When you miscarry does the fetus come out
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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Miscarriage | Pregnancy Birth and Baby
The loss of a baby through miscarriage can be very distressing. A miscarriage generally occurs for reasons outside your control and nothing can be done to prevent or stop it from happening. Most women who have had a miscarriage will go on to have a healthy pregnancy in the future.
What is a miscarriage?
A miscarriage is the loss of your baby before 20 weeks of pregnancy. The loss of a baby after 20 weeks is called a stillbirth.
Up to 1 in 5 confirmed pregnancies end in miscarriage before 20 weeks, but many other women miscarry without having realised they are pregnant.
Common signs of miscarriage include:
- cramping tummy pain, similar to period pain
- vaginal bleeding
If you think you are having a miscarriage, see your doctor or go to your local emergency department.
Many women experience vaginal spotting in the first trimester that does not result in pregnancy loss.
What are the types of miscarriage?
There are several types of miscarriage — threatened, inevitable, complete, incomplete or missed.
Other types of pregnancy loss include an ectopic pregnancy, molar pregnancy and a blighted ovum.
Threatened miscarriage
When your body is showing signs that you might miscarry, that is called a 'threatened miscarriage'. You may have light vaginal bleeding or lower abdominal pain. It can last days or weeks and the cervix is still closed.
The pain and bleeding may resolve and you can go on to have a healthy pregnancy and baby. Or things may get worse and you go on to have a miscarriage.
There is rarely anything a doctor, midwife or you can do to prevent a miscarriage. In the past bed rest was recommended, but there is no scientific proof that this helps at this stage.
Inevitable miscarriage
Inevitable miscarriages can come after a threatened miscarriage or without warning. There is usually a lot more vaginal bleeding and strong lower stomach cramps. During the miscarriage your cervix opens and the developing fetus will come away in the bleeding.
Complete miscarriage
A complete miscarriage has taken place when all the pregnancy tissue has left your uterus. Vaginal bleeding may continue for several days. Cramping pain much like labour or strong period pain is common — this is the uterus contracting to empty.
If you have miscarried at home or somewhere else with no health workers present, you should have a check-up with a doctor or midwife to make sure the miscarriage is complete.
Incomplete miscarriage
Sometimes, some pregnancy tissue will remain in the uterus. Vaginal bleeding and lower abdominal cramping may continue as the uterus continues trying to empty itself. This is known as an 'incomplete miscarriage'.
Your doctor or midwife will need to assess whether or not a short procedure called a ‘dilatation of the cervix and curettage of the uterus’ (often known as a ‘D&C’) is necessary to remove any remaining pregnancy tissue. This is an important medical procedure done in an operating theatre.
Missed miscarriage
Sometimes, the fetus has died but stayed in the uterus. This is known as a 'missed miscarriage'.
If you have a missed miscarriage, you may have a brownish discharge. Some of the symptoms of pregnancy, such as nausea and tiredness, may have faded. You might have noticed nothing unusual. You may be shocked to have a scan and find the fetus has died.
If this happens, you should discuss treatment and support options with your doctor.
Recurrent miscarriage
A small number of women have repeated miscarriages. If this is your third or more miscarriage in a row, it’s best to discuss this with your doctor who may be able to investigate the causes, and refer you to a specialist.
A miscarriage can occur suddenly or over a number of weeks. The symptoms are usually vaginal bleeding and lower tummy pain. It is important to see your doctor or go to the emergency department if you have signs of a miscarriage.
The most common sign of a miscarriage is vaginal bleeding, which can vary from light red or brown spotting to heavy bleeding. If it is very early in the pregnancy, you may think that you have your period.
Other signs may include:
- cramping pain in your lower tummy, which can vary from period-like pain to strong labour-like contractions
- passing fluid from your vagina
- passing of blood clots or pregnancy tissue from your vagina
What really happens during a miscarriage?
WARNING — This article contains some graphic descriptions of what you might see during a miscarriage.
What should I do if I think I’m having a miscarriage?
If you are concerned that you are having a miscarriage, call your doctor or midwife for advice and support.
Keep in mind that many women experience vaginal spotting in the first trimester of pregnancy that does not result in a miscarriage.
If you are alone, consider calling your partner or a friend for help and support.
If you have very heavy bleeding, strong pain or feel unwell, call triple zero (000) or have someone take you to your nearest emergency department.
How is a miscarriage managed?
Unfortunately, nothing can prevent a miscarriage from happening once it has begun. What happens now depends on your own health and what is happening to you.
Each approach has benefits and risks. You should discuss these with your doctor.
Expectant or natural management
Also called ‘watch and wait’, expectant management may be recommended in early pregnancy. This involves going home and waiting until the pregnancy tissue has passed from your womb by itself. This can happen quickly, or it may take a few weeks.
Medical management
You may be offered medication that speeds up the passing of the pregnancy tissue. You may be asked to stay in hospital until the tissue has passed, or you may be advised to go home.
Surgical management
You may be advised to have a form of minor surgery called a 'dilatation and curettage' (also called a D&C or a curette). This procedure is often recommended if you have heavy bleeding, significant pain or signs of infection. It may also be recommended if expectant or medical management has failed. You may also decide that you prefer this option.
This procedure is done under general anaesthesia in an operating theatre. It takes 5-10 minutes once you are asleep. The doctor opens the cervix and removes the remaining pregnancy tissue.
How is a miscarriage treated?
Once it is confirmed that you are having a miscarriage, your doctor may offer or recommend treatment. There are many options. All have benefits and risks — discuss these with your doctor.
If the miscarriage is complete
If it seems the miscarriage is complete, you should still see your doctor for a check-up. You may be advised to have an ultrasound to make sure your uterus is empty.
If you go to hospital
If you go to your hospital’s emergency department, you will be seen first by a triage nurse, who will assess how urgently you need to be seen by a doctor. Depending on your symptoms, you will either be taken in to see a doctor immediately, or you will be asked to wait.
If you are waiting to be seen and your symptoms become worse or you feel like you need to go to the toilet, let the staff know immediately.
What happens if I miscarry at home?
Some women miscarry at home before they have a chance to see their doctor or get to the hospital.
If this happens, then:
- use pads to manage the bleeding
- if you can, save any pregnancy tissue that you pass, as your doctor may recommend it is tested to see why your miscarriage happened
- take medications such as paracetamol if you have pain
- rest
- call your doctor or midwife
There is a chance you may see your baby in the tissue that you pass, but often the baby is too small to recognise, or may not be found at all. It is normal to want to look at the remains, but you may decide you do not want to. There is no right or wrong thing to do.
Some women miscarry while on the toilet. This can also happen if you are out and about, or in hospital. There is no right or wrong way to handle this.
Why do miscarriages happen?
Many women wonder if their miscarriage was their fault. In most cases, a miscarriage has nothing to do with anything you have or have not done. There is no evidence that exercising, stress, working or having sex causes a miscarriage.
Most parents do not ever find out the exact cause. However, it is known that miscarriages often happen because the baby fails to develop properly, usually due to a chromosomal abnormality that was spontaneous, not inherited.
Occasionally, miscarriage is caused by:
- hormonal abnormalities
- immune system and blood clotting problems
- medical conditions such as thyroid problems or diabetes
- severe infections causing high fevers (not common colds)
- physical problems with your womb or cervix
What are the risk factors for miscarriage?
Women are more likely to have miscarriages if they:
- are older
- smoke
- drink alcohol in the first trimester
- drink too much caffeine in coffee, tea or energy drinks
- have had several previous miscarriages
Can you prevent a miscarriage?
Living healthily — no cigarettes, no alcohol and little to no caffeine — can decrease your risk of miscarriage. It’s a good idea to avoid contact with people who have a serious infectious illness when you’re pregnant.
Who can I talk to for advice and support?
Talk to your doctor or midwife for information and advice on what do and how to look after yourself if you experience a miscarriage.
Your hospital should be able to provide details of available support services, such as bereavement support.
SANDS is an independent organisation that provides support for miscarriage, stillbirth and newborn death. You can call them on 1300 072 637 or visit www.sands.org.au.
You can also call Pregnancy, Birth and Baby on 1800 882 436, 7am to midnight (AET) to speak to a maternal child health nurse for advice and emotional support.
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.
Learn more here about the development and quality assurance of healthdirect content.
Miscarriage due to missed pregnancy
What is a miscarriage?
According to medical statistics, miscarriage is the most common complication during pregnancy. About 10-20% of all recorded pregnancies end in miscarriage. Miscarriage is a sporadic, sudden, termination of pregnancy, which is accompanied by complete or partial emptying of the uterus.
Missed pregnancy loss (MP) can be seen on ultrasound. It consists in confirming the non-viability of the fetus without bleeding. The ST can end in a miscarriage, when the body gets rid of the dead fetus on its own, or in a medical abortion, when medical or surgical manipulations are used to clean the uterine cavity.
Causes of miscarriage and miscarriage
80% of miscarriages occur in the first trimester before 12 weeks. In 50% of cases, this occurs due to genetic defects in the fetus. The threat of miscarriage due to chromosomal abnormalities decreases with the course of pregnancy: by 20 weeks it is 10-20% versus 41-50% in the first trimester. The main cause of genetically determined early miscarriages are autonomous trisomies - when three homologous chromosomes are present in the cells instead of two. Such defects occur at the time of conception and are not subject to correction. They lead to miscarriage or to the development of severe genetic diseases. In addition to genetics, immunological, endocrine and infectious causes are distinguished.
In the second trimester, various diseases and disorders in the mother's body become the main cause of miscarriage.
There is a list of factors that can trigger early pregnancy loss:
-
woman's age. At the age of 20-30 years, the risk of spontaneous miscarriage is 9-17%, at 35-40 years old - 20%, at 40-45 - 40%;
-
alcohol abuse;
-
abuse of caffeine;
-
smoking;
-
drug use;
-
chronic diseases of the mother;
-
maternal infections;
-
use of medications incompatible with pregnancy;
-
history of spontaneous abortion. The risk of subsequent pregnancy loss in women with one miscarriage in history is 18-20%, with two - 30%, with three - 43%.
Symptoms and signs of miscarriage
You can suspect a miscarriage by sudden spotting and sharp pain in the lower abdomen. If these symptoms appear, seek immediate medical attention. The doctor must conduct an ultrasound diagnosis. Transvaginal scanning (TVS) is considered the gold standard for diagnostics - when the sensor is inserted into the uterus through the vagina. If TVS is not available, a transabdominal scan can be applied - through the anterior abdominal wall.
Missed pregnancy may be asymptomatic and not manifest until the next scheduled ultrasound.
How does a miscarriage happen?
The miscarriage process has four stages. This does not happen overnight and lasts from several hours to several days.
The first stage - the threat of miscarriage. Among the symptoms: pulling pains in the lower abdomen, scanty blood discharge, increased uterine tone. The process of detachment of the placenta from the place of attachment in the uterus begins. The internal os is closed. The main thing is to seek help in time, then with proper therapy if there is a chance to stop the miscarriage and save the pregnancy.
The second stage - the beginning of a miscarriage. Strong discharge, the cervical canal is ajar, the doctor diagnoses the final detachment of the placenta.
The third stage is a miscarriage in progress. You can feel the regular contractions of the uterus, the outcome of the fetus, placenta and uterine contents, profuse blood discharge has begun.
The last fourth stage is a complete miscarriage. The pregnancy is interrupted, the uterine cavity does not contain the fetus and products of conception.
How to determine the ST?
It should be remembered that a miscarriage can be diagnosed only during an ultrasound examination. Home tests will not give reliable results. Ultrasound will show the presence or absence of a heartbeat in the fetus.
Treatment of miscarriage and miscarriage
Due to the fact that the vast majority of spontaneously terminated pregnancies are due to genetic abnormalities (non-viability) of the fetus, then, speaking about the treatment of miscarriage, it is worth talking about ensuring complete and safe cleansing of the uterus, preventing infection and preventing bruising. With the help of an ultrasound examination, the doctor will check whether the uterus has completely cleared. If yes, then no additional treatment is required. In the event of an incomplete miscarriage or STD, the patient will be indicated for surgical or medical cleaning. If the miscarriage is only in a state of threat, the treatment tactics will be aimed at blocking uterine contractions and stopping the development of a miscarriage. If you need treatment for a missed pregnancy in Moscow, contact our specialists.
Spontaneous abortion (miscarriage)
If the pregnancy is terminated naturally before the fetus reaches gestational age, this is called a spontaneous abortion or miscarriage. More than half of miscarriages occur no later than 12 weeks of gestation due to fetal abnormalities. The rest falls on the period up to 20 weeks and is associated with pathologies of pregnancy. If the pregnancy is terminated in the second half, it is called preterm labor.
Spontaneous abortion, otherwise known as miscarriage, is one of the most common complications during pregnancy, accounting for 10-20% of diagnosed pregnancies, and is the rejection of a fetus weighing no more than 500 grams. and less than 22 weeks. Unfortunately, with such indicators, the fetus is not viable. Usually 80% of the total number of spontaneous abortions occurs before the 12th week of pregnancy.
Types of spontaneous abortion
1. Threat of miscarriage - characterized by mild uterine cramps, pulling pain in the lower abdomen and sometimes mild bloody discharge from the vagina.
2. A miscarriage that has begun - is characterized by more severe pain and profuse bleeding. At the same time, the tone of the uterus is slightly increased, and the internal os is closed.
3. Inevitable miscarriage - accompanied by dilatation of the cervix - a fetal egg can be distinguished - with profuse bleeding and severe cramps in the lower abdomen.
4. Incomplete miscarriage - part of the fetus comes out. The bleeding is so profuse that it can lead to the death of a woman.
5. Completed miscarriage - the fetal egg and the fetus itself are completely out. After that, the bleeding and spasms stop.
The etiology of miscarriage is due to many factors. Among them:
- genetic disorders;
- previous induced abortions;
- too little time has passed since the previous pregnancy;
- inflammatory infections in the mother, endocrine disorders;
- blood conflict between mother and fetus;
- taking hormonal contraceptives and certain medications;
- smoking during pregnancy and drinking alcohol;
- unknown causes.
To prevent miscarriage, it is necessary to give up bad habits, not to have abortions and to be regularly examined by a doctor.
Spontaneous abortion begins with the appearance of cramp-like pulling pains, similar to pain during menstruation. Then bleeding from the uterus begins. At first, the discharge is slight or moderate, and then, after detachment of the fetal egg, abundant discharge with bloody clots begins. The appearance of these symptoms requires urgent hospitalization.
After examining a woman in a hospital, having determined the degree of detachment of the embryo, one of the following diagnoses will be made:
- the threat of pregnancy - detachment is only outlined or is completely insignificant. In this case, the pregnancy can be saved;
- a miscarriage that has begun - detachment is already quite decent with a pronounced pain syndrome. And in this case, the fetus can be saved;
- abortion in progress - detachment with displacement progresses, labor-like contractions begin. Pregnancy cannot be saved, cleaning is required;
- incomplete miscarriage - independent exit of a part of the fetus and membranes, curettage is necessary for the final curettage of the uterus;
- late abortion - premature delivery of an unviable baby.
After a spontaneous abortion, it is recommended to take a short break in planning and take preventive measures to avoid recurrence.
In case of repeated miscarriage, a thorough comprehensive examination is necessary to determine the causes of miscarriage and eliminate them.
A miscarriage is a severe psychological trauma, especially during the first pregnancy. But do not give up, with a competent approach to planning and bearing, the next pregnancy will certainly end with the appearance of a long-awaited baby.
Causes of spontaneous abortion
1. Doctors call various chromosomal pathologies one of the main reasons: monosomy, autosomal trisomies, polyploidy. They account for 82-88% of spontaneous miscarriages.
2. The second most common cause is disorders in the female genital area: endometritis - inflammation of the uterine mucosa - preventing the implantation of the fetal egg and its development and polycystic ovaries.
3. Hormonal disorders, namely progesterone deficiency.