WARNING — This article includes graphic descriptions of what you might see during a miscarriage.
If you suspect you are having a miscarriage, it’s crucial to contact your doctor or midwife for immediate advice and support. For severe symptoms like heavy bleeding, intense pain, or feeling severely unwell, call emergency services or go to the nearest emergency room immediately.
Key Facts About Miscarriage
- The primary initial sign of a miscarriage is typically vaginal bleeding, often followed by pain in the lower abdomen.
- It’s important to know that vaginal bleeding during pregnancy doesn’t always indicate a miscarriage. However, if you experience any bleeding, promptly consult your doctor or midwife.
- The appearance of miscarriage discharge can vary based on the gestational week. It may include blood clots, tissue, or, in later miscarriages, the discernible form of a small baby.
- Remember, emotional support is available for both you and your partner if you experience a miscarriage.
Understanding the Physical Sensations of a Miscarriage
A miscarriage usually begins with vaginal bleeding. This bleeding can vary significantly, ranging from light spotting to very heavy bleeding. Alongside bleeding, most miscarriages involve lower abdominal pain, similar to period cramps or more intense contractions. As the miscarriage progresses, you might also pass fluid and blood clots from your vagina.
It’s vital to remember that spotting or bleeding during pregnancy doesn’t automatically mean you’re miscarrying. However, any bleeding should be discussed with your healthcare provider as soon as possible.
In some instances, a miscarriage might occur with minimal or no noticeable symptoms. These are often discovered during routine ultrasound appointments. Some women may only experience subtle signs like a reduction in pregnancy symptoms, such as decreased morning sickness or less breast tenderness.
Experiencing emotional distress when you suspect a miscarriage is completely normal. Reactions vary greatly among individuals. It’s essential to allow yourself time to process what’s happening. Your partner can be a source of support, even as they navigate their own emotions.
Immediate Steps if You Suspect a Miscarriage
Miscarriage requires timely medical attention. If you believe you are having a miscarriage, immediately contact your doctor or midwife for guidance and support. Seek emergency medical care at the nearest hospital if you experience any of the following:
- Heavy vaginal bleeding (soaking through more than two maxi pads per hour or passing clots larger than golf balls)
- Severe pain in your abdomen or shoulder
- Fever (temperature above 100.4°F or 38°C)
- Dizziness or fainting spells
- Foul-smelling fluid discharge from your vagina
- Diarrhea or pain during bowel movements
The Process of Miscarriage: What to Expect
Unfortunately, once a miscarriage begins, there is no way to stop it. Medical intervention focuses on managing symptoms, minimizing heavy bleeding, and preventing infection.
The duration of a miscarriage varies depending on the chosen management approach, decided in consultation with your doctor or midwife. The options include:
- Expectant Management (Wait and See): Allowing the miscarriage to progress naturally.
- Medical Management: Using medication to help the body expel pregnancy tissue.
- Surgical Management: A surgical procedure to remove pregnancy tissue from the uterus.
Expectant Management: Natural Progression
Expectant management involves waiting for the body to naturally expel the pregnancy tissue (embryo or fetus, gestational sac, and placenta). This process typically begins with spotting and cramping, followed by heavier bleeding. Cramps usually intensify as the pregnancy tissue passes.
The complete process can take up to two weeks. Light bleeding might persist for another two weeks after passing the tissue.
Waiting for a miscarriage to occur naturally can be emotionally challenging due to the uncertainty of when it will happen.
Medical Management: Medication Assistance
Medical management is chosen by some women to expedite the process of miscarriage, avoiding a potentially lengthy wait. Doctors can prescribe medication to induce contractions and expel the pregnancy tissue more quickly. This method will cause pain and bleeding similar to a natural miscarriage. The pregnancy tissue usually passes within 4 to 6 hours after medication, but sometimes additional doses are needed.
Surgical Management: Dilatation and Curettage (D&C)
If tissue remains in the uterus after a miscarriage, or if a woman prefers to avoid the pain and bleeding associated with natural or medical miscarriage, surgical management via Dilatation and Curettage (D&C) might be chosen. There might be a waiting period for the surgery. The procedure is brief, lasting only 5 to 10 minutes, performed under general anesthesia, and allows most women to return home the same day.
While awaiting the completion of a miscarriage, resting at home and prioritizing self-care is recommended. Over-the-counter pain relievers like acetaminophen (paracetamol) can help manage pain. Sanitary pads are preferred over tampons to reduce the risk of infection during bleeding.
Visual Guide: What Miscarriage Tissue Looks Like at Different Stages
The appearance of miscarriage tissue varies significantly depending on the gestational age of the pregnancy. Here’s a guide to help understand what you might see at different stages:
Very Early Miscarriage (around 4-5 weeks/First Month of Pregnancy)
At this stage, the developing embryo is extremely small, about the size of a grain of rice, making it virtually impossible to see. You may observe blood clots, possibly multiple, passed from the vagina. These clots might contain some whitish or greyish tissue. The bleeding should subside within a few days, though it can last up to two weeks.
Miscarriage at 6 Weeks
Most women will not see anything clearly recognizable during a miscarriage at six weeks. You may notice blood clots that contain a small sac filled with fluid. Within this sac, you might find the embryo, roughly the size of a fingernail on your little finger, along with the placenta. It’s also possible to see something resembling an umbilical cord.
Miscarriage at 8 Weeks
The tissue passed during a miscarriage at 8 weeks might appear dark red and shiny, often described as liver-like in appearance. You might identify a sac containing the embryo, which is now about the size of a small bean. Upon closer inspection, you may discern the developing features of eyes, arms, and legs.
Miscarriage at 10 Weeks
At 10 weeks, the blood clots passed are typically dark red and have a jelly-like consistency. You might observe a membrane-like structure within these clots, which is part of the developing placenta. The gestational sac will likely be contained within one of these clots. By this stage, the baby is usually fully formed but still very small and difficult to distinguish.
Miscarriage Between 12 to 16 Weeks
For miscarriages occurring between 12 and 16 weeks, you might first notice a watery discharge from your vagina, followed by bleeding and clots. The fetus at this stage is tiny but fully formed. If visible, it might be outside the sac. It could also still be attached to the umbilical cord and placenta.
Late Miscarriage: 16 to 20 Weeks
Miscarriage after 16 weeks is often termed a ‘late miscarriage.’ You might pass large, shiny, red clots resembling liver, along with other tissue pieces that feel like membrane. This process can be painful, similar to labor, and may necessitate hospital pain management. At this stage, the baby is fully formed and small enough to fit in the palm of your hand.
What Happens in the Body After a Miscarriage?
Following a miscarriage, you will experience cramping and bleeding, similar to a menstrual period. This bleeding will gradually lessen and typically stop within two weeks.
Pregnancy symptoms, such as nausea and breast tenderness, usually diminish in the days following a miscarriage. In cases of late miscarriage, breasts might produce milk. Your menstrual cycle should return within 4 to 6 weeks.
It is important to acknowledge the wide range of emotions experienced after a miscarriage and remember that support is available.
Resources and Support for Miscarriage
Consult your doctor or midwife for personalized advice and support after a miscarriage. Hospital social workers are also often available for support.
Miscarriage Australia: Offers resources on physical and emotional recovery after miscarriage. Miscarriage Australia
Red Nose Grief and Loss: Provides 24/7 support for pregnancy loss, stillbirth, and infant death. Call 1300 308 307. Red Nose Grief and Loss
NSW Health: Offers a booklet about miscarriage in multiple languages. NSW Health
The Pink Elephants Support Network: Provides information and peer support for early pregnancy loss. The Pink Elephants
Speak to a Maternal Child Health Nurse
For support and advice, call Pregnancy, Birth and Baby to speak with a maternal child health nurse at 1800 882 436 or use video call. Available 7am to midnight (AET), 7 days a week. video call
