Miscarriage, or pregnancy loss, can look and feel different for each person. Possible symptoms include bleeding, blood clots, cramping, and more.

It is important to note that bleeding is common during pregnancy — especially in early pregnancy. It does not necessarily mean that anything is wrong.

The only way to accurately identify a pregnancy loss is to test pregnancy hormone levels and have an ultrasound of the uterus.

Read on to learn more about what pregnancy loss can look and feel like.

According to a 2016 study, not all pregnancy losses involve bleeding. Overall, they do not follow a single pattern. This is why it is crucial to seek medical care for bleeding and any unusual symptoms during pregnancy.

Pregnancy loss during the first trimester may involve:

  • heavy bleeding
  • bleeding that starts light and gets heavier
  • passing blood clots or tissue
  • cramping, which may come in waves
  • a gush of fluid from the vagina

If a person takes a pregnancy test after experiencing a pregnancy loss during the first trimester, the result may be negative, or the test may have a positive line that gets fainter.

Experiencing pregnancy loss later in the first trimester and beyond will involve passing more tissue.

Second-trimester pregnancy loss can also cause intense cramping and sometimes even contractions.

In addition to bleeding and cramping, some people may notice larger blood clots.

According to a 2019 meta-analysis, one-quarter of pregnant women experience bleeding during the first trimester. Another study from 2016 puts that percentage higher, at closer to 20–40%.

A large-scale 2010 study found that about 12% of pregnant women experienced pregnancy loss, and about two-thirds of that group reported bleeding during their pregnancy.

Some differences between bleeding due to a pregnancy loss and other types of bleeding during pregnancy include:

  • Amount of blood: Heavy bleeding is more likely to signal a pregnancy loss.
  • Bleeding pattern: Bleeding that gets progressively heavier may indicate a pregnancy loss.
  • Pain: Cramping, especially when it occurs in a clear pattern, is more likely to signal a pregnancy loss.
  • Passing tissue: Some — not all — people who experience a pregnancy loss pass large blood clots or tissue.

For people who do experience bleeding during a pregnancy loss, the duration tends to depend on how far the pregnancy has progressed.

Pregnancy losses that occur in the first weeks of pregnancy tend to cause bleeding that lasts a few days. Those that occur later may cause bleeding that lasts for as long as 4 weeks.

Sometimes, the bleeding stops and starts again. Over time, it should get lighter.

A very early pregnancy loss is sometimes called a chemical pregnancy. These pregnancies are lost shortly after the embryo implants, usually within a few days or weeks.

A chemical pregnancy may be detectable by a pregnancy test, but it would likely not be seen on an ultrasound.

In many cases, early pregnancy losses can happen before a person knows they are pregnant.

In fact, around 80% of early pregnancy losses occur in the first trimester, or in weeks 0–13. The end of these early pregnancies may be mistaken for a period because the symptoms are similar.

For example, both a period and an early pregnancy loss can involve bleeding and cramping. Pregnancy tissue that passes out of the vagina may look like typical blood clots that occur during a period.

It is possible that a person will not realize they have missed a period. Instead, they may mistake the symptoms of a pregnancy loss for those of a menstrual period.

Pregnancy losses and periods can both cause:

  • vaginal bleeding
  • passing blood clots or tissue
  • abdominal pain

However, a pregnancy loss will often cause additional symptoms that set it apart from a period, especially if the pregnancy loss occurs several weeks into the pregnancy. These symptoms include:

  • larger clots or pregnancy loss tissue
  • more clots than typical periods
  • lower abdominal cramping
  • back pain
  • passing a significant amount of clear or pinkish fluid
  • sudden heavy bleeding, or heavier bleeding than a typical period
  • longer bleeding
  • sudden easing of some early pregnancy symptoms, such as nausea and breast tenderness

It is important to remember that bleeding during the first weeks of a pregnancy is not uncommon, and it is not always a sign of pregnancy loss or a problem with a pregnancy.

However, if a person experiences other symptoms of pregnancy loss, they should seek care from a doctor.

A “missed miscarriage” refers to a delay between the loss of the pregnancy and any bleeding or passing of tissue.

During a missed miscarriage, an embryo dies but does not leave the uterus for several weeks. In fact, a pregnant person may not realize the pregnancy has ended until an ultrasound finds no heartbeat.

When the embryo does leave the uterus, the blood, tissue, and clots may be dark brown. The tissue has had time to deteriorate, so bright red blood or heavy bleeding may not occur. The bleeding may last several days to several weeks.

A doctor may prescribe medication to help the person who has had the pregnancy loss bleed and pass the tissue. Surgery may also be necessary.

It is not possible for healthcare professionals to stop a pregnancy loss once it starts.

Call a doctor and schedule an appointment within 24 hours if any of the following occur:

  • vaginal bleeding
  • a fever
  • intense pain or cramping
  • bleeding that stops and starts again
  • any other changes in the pattern of bleeding, even if a doctor has already addressed the cause
  • bleeding that lasts for longer than 7 days, even if a doctor has already confirmed pregnancy loss

Pregnant people should receive emergency medical attention if they:

  • experience heavy bleeding during the second trimester and cannot reach their doctor
  • bleed heavily enough to soak through more than one pad per hour for more than 2 hours
  • feel faint, lightheaded, or confused
  • experience contractions, amniotic fluid leakage, the water breaking, or other signs of premature labor

Most pregnancy losses pass on their own.

In some cases, the fetus dies without causing any bleeding. When this happens, the person carrying the fetus may want to wait for the pregnancy to pass on its own or want it to be over as quickly as possible.

If a person wants to expedite a pregnancy loss, a doctor can supply medication that helps with passing the pregnancy at home. This approach is safest during early pregnancy.

A healthcare professional can also perform surgery to remove the remains of the embryo or fetus.

Sometimes a pregnancy loss is incomplete, leaving behind tissue that can lead to infection or other health problems. When this happens, a doctor may recommend medication or surgery.

Doctors used to advise couples to wait 1 month, or sometimes much longer, before trying to conceive again after a pregnancy loss.

However, research now shows that there is no medical justification for this recommendation. If a couple feels ready, it is safe to begin trying to conceive again right away.

A 2017 study indicates that fertility may even be slightly higher immediately following a pregnancy loss.

Sometimes, however, it takes a while for a menstruating person’s cycle to resume following a pregnancy loss.

This can make it difficult to time sexual intercourse for conception and to accurately date a pregnancy — especially if a person becomes pregnant before the first menstrual period after a pregnancy loss.

To improve accuracy, it can be helpful to:

Early pregnancy losses can sometimes result from chromosomal irregularities. This means that the developing embryo or fetus has an irregular number of chromosomes.

These irregularities usually occur at random, meaning they are unlikely to reoccur. In other words, experiencing one pregnancy loss does not increase the likelihood of experiencing another.

A 2017 study finds that 15.7% of women with a previous pregnancy loss had another during the 2-year study period.

Meanwhile, a 2016 study finds that women were more likely to become pregnant in the 3 months following a pregnancy loss.

Many people become pregnant again shortly after a pregnancy loss, and a smaller number experience multiple losses in a row.

The risk of repeat pregnancy losses increases with age, according to a 2019 study. The risk is also higher among people with a history of:

A 2017 study found that 15.7% of participants whose most recent pregnancy ended in a pregnancy loss went on to have a second pregnancy loss.

A 2018 study focused on women who had three or more pregnancy losses. This study found that 64.5% of those women had a live birth within 5 years. Some of these participants may have received fertility treatments.

Pregnancy loss is one of the less common causes of bleeding during pregnancy, especially when the bleeding occurs early on.

But bleeding in early pregnancy is not always a sign of pregnancy loss.

Some other signs of pregnancy loss include cramping and passing blood clots or tissue.

Only a healthcare professional can accurately identify a pregnancy loss. For this reason, it is important to consult a doctor or nurse midwife about any bleeding during pregnancy.

What does an early miscarriage look like?

Bleeding is common in the early weeks of pregnancy. That is why bleeding alone should not be seen as an indication of an early pregnancy loss.

In addition to bleeding, an early pregnancy loss may cause a person to experience:

  • a gush of clear or pale pink fluid from the vagina
  • passing blood clots or tissue
  • a sudden decrease in pregnancy symptoms (such as nausea and morning sickness)
  • a negative result on a pregnancy test, or a positive sign that is very faint

How do I know if I’m miscarrying?

The signs and symptoms of a pregnancy loss will remain largely the same, no matter the week. But the further along a person is, the greater the amount of tissue loss during the miscarriage.

Symptoms of pregnancy loss include:

  • sudden bleeding, sometimes heavy
  • a gush of clear or pink fluid from the vagina
  • mild to severe back pain and abdominal cramping
  • contraction-like pain

What does miscarriage tissue look like?

The clots and tissue passed during a pregnancy loss may look like typical period clots, or they may be larger.

Pregnancy loss tissue includes:

  • the fetus or embryo
  • gestational sac
  • placenta

When a pregnancy is more advanced (after 6 to 8 weeks), the gestational sac may be noticeable. Before that, it may be too small to see.

The tissue passed during a pregnancy loss may be:

  • brown
  • black
  • dark red
  • bright red or pink
  • white or gray, in some cases

If the pregnancy began to deteriorate before the start of bleeding, the clots may be smaller and darker. This is common with a missed miscarriage.

What does miscarriage tissue vs. a blood clot look like?

It is not always easy to tell the difference between pregnancy loss tissue and a blood clot. Both may look like typical period clots, though it is not uncommon for them to be larger than normal.

Actual pregnancy tissue may not be discernible until after the eighth week. Then, the tissue may look like pink, white, or gray tissue. A person may also be able to see a fluid-filled sac in the passed tissue.