Miscarriage: Signs, Options, Recovery and Grief

The basics

• Early pregnancy loss means losing a pregnancy before 13 weeks. It happens in about 1 in 10 known pregnancies, and more often as age rises.
• About half are caused by a chromosome problem in the embryo that happened by chance.
• It is not caused by exercise, sex, work, lifting, a minor fall, an argument, mild stress, or morning sickness ending. Nothing you did or didn't do is the reason.

Signs

• Bleeding that becomes heavier than spotting, often with cramping, and sometimes passing tissue or clots.
• Sometimes no symptoms: a loss is found on an ultrasound (a missed miscarriage).
• Spotting alone is common in healthy early pregnancies, so a scan and sometimes blood tests (hCG levels) are used to confirm what's happening.

Your three options (when there's no emergency)

• Waiting: letting it pass on its own. Works for most people within a few weeks; avoids procedures.
• Medication: pills that help the uterus empty, usually within days. Bleeding and cramping can be heavy for a few hours.
• Procedure: uterine aspiration (sometimes called a D&C), in an office or operating room. Quickest and most predictable; often chosen when bleeding is heavy or you want it over.
• All three are safe and effective. Your choice can depend on timing, privacy, cost, and how you want to experience it.

Practical care at home

• Use pads, not tampons, so you can track bleeding.
• Pain relief and a heating pad help with cramps; ask which medicine to use.
• If you're Rh-negative, ask whether an anti-D shot is needed. Current guidance says it often isn't before 12 weeks.
• Bleeding usually tapers over 1-2 weeks. A period typically returns in 4-6 weeks.
• Ovulation can come back within about 2 weeks, so use contraception if you don't want to conceive.
• There's no medical need to wait before trying again once you feel ready, after bleeding stops.

Grief

• A loss at any stage can be devastating, a relief, or something in between. All of these are valid.
• Partners, co-parents, intended parents and surrogates feel loss too.
• Some people name the baby, keep a scan photo, or mark the due date. Others prefer to move on quietly. Both are fine.
• It's fine to tell work only that you have a medical issue and need time off.
• If it happens twice or more, testing for causes is often offered. See the pregnancy after loss guide.

When to check in

• Contact your provider the same day for a fever of 100.4°F (38°C) or higher, foul-smelling discharge, or bleeding that lasts beyond 2 weeks.
• Reach out if sadness or anxiety lasts weeks or makes it hard to function. The National Maternal Mental Health Hotline is 1-833-852-6262.
• If you soak two maxi pads an hour for two hours in a row, feel faint, or have severe one-sided belly or shoulder-tip pain (possible ectopic pregnancy), call 911 or go to the emergency room.