When do you stop bleeding after a 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

Treating miscarriage | The Royal Women's Hospital

If a miscarriage has begun, there is nothing that can be done to stop it. Any treatment you have will be aimed at avoiding heavy bleeding and infection.

A discussion with the doctor or nurse will help you to work out which treatment options are best and safest for you.

On this page:

No treatment (expectant management)
Treatment with medicine
Surgical treatment (curette)
Waiting for treatment
After a miscarriage

No treatment (expectant management)

You can choose to wait and see what will happen. This is called 'expectant management'. If nothing is done, sooner or later the pregnancy tissue will pass naturally. If it is an incomplete miscarriage (where some but not all pregnancy tissue has passed) it will often happen within days, but for a missed miscarriage (where the fetus or embryo has stopped growing but no tissue has passed) it might take as long as three to four weeks.

While you are waiting you may have some spotting or bleeding, much like a period. When the pregnancy tissue passes, you are likely to have heavier bleeding with crampy, period-like pains. You can use sanitary pads and take pain relieving tablets, such as paracetamol.

If your miscarriage is incomplete, with just a small amount of pregnancy tissue remaining, it’s probably best to take a wait and see approach. But if there is heavy bleeding or signs of infection you will need treatment.

If the tissue does not pass naturally or you have signs of infection, the doctor will recommend a dilatation and curettage (D&C). You and the doctor can discuss and decide the preferred option for you.

Things to know

There are many reasons why some women prefer to wait and see. It may feel more natural, it may help with the grieving process or it may give you more of a sense of control.
Some women become worried or frightened when the bleeding gets heavier, especially if blood clots, tissue or even a recognisable embryo is passed.
Usually, the wait and see approach takes longer than any other approaches such as surgery or medication. Sometimes bleeding can last for up to four weeks.
Although excessive bleeding and blood transfusion are very rare, they are slightly more common with expectant management than with surgery.
A few women still need to have surgery – sometimes urgently – if they develop infection, bleed heavily or if the tissue does not pass naturally.
The waiting time can be emotionally draining for some women.

Treatment with medicine

Medicine is available that can speed up the process of passing the pregnancy tissue. For an incomplete miscarriage, the medicine will usually encourage the pregnancy tissue to pass within a few hours. At most it will happen within a day or two. For a missed miscarriage, it may happen quickly, but it can take up to two weeks and, occasionally, longer.

Medication is not suitable if there is very heavy bleeding or signs of infection. It is usually not recommended for pregnancies that are older than about nine weeks.
If the tissue does not pass naturally, eventually your doctor will recommend a dilatation and curettage (D&C).

Things to know

The pregnancy tissue will pass between four to six hours after taking the medicine, during which time you may be in hospital. After a few hours, if the pregnancy hasn’t passed, you may be sent home to wait. This will depend on where you are and which hospital you are in.
The medicine has side effects which usually pass in a few hours but can be unpleasant, such as nausea, vomiting, diarrhoea, fever and chills. The tablets can be swallowed or dissolved under the tongue, or inserted in the vagina.
After receiving the medication there may be some spotting or bleeding like a period. When the pregnancy tissue passes, you are likely to notice heavier bleeding and clots with strong cramping, period-like pains. You can use sanitary pads and take pain relieving tablets such as paracetamol.
Some women may need stronger pain killers or a pain relieving injection.
A few women still need to have surgery, sometimes urgently, if they develop infection, bleed heavily or if the tissue does not pass.

Surgical treatment (curette)

A D&C (or ‘curette’) is a minor operation. The full name is dilatation and curettage. It is done in an operating theatre, usually under general anaesthetic. There is no cutting involved because the surgery happens through the vagina. The cervix (neck of the uterus) is gently opened and the remaining pregnancy tissue is removed so that the uterus is empty. Usually the doctor is not able to see a recognisable embryo.

The actual procedure usually only takes five to ten minutes, but you will usually need to be in the hospital for around four to five hours. Most of this time will be spent waiting and recovering.

You may have to wait a day or two to have a curette and sometimes, while you are waiting, the pregnancy tissue will pass on its own. If this happens and all of the tissue is passed you may not need to have a curette.

A curette is done in the following circumstances:

You have heavy or persistent bleeding and/or pain.
The medical staff advise that this is a better option for you; this may be because of the amount of tissue present, especially with a missed miscarriage.
This is an option you prefer.

Things to know

The risks of a D&C are very low, but include:

some pregnancy tissue remains in uterus. This can cause prolonged or heavy bleeding and the operation may need to be repeated
infection needing antibiotics
damage to the cervix or uterus. This is very rare (around 1 in 1000) and, when it does happen, it is usually a small hole or tear which will heal itself
excessive bleeding (very rare)
anaesthetic risks. These are very low for healthy women, but no anaesthetic or operation is without risk.

Waiting for treatment

If you have heavy bleeding with clots and crampy pain, it is likely that you are passing the pregnancy tissue. The bleeding, clots and pain will usually settle when most of the pregnancy tissue has been passed. Sometimes the bleeding will continue to be heavy and you may need further treatment.

You should go to your nearest emergency department if you have:

increased bleeding, for instance soaking two pads per hour and/or passing golf ball sized clots
severe abdominal pain or shoulder pain
fever or chills
dizziness or fainting
vaginal discharge that smells unpleasant
diarrhoea or pain when you open your bowels.

What to do while you are waiting

You can try to rest and relax at home.
Usual activity that is not too strenuous will not be harmful. You can go to work if you feel up to it.
If you have pain you can take paracetamol.
If there is bleeding, use sanitary pads rather than tampons.

After a miscarriage

It is usual to have pain and bleeding after a miscarriage. It will feel similar to a period and will usually stop within two weeks. You can take ordinary painkillers for the pain. Your next period will usually come in four to six weeks after a miscarriage.
See a doctor or attend a hospital emergency department if you have strong pain and bleeding (stronger than period pain), abnormal discharge, (especially if it is smelly), or fever. These symptoms may mean that you have an infection or that tissue has been left behind.
Try and avoid vaginal sex until the bleeding stops and you feel comfortable.
Use sanitary pads until the bleeding stops (do not use tampons).
All contraceptive methods are safe after a miscarriage
See a GP (local doctor) in four to six weeks for a check-up.

Anti-D injection after a miscarriage

It is important to have your blood group checked. If you’re RhD negative and the fetus is RhD positive this can cause problems for future pregnancies. This is because the fetus’s blood cells have RhD antigen attached to them, whereas yours do not. If small amounts of the fetus’s blood mixes with your blood, your immune system may perceive this difference in blood cells as a threat and produce antibodies to fight against the fetus’s blood. Once your body has made these antibodies they can’t be removed. This is unlikely to have caused your miscarriage and is more likely to affect future pregnancies. Women with a negative blood type usually need an Anti-D injection, which will stop the antibodies forming.

Future pregnancies after a miscarriage

One of the most common concerns following a miscarriage is that it might happen again. However, if you have had one miscarriage the next pregnancy will usually be normal.

If you do try for another pregnancy, try and avoid smoking, alcohol and excess caffeine as they increase the risk of miscarriage. It is recommended that all women take folic acid while trying to conceive, and continue until three months of pregnancy. In your next pregnancy you are encouraged to see your GP and have an ultrasound at about seven weeks. If ultrasound is done too early in pregnancy the findings are often uncertain and cause unnecessary worry.

Feelings and reactions

There is no ‘right’ way to feel following a miscarriage. Some degree of grief is very common, even if the pregnancy wasn’t planned. Partners may react quite differently, just as people can respond differently to a continuing pregnancy. Feelings of loss may persist for some time and you may have mixed feelings about becoming pregnant again. Some friends and family may not understand the depth of emotion that can be attached to a pregnancy and may unreasonably expect for you to move on before you are ready.

Some couples decide that they want to try for a pregnancy straight away, while others need time to adjust to their loss. If you feel anxious about a possible loss in future pregnancies, you may find it helpful to talk to someone about this. If it’s difficult to speak with your friends and family about these issues, your doctor, community support group and counsellors can provide information and assistance.

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Useful articles

Bleeding after abortion: normal or cause for alarm

Uterine bleeding after termination of pregnancy is a common phenomenon in obstetric practice that occurs on the first day after the operation. The intensity and duration of blood loss are individual and depend not only on the characteristics of the female body, but also on the type of abortion.

Features of bleeding after abortion

Bleeding may be completely absent during the first two days after surgical termination of pregnancy, but later increases to menstrual bleeding and continues in some clinical pictures up to 6 weeks. This pathology indicates a hormonal imbalance, that is, there is insufficient "support" of endometrial tissues, which supports the development of pregnancy. As a result of this bleeding after termination of pregnancy can only intensify, and continue intermittently for several weeks. It is important to understand that here we are talking about pathology.

Most women of reproductive age are concerned about the main question, how long will the bleeding after an abortion last? The question is individual, but if it does not pass more than two weeks after getting rid of the fetus, it is important to urgently contact the local gynecologist. The duration of the hemorrhage also depends on the gestational age: the earlier an abortion is performed, the more likely it is to solve such a piquant problem in a gentle “mode” and without serious consequences.

Cause of abnormal bleeding after an abortion

The occurrence of bleeding after an abortion should not confuse the patient, but its duration should be a cause for concern. Among the pathological causes of this symptom, the following should be singled out:
- Perforation of the uterus;
- Injury of the cervix;
- Presence of residual fetal tissue;
- Blood clotting disorder;
- The reaction of the female body to individual anesthetics.
With such diagnoses, along with hemorrhage, there is an obvious violation of the temperature regime, convulsions, general weakness, fainting, hypotension, increased heart rate. It is important not to ignore such signs of shock, but to visit a medical center and a qualified specialist in a timely manner.

How to deal with bleeding after a miscarriage

It is important to understand that to stop prolonged bleeding after a miscarriage at home is impossible, only a competent gynecologist can determine an accurate and effective treatment regimen. Delay in this matter can cost the patient her life.

If the appeal to the doctor is timely, then the first thing the patient is referred for is an ultrasound scan. This accurate clinical examination allows to determine the etiology of the pathological process and the future treatment regimen. If it became known that there is residual fetal tissue in the uterus, additional surgical intervention is necessary to properly clean its cavity. In case of mechanical damage to the uterus or its cervix after interruption, the gynecologist prescribes the repair of the injured area of the uterus, bladder or intestines.

Possible complications

Bleeding after an abortion is dangerous for women's health and causes serious damage to the woman's reproductive system. Among the potential complications, doctors distinguish infertility, malignant tumors and even death of the patient. Therefore, the problem needs to be addressed in a timely manner, and early termination of pregnancy in order to avoid heavy bleeding.

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What to do after a miscarriage - recovery after a miscarriage

A miscarriage can be a difficult topic to talk about, but sometimes talking is the best way to come to terms with it and start healing from it all.
Let's dive deeper into what happens to the body after a miscarriage, as well as learn how to deal with your own feelings.

A miscarriage is when an embryo or fetus does not survive in the uterus during the first 23 weeks of pregnancy. ^[1] Miscarriage is more common than most people think: every 4th pregnancy ends like this. Just because it isn't talked about often doesn't mean it's rare.

Talking about miscarriages can be difficult, because often it is a real grief. However, this topic is becoming less and less taboo, and many women come together in solidarity to share their experiences. This way they know they are not alone in their grief.

A miscarriage is a whole process: your body will be under a lot of physical and emotional stress both during and after the miscarriage. Therefore, we will look at how this situation changes your body in terms of periods, future pregnancies and emotions.

What is bleeding and discharge during a miscarriage?

The most common symptom of a miscarriage is vaginal bleeding during pregnancy. The severity of this bleeding can vary from person to person: sometimes it is heavy with blood clots, other times it can be just spots or brown discharge. This bleeding can last up to 2 weeks. Another symptom of a miscarriage is abdominal pain. They occur when the muscles of the uterus contract to push all the tissues of the embryo or fetus out of the cavity in the form of clots through the vagina.

Regardless of the amount of blood you bleed from your vagina during pregnancy, you need to see a doctor as soon as possible. While not all bleeding during pregnancy is a sign of a miscarriage (implantation bleeding is considered normal in the early stages of pregnancy), it's always best to see a doctor if you're concerned.

What will my first period be like after a miscarriage?

Having experienced a miscarriage, you may wonder how your body will react to it and if there will be any long-term consequences. Miscarriages rarely change the body forever, but you need to give the body time to get used to and return to its normal rhythm of life.

After a miscarriage, you can expect your period to return to normal in about 4-6 weeks, although recovery time varies from person to person and can take up to several months. ^[2]

Don't worry about the return of your period, instead give yourself time to rest while your body repairs and heals.

Getting pregnant after a miscarriage

Some women may immediately return to trying to conceive after a miscarriage, while others may take some time to "digest" the event. Some may even wonder if they even want to have children. Whatever your reaction to your own experience, it is important to recognize that there is no right or wrong way - we all cope differently.

If you still want to try again, it is usually recommended to wait until the symptoms of the miscarriage have passed to prevent infection. ^[3] You can also wait until your period starts again so that you can calculate your future pregnancy dates more accurately.

And remember: you can always consult your doctor about a new pregnancy, but most importantly, you decide when you are ready.

Dealing with your feelings after a miscarriage

The consequences of a miscarriage can be felt immediately after it or after a while - everyone mourns the baby in different ways. No matter how you react, it is important to understand that you did nothing wrong: miscarriage is not related to your personal strength or ability.

I hate to talk about this, but expressing thoughts and emotions can really help in the healing process. And even if at first it seems uncomfortable to talk to people about a miscarriage, you will be surprised how many women understand what you have gone through and are ready to provide support.

There are also many charities and associations dedicated to helping people with miscarriage. So if you ever need comforting advice, there are many more people you can turn to besides friends and family.

Miscarriage is no doubt a difficult topic to discuss, but silence only reinforces the taboo and prevents many people from seeking support.
Learn more