What Symptoms Can I Expect During a Miscarriage?

All over the internet, there are articles about what miscarriage is from a technical standpoint but it’s rare that, as women, we can find the actual nitty-gritty details about what symptoms to expect during and after a pregnancy loss. The more we know, the better we can advocate for ourselves and receive support from those around us.

When I went through my first miscarriage, it was three weeks after learning that our baby was no longer growing. It took my body three whole weeks to recognize what was happening and those weeks were torture for my husband and I. Even though it took three weeks to recognize the loss, it only took about three hours from start to finish, to miscarry our first child. I have never been so broken in my entire life, nor had I ever been so unprepared for something.

Within six months, we suffered a second pregnancy loss and chose to undergo medical treatment to prompt uterine cramping to miscarry at home, thinking we would be more prepared the second time around. Unfortunately, that did not prove to be true and I had to have a D&C a few days later. What I’ve learned from my experiences could save you from feeling as unprepared as I was.

Obviously, we know that during a miscarriage, we go from being pregnant to no longer being pregnant. But what does miscarriage really look like? What symptoms should you expect during the physical loss and the weeks that follow? Here’s everything you need to know about miscarriage symptoms.

Important things to know about miscarriage

You have options

In many instances, you have options when it comes to how you miscarry. If you are afraid of miscarrying at home (which we totally get), ask your doctor about having a dilation & curettage (D&C). This scenario may, however, be the other way around — your doctor may recommend a D&C, but you may have a hard time affording the procedure, even through insurance. It’s important to know what your options are. And, as always, don’t be afraid to ask questions.

How to physically prepare for a miscarriage

• You won’t be able to use tampons during your recovery, so make sure to stock up on extra wide, large maxi pads. The overnight ones work best.
• Other items to buy would include adult diapers for comfort during the first few days after loss, especially if you miscarry at home without any intervention.
• A heating pad will work wonders for cramps you may experience for 2-4 weeks after your loss as your uterus shrinks to it’s pre-pregnancy size.

What miscarriage symptoms to expect

The most important thing for you to know about miscarriage (and pregnancy loss in general) is that it’s in no way your fault that this is happening to you and your family. Most women will feel self-blame during and after a miscarriage but it’s important for you to know that this is happening to you, not because of you.

If you think you might be miscarrying, here are some tips for what to expect. Of course, we *in no way* mean to freak you out. We just want you to be prepared. If you do miscarry, it will undoubtedly be incredibly tough in so many ways. But hopefully, these tips help give a heads up for what you might expect.

At-home miscarriage

What you should know:

• While some women experience bleeding that’s heavier than their period, other women experience intense cramping during a first-trimester miscarriage. If you do not already experience heavier PMS or cramps during your period, you may be caught off guard with your miscarriage experience.
• Even at a young gestation, these miscarriage symptoms can be physically taxing
• Many women describe miscarriage as labor, with painful contraction-like pains (even during the first trimester)
• If you are miscarrying at home, here are some reasons to go to the nearest emergency room/call your doctor.
• Abdominal pain that cannot be tolerated, despite treatment with over the counter medications such as tylenol or motrin.
• Heavy vaginal bleeding, or more than 2 pads per hour in the first few hours of bleeding. If you are feeling lightheaded, dizzy, have palpitations, chest pain, or shortness of breath, it could be a sign that your blood pressure is low from losing large amounts of blood.

What you might see:

• It’s possible that you’ll see a mixture of dark and bright red blood mixed with blood clots that range in size from dime size to as big as a lemon
• During the process of a miscarriage, you may pass tissue, or even an intact pregnancy sac that is recognizable.
• Depending on the gestational age of your pregnancy, you may be able to identify the pregnancy after the birth.

How to prepare:

• Don’t be afraid to ask your healthcare professional for a pain reliever recommendation or prescription. During the thick of miscarriage, the pain may be heightened, and having something available to alleviate pain will be one less thing to worry about.
• Have your partner, a family member, or friend with you during the physical loss. Although it seems like something you would rather do on your own, you will need support from others.

Recovery may look like this:

• Once you have passed the pregnancy, recovery will begin. You may experience heavy bleeding for another few days and then the bleeding will start to fade into lighter and lighter until it stops. Some women bleed for a few days to a few weeks after their physical miscarriage.
• You may feel sore and physically weak during the first few days after your miscarriage. This is normal as your body just went through a lot, both physically and mentally, and needs to rest. Give yourself the time to rest and begin to heal. If possible, take off of work for at least 3-5 work days. Taking more time off from work may benefit your mental health as you cope with your miscarriage. Don’t be afraid to ask your employer for bereavement leave.
• It’s important to check in with your doctor and partner during your recovery period. This may also be a good time to look into therapy or behavioral therapies. Experiencing miscarriage may be traumatic and taking care of your mental health is a priority.It can take 3-6 weeks (sometimes even longer) for the pregnancy hormones to leave your body entirely, which will ultimately trigger your first period post-miscarriage. Give your body time to recover chemically, and remember that recovery looks different for everyone.

Taking Cytotec (Misoprostol) for miscarriage

What you should know:

• Cytotec is not the same medication given to terminate a pregnancy. It’s actually most commonly used to induce labor at all gestations, including live births in the third trimester.
• The medication can be given orally, vaginally, or be dissolved in between the gums and the inner cheek.
• From the time you take the medication, you may start to feel the effects 30 minutes after to a few hours.

After taking the Cytotec, many of the same tips above for an at-home miscarriage will apply. The only change to look for would be intensified cramping due to the medication. At any point in your miscarriage if you fill a pad in under an hour or feel that your blood loss is more than expected, please call your OBGYN or go to the nearest emergency room.

Having a D&C (Dilation & Curettage):

What you should know:

• Most often performed in the operating room and under general anesthesia, but may also be performed in your doctor’s office with controlled pain medications.
• They’re covered by most insurance plans but could require high out-of-pocket costs.

How to prepare:

Follow the directions of your physician and prepare yourself for the recovery period. There may be restrictions on eating prior to the procedure, requirements with hydration, or other protocols to follow.

Recovery may look like this:

• You may experience bleeding for a few days to a few weeks after the D&C.
• Slight cramping is considered normal for multiple weeks after the procedure.
• Even though having the procedure seems like a less physically demanding process compared to miscarrying at home, the recovery may look very similar and the emotional recovery still exists. Give yourself time to begin healing, but don’t put expectations on yourself to grieve and move on within a week.

We’re here for you

Although there are a few different options for experiencing a miscarriage physically, each comes with its own aspects and recovery process. It’s important to know your options, understand what they mean, and move forward from a knowledgeable place.

After you physically miscarry, it’s so important to take the time necessary to grieve, or begin to grieve, and think of how you want to move forward with your family. This may look like taking some time off to heal — although, let’s be honest, you don’t ever fully heal and these experiences stick with you. For those undergoing fertility treatment, speaking to your doctor about how the miscarriage may impact the treatment timeline, especially if you want to try to conceive again as soon as possible.

Know that this is a difficult part of the journey, but you will get through it. And we’re right here with you.