A miscarriage, also called pregnancy loss, can look and feel different for each person. Possible symptoms include bleeding, passing blood clots, cramping, and more.
It is important to note that spotting or bleeding is common during pregnancy, especially early pregnancy. This is known as implantation bleeding. It does not necessarily mean that anything is wrong.
That said, anyone experiencing this symptom should contact a doctor. The only way to confirm a pregnancy loss is for a medical professional to test pregnancy hormone levels and perform an ultrasound of the uterus.
Read on to learn more about what pregnancy loss can look and feel like.
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Pregnancy loss does not follow a set pattern in all people. However, some of the common symptoms in early pregnancy include:
- vaginal bleeding, which is often heavy
- passing blood clots
- lower back pain or pressure
- cramping, which may come in waves
- fluid from the vagina, which may be clear or pink
Some people only experience mild cramps. For others, the pain may be severe.
Before 8 weeks of gestation, the embryo will be very small. A person may not see or notice it. After 10 weeks, the embryo becomes a fetus and will be larger. Pregnancy loss in the second trimester may involve passing more tissue or larger blood clots.
Tissue passed during a pregnancy loss may be:
- brown
- black
- dark red
- bright red or pink
- white or gray
If a person takes a pregnancy test after experiencing a pregnancy loss, the result may be negative, or the test may have a positive line that gets fainter.
A small amount of bleeding is common in early pregnancy and does not necessarily indicate a pregnancy loss. According to a 2019 meta-analysis, approximately 25% of pregnant people experience bleeding during the first trimester.
Additionally, according to the American College of Obstetricians and Gynecologists (ACOG), about half of people do not experience any bleeding before a pregnancy loss. They may have other symptoms first.
As a result, there is no one pattern that pregnancy loss bleeding will always follow. When a person does experience bleeding for this reason, it may be:
- heavy
- progressive, starting light or with spotting, but getting heavier as time passes
- accompanied by cramping, particularly if the cramps happen in waves
It is crucial to seek medical care for bleeding or any unusual symptoms during pregnancy.
In some cases, early pregnancy losses happen before a person knows they are pregnant. Because the symptoms are similar to those of a period, people may mistake one for the other.
This is especially the case for very early pregnancy losses, also known as “chemical pregnancies.” These pregnancies end shortly after the embryo implants.
Both pregnancy losses and periods can cause:
- vaginal bleeding
- passing blood clots or tissue
- abdominal pain
However, a pregnancy loss may cause additional symptoms that set it apart from a period, especially if the pregnancy loss occurs several weeks into the pregnancy. These symptoms include:
- bleeding that lasts longer or is heavier than a typical period
- bleeding that starts or stops suddenly
- passing tissue
- passing larger clots than during a typical period or passing clots more frequently
- passing a significant amount of clear or pinkish fluid
- a sudden easing of some early pregnancy symptoms, such as nausea and breast tenderness
A doctor may be able to identify whether a person has had a period or experienced pregnancy loss via testing.
Learn more about differentiating a period from pregnancy loss.
If a person experiences bleeding during a pregnancy loss, the duration tends to depend on how far the pregnancy has progressed and how the pregnancy loss occurs.
Sometimes, bleeding may happen suddenly and stop quickly. In other cases, it may last several hours or a few days.
Some people refer to a delay between pregnancy loss and any bleeding or passing of tissue as a “missed miscarriage“.
When this occurs, an embryo dies but does not leave the uterus for several weeks. 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.
Most pregnancy losses pass on their own. A doctor may recommend waiting for this to happen naturally. However, there are some situations where medical treatment is necessary.
This could involve:
- Medication: A doctor can supply medication that helps with passing the pregnancy more quickly at home. This approach is safest during early pregnancy.
- Vacuum aspiration: This procedure removes the contents of the uterus via suction. Doctors do this when not all the pregnancy tissue passes on its own. A doctor may be able to perform this procedure in their office.
- Dilation and curettage (D&C): If a person has a more advanced pregnancy or is bleeding heavily, doctors may recommend a D&C. This involves dilating the cervix and removing the material from the uterus.
A person cannot stop a pregnancy loss once it starts. However, there are still things a doctor may need to address to prevent complications, such as infections.
It is important to call a doctor if a pregnant person experiences:
- any vaginal bleeding, particularly if it gets progressively heavier
- intense pain or cramping
- bleeding that stops and starts again
- bleeding that lasts a long time, even if a doctor has already confirmed pregnancy loss
Pregnant people should receive emergency medical attention if they:
- experience heavy bleeding, fever, or chills, and cannot reach their doctor
- bleed heavily enough to soak through more than two pads per hour for more than 2 hours
- feel faint, lightheaded, or confused
- experience contractions, amniotic fluid leakage, water breaking, or other signs of premature labor
It is possible to become pregnant as early as 2 weeks after a pregnancy loss. However, it is important that people feel physically and emotionally ready to try conceiving again.
People should not put anything inside their vagina for at least 1 to 2 weeks after experiencing a pregnancy loss, including tampons, to reduce the risk of infection. After this point, if they feel ready, it may be safe to begin trying to conceive again.
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Sometimes, though, it takes a while for a person’s menstrual cycle to resume. This can make it difficult to time sexual intercourse for conception and to date a pregnancy accurately. To increase accuracy, it may be helpful to:
- wait until after the next period
- monitor basal body temperature
- use ovulation tests
It can also take time to recover emotionally after pregnancy loss. It is typical for people to experience sadness, grief, or shock. If they do want to try conceiving again, they may need support in recovering from the experience before they feel ready.
According to ACOG, fewer than 5 in 100 people have two pregnancy losses in a row.
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.
Many people become pregnant again shortly after a pregnancy loss, but a small number experience multiple losses. In around half of cases, the reason for this is uncertain.
The risk of repeat pregnancy losses increases with age, according to a
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Depending on the timing, having two or more consecutive pregnancy losses may require further investigation to try and find the cause.
Below are some commonly asked questions about pregnancy loss.
How can you tell if you have had a miscarriage?
The only way to know for sure is to ask a doctor. They may use an ultrasound scan, blood tests, or a pelvic examination to make a diagnosis. Sometimes, they may need to perform the tests several times to be certain.
What does an early miscarriage look like?
A very early pregnancy loss may be hard to distinguish from a period. There may be bleeding and, sometimes, blood clots.
However, with pregnancy loss, the bleeding tends to be heavy, and a person may pass fairly large clots. Severe cramping is also common. Some people may notice a sudden decrease in pregnancy symptoms, such as nausea.
What does miscarriage tissue look like?
Pregnancy tissue may not be discernible until after 8 weeks. Then, the tissue may look pink, white, or gray. A person may also be able to see a fluid-filled sac in the passed tissue.
Bleeding in early pregnancy is not always a sign of pregnancy loss. In cases where it is, the bleeding may be heavier than a person’s typical period, and they may pass clots or tissue. People may also experience cramps that occur in waves.
Only a healthcare professional can accurately identify a pregnancy loss. For this reason, it is important to consult a doctor or certified nurse-midwife about any bleeding during pregnancy.