dealing with miscarriage. nine0011
How an early miscarriage occurs
There are three successive steps in this process. First, the fetus dies, after which it detaches from the endometrial layer. This is manifested by the fact that bleeding begins.
At the third stage, everything that has exfoliated is removed from the uterine cavity. The process may be complete or incomplete. In the early stages - five to six weeks - the process resembles ordinary menstruation. They are characterized by painful and much more unpleasant sensations. You can find out that it was just an early miscarriage by taking tests for the ratio of hCG in the blood. nine0011
Symptoms of a miscarriage
Signs of spontaneous abortion are abdominal cramps, cramps or bloody discharge. However, they do not always appear.
It is necessary to note the most typical manifestations of the presented state and their main characteristics.
Temperature
For a short period of time, hyperthermia may well not be observed. Fever is not the most common symptom. In some cases, the thermometer readings really rise to 38 degrees or more. nine0011
At the same time, when hyperthermia is accompanied by a number of additional symptoms, a septic miscarriage is likely. These are its signs:
- severe pain in the abdomen and in the depths of the vagina;
- increase in the tone of the uterus, which is felt by jerks inside;
- pungent, pungent and unpleasant odour.
All this indicates that the infection has joined. In such a case, emergency hospitalization is strongly recommended to stop the development of the process. It is better not to engage in self-medication or the use of folk recipes. nine0011
Discharge
Early miscarriage can indeed be accompanied by discharge.
They may be habitual, as during menstruation. Also, the discharge may be smearing, insignificant.
Secretion brown, scanty, much less likely to end in spontaneous abortion. Most often, this is indicated by abundant and bright red discharge. It is blood that normally appears when the fetus is rejected from the inner layer of the uterus.
Pain
The severity of unpleasant and specific sensations may differ from each other depending on the duration of pregnancy. Probably the accession of pain, similar to menstruation. Most often, a similar symptom indicates an early miscarriage - no more than six weeks. nine0011
Probably cramping pains in the abdomen, which pull in the back. Their strength can vary from subtle to much more pronounced. In the rarest cases, when the clinical picture is complicated by a long course, this leads to a state of shock.
Another typical manifestation of pain is discomfort in the back or abdomen. Only then are the discharges identified.
A similar situation is most typical for spontaneous abortion at the seventh or eighth week of pregnancy. nine0011
Causes of miscarriage
The first factor is genetic abnormalities in the development of the fetus. It is they who most often lead to miscarriage in the early stages. Violations can be expressed in qualitative or quantitative failures in chromosomes. In this regard, the female body recognizes the defect, and therefore does not allow such a fetus to develop further. Most often, such rejection is noted in the third week of pregnancy.
The next reason that an early miscarriage has developed may be disturbances in the work of the endocrine gland. Hormones determine not only the success and regularity of the cycle, but also how well the fetus is attached to the mucous surface of the uterus. If, due to a malfunction of the thyroid gland, the endometrium is not able to provide the fetus with all the necessary components, the pregnancy will not go well. Most often, a miscarriage occurs at the beginning or at the end of the fourth week.
nine0011
Other reasons why pregnancy is terminated:
- Rhesus conflict. If the parents have different Rh factors, then the risk that a miscarriage will occur after the first weeks of pregnancy increases significantly. This happens if a woman has a negative Rh, and the child has a positive, inherited from the father. In such a situation, the female body recognizes the fetus as a foreign object. Therefore, it is excreted from the uterus. Timely diagnosis allows you to save the child through full-fledged drug therapy. nine0004
- Sexually transmitted diseases, other infections. Similar problematic conditions also lead to spontaneous abortion. In this case, the embryo is infected at a very early stage. That is why the body will perceive it as a foreign object. In this regard, a miscarriage will occur already in the fifth week.
- Previous abortions. Another common reason why a miscarriage occurred. Abortion is a huge stress for the reproductive system, which leads to thinning of the lining of the uterus.
That is why the risk of miscarriage may be greater. nine0004
Abdominal injuries should not be excluded from the list. Sharp pressure on the peritoneum, including when lifting weights, can provoke an abortion. Also on the list are severe stress, anxiety and depression. Anything that violates the normal state of a woman can lead to serious consequences.
How to avoid miscarriage
The main goal of treatment is to relieve tension in the uterus. It will be equally important to stop the bleeding and prolong the pregnancy, but only on the condition that the fetus is viable. The sooner medical assistance is provided, the higher the likelihood of preserving the fetus, without the need to determine the expected timing of miscarriages. nine0011
Our specialists will help you with this. Only we have the most qualified and experienced doctors who know exactly how to treat even the most difficult cases. They will conduct a full diagnosis and prescribe the most effective, effective medicines.
Drug treatment
Hormonal drugs are used. They at an early stage determine the normal course of pregnancy. Medicines based on the hormone progesterone are effective.
- The use of hemostatic drugs. In the case of pregnant women, droppers are used with drugs such as Dicinon or Tranexam. They are needed to stop bleeding.
- Antispasmodics. Experts recommend injections of Drotaverin, followed by a switch to painkillers such as No-shpa. Papaverine suppositories, droppers with the addition of magnesia are also used. All of them are necessary in order to remove a number of signs of a pathological condition, namely, an increased tone of the uterus and pronounced pain. nine0004
- Use of Tocopherol. Vitamin E is an indispensable component for women, including pregnant women. It ensures the normal and full functioning of the ovaries. Tocopherol also strengthens the vascular walls, eliminates the formation of blood clots.
- Sedative preparations.
Use motherwort or valerian tincture. The presented measure is recommended for increased irritability or nervousness of a pregnant woman.
To prevent early miscarriage, our clinic's specialists recommend glucocorticosteroids. Apply Dexamethasone or Metipred. They are prescribed to patients with diagnosed immune disorders that can lead to early termination of pregnancy. nine0011
A special relief ring can be fitted as an option. The presented procedure is carried out in the second trimester, or rather after the 20th week of gestation.
Remove such a device not earlier than 38 weeks. It is necessary for a woman to maintain the correct position of the uterus. Also, the unloading ring helps to prevent premature birth.
Additional measures
To prevent early miscarriage, it is recommended to stop physical activity. Especially when it comes to jumping, lifting weights. Rest, lack of sudden physical activity and adherence to bed rest will help to keep the pregnancy.
nine0011
Another preventive measure will be the exclusion of sudden movements. At any stage of pregnancy, they can provoke detachment of the embryo or lead to serious complications in its development.
To exclude an early miscarriage will allow:
- emotional calm and absence of stress;
- refusal to take a hot bath or visit a bath, sauna - this is due to the fact that high temperatures provoke increased bleeding, as well as detachment of the fetus; nine0004
- restriction of sexual intercourse - if there is a threat that an early miscarriage will occur, they refuse to have sex;
- exclusion of alcohol, nicotine addiction.
It is also important to stop eating certain foods. The ban applies to chocolate, coffee, and any other caffeinated drinks. In no case should you self-medicate. The fact is that the use of drugs without the appointment of a specialist will only aggravate the situation. It is not recommended to use folk remedies to stop bleeding, relieve pain.
All medicines and prescriptions used must be coordinated with a specialist, because there is a high probability of harm to the embryo. nine0011
It is really possible to exclude such a problem as an early miscarriage. It is necessary to observe all safety measures, fully and in a timely manner to be treated. It is in this case that the pregnancy will end with the birth of a healthy child.
Early miscarriage - symptoms and how to prevent it
The term "early miscarriage" refers to a spontaneous abortion that occurs in the first 6-8 weeks of pregnancy. It can occur before 20 weeks of pregnancy for reasons related to the natural states of the fair sex. According to statistics, the logical outcome of every fifth pregnancy is a miscarriage. However, quite often a woman does not even know that she was pregnant by the time the fetus is rejected by the body. nine0011
In addition, a curious pattern was revealed: more often than a natural one, a pregnancy induced artificially ends in a miscarriage.
For example, in vitro fertilization, unfortunately, does not always lead to a successful pregnancy and the birth of a baby on time.
Why can an early miscarriage occur?
Here are the most common causes, each of which significantly increases the risk of miscarriage: nine0011
- the future mother has certain infectious diseases, as well as STDs;
- intoxication of a woman's body for various reasons, including as a result of her living in an ecologically unfavorable region;
- all kinds of metabolic disorders in the body;
- hormonal failures, including those provoked by a malfunction of the thyroid gland;
- various neoplasms in the uterus and others, as well as the cervix, pathologies; nine0004
- future mother leading a life far from a healthy lifestyle. May include drinking alcohol, smoking, taking psychotropic and narcotic drugs, as well as malnutrition;
- obesity;
- immune status disorders;
- cardiac diseases;
- diabetes mellitus;
- too early for pregnancy or, conversely, the patient's overly mature age at times increases the risk of miscarriage; nine0004
- all kinds of pathologies of chromosomes and genes;
- prolonged exposure to stress or severe psycho-emotional trauma in a woman.
The timing of a miscarriage may depend, among other things, on the patient's genetic predisposition to miscarriage. Finally, often its specific cause remains unexplained to the end.
Symptoms of miscarriage
A pregnant woman should urgently seek medical help if she has the following warning signs: nine0011
- bleeding from the vagina;
- spotting discharge from the genital tract. They can have both light pink and intense red or brownish tint;
- convulsions;
- severe pain in the lumbar region;
- abdominal pain, etc.
All of the above signs can be symptoms of a miscarriage. Timely provision of qualified medical care is the key to maintaining pregnancy. nine0011
Life after miscarriage
If a woman could not bear the pregnancy - an early miscarriage crossed out all her plans - then she needs to calm down and take all measures to prevent such complications in the future.
