What does an early miscarriage look like at 4 weeks

What Does a Miscarriage Look Like? Bleeding, Duration, and More

A miscarriage is a spontaneous pregnancy loss before 20 weeks of gestation. Some 8 to 20 percent known pregnancies end in miscarriage, with the majority happening before the 12th week.

The signs and symptoms of miscarriage vary from person to person. Symptoms may also vary depending on how far along you are. For example, a fetus at 14 weeks will be much larger than a fetus at 5 weeks of gestation, so there may be more bleeding and tissue loss with a later miscarriage.

Miscarriage symptoms may include:

• spotting or bleeding from the vagina
• abdominal cramping or pain in the lower back
• passage of tissue, fluid, or other products from the vagina

Read on to learn more about identifying a miscarriage and what to do if you suspect you’re experiencing one.

Bleeding may start as light spotting, or it could be heavier and appear as a gush of blood. As the cervix dilates to empty, the bleeding becomes heavier.

The heaviest bleeding is generally over within three to five hours from the time heavy bleeding begins. Lighter bleeding may stop and start over one to two weeks before it completely ends.

The color of the blood can range from pink to red to brown. Red blood is fresh blood that leaves the body quickly. Brown blood, on the other hand, is blood that’s been in the uterus a while. You may see discharge the color of coffee grounds, or near black, during a miscarriage.

Exactly how much bleeding you’ll experience depends on a variety of circumstances, including how far along you are and whether or not your miscarriage is progressing naturally.

While you may see a lot of blood, let your doctor know if you fill more than two sanitary pads an hour for two or more hours in a row.

What does a missed miscarriage look like?

You may not experience bleeding or other symptoms with a miscarriage, at least at first.

A missed miscarriage, also referred to as a missed abortion, happens when the fetus has died but the products of conception remain in the uterus. This type of miscarriage is usually diagnosed via ultrasound.

Just as with the amount of blood you’ll see, the duration of a miscarriage will vary from person to person and even from pregnancy to pregnancy.

In many cases, a miscarriage will take around two weeks to pass naturally. Your doctor may prescribe the medication misoprostol (Cytotec) to help a miscarriage pass more quickly. Bleeding may start within two days of beginning the medication. For others, it may take up to two weeks.

Once the miscarriage has started, the tissue and heaviest bleeding should be passed in about three to five hours. After the fetus has passed, you may still experience spotting and mild tissue loss for one to two weeks.

It may be difficult to tell a very early miscarriage from a late period. In fact, many miscarriages happen before a person even knows they’re pregnant.

In general, a miscarriage will cause more intense symptoms than a menstrual period. For example:

• Your menstrual flow may be relatively similar from month to month with heavy days and light days. A miscarriage can also have heavy and light days, but bleeding may be especially heavy at times and last longer than you’re used to.
• Bleeding from a miscarriage may also contain large clots and tissue you don’t normally see during your period.
• Cramps can be a part of your normal monthly cycle, but with a miscarriage, they may be particularly painful as the cervix dilates.
• The color of blood during your period can range from pink to red to brown. If you see a color you’re not used to seeing, it may be a sign of miscarriage.

Always contact your doctor if you’re pregnant and experience bleeding. While a miscarriage can’t be stopped once it starts, you doctor can run tests to help determine if you’re experiencing the loss of your pregnancy or something else.

To diagnose a miscarriage, your doctor will likely perform an ultrasound to look for the baby’s heartbeat, if you’re far enough along to see a heartbeat. Your doctor may also order a blood test to check human chorionic gonadotropin (hcG) levels to see if they’re rising or falling.

If a miscarriage is confirmed, your doctor may suggest “expectant management” or waiting for the miscarriage to pass naturally. This generally happens within two weeks.

Incomplete miscarriage

The miscarriage may be incomplete if:

• your bleeding is particularly heavy
• you have a fever
• an ultrasound reveals there’s still tissue in your uterus

If this is the case, your doctor may suggest a dilation and curettage (D and C), which is a surgical procedure done to remove remaining tissue. The procedure is done under general or regional anesthesia, and is considered safe. D and C doesn’t usually lead to long-term complications.

Threatened miscarriage

It’s important to report any bleeding or pain you experience in your pregnancy to your doctor. In some cases, you may have what’s called a threatened miscarriage, and there may be certain treatments that can help. These include:

• hormone supplements if the bleeding is caused by low progesterone
• a cerclage (stitch in the cervix) if the issue is with the cervix opening prematurely

Speak with your healthcare provider if you’re looking to get pregnant again after a miscarriage. While it may be safe to start trying after your first normal period, you may want to schedule a checkup depending on the cause or the number of miscarriages you’ve had.

The reason for loss isn’t always known, but around half of miscarriages are caused by issues with the baby’s chromosomes.

Other possible causes include:

• uterine issues
• hormonal imbalances
• other health conditions, such as diabetes, autoimmune disorders, or polycystic ovary syndrome

After a miscarriage, you may have hcG in your blood for one to two months, which could lead to a false positive pregnancy test. In most cases, your period will return within four to six weeks, though you may start ovulating almost immediately following a miscarriage.

Speak with your doctor about birth control options if you don’t wish to become pregnant after a miscarriage.

Will I miscarry again?

Having one miscarriage doesn’t necessarily increases your chances of having another. The risk remains around 20 percent.

Two or more miscarriages is referred to as recurrent pregnancy loss (RPL). The risk of miscarriage after two losses is 28 percent. After three consecutive losses, it increases to 43 percent.

Only 1 percent of people experience three or more miscarriages. About 65 percent of those with unexplained RPL go on to have successful pregnancies.

Activities like exercise, work, morning sickness, and sex don’t cause miscarriages. Even things like smoking or drinking alcohol or caffeine, which can lead to other complications, are also unlikely to lead to early pregnancy loss.

A miscarriage can be physically painful, and it may also cause a variety of emotions. While your body may recover in a few weeks, be sure to take time to process your feelings, grieve, and reach out for help when you need it.

Miscarriage - what you might actually see and feel

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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:

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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