If you choose to wait it out for a natural miscarriage, you will most likely have a difficult wait. It may not seem real; you will harbor hope that it will never happen. Eventually the cramping and bleeding will begin, and you may react with severe grief and panic. You may feel ridiculous or morbid trying to catch tissue in a jar or plastic bag for testing. All these things are fine. Do the best you can. If all goes well, the cramps will subside and a regular blood flow will resume. Keep in mind that you may not pass all the tissue and will have to have a D&C to empty your uterus.

During the next few days you will likely experience the following:

• Cramps and bleeding, sometimes quite painful and heavy.
• Passage of tissue, resembling large blood clots in the earliest weeks up to pinkish/grayish material, possibly even in a discernible sack. Try not to traumatize yourself by searching for the baby. Most of what you see will be bits of the placenta. Believe me, I understand the impulse. Not seeing my baby was traumatizing in itself. And mine was fully formed at 20 weeks. Just do the best you can.
• If you collect the tissue, it may be refrigerated until you take it for testing. If this is your first miscarriage, it is not necessary to keep the tissue. It is rarely tested in this case. Any tissue that falls into the toilet is not testable, so you do not need to retrieve it.

Call your doctor if you experience the following:

• Any sort of abdominal pain that lasts beyond the cramping stage. You could be developing an infection. Don’t panic though, just call and you will get an antibiotic and a check up.
• A fever that starts to approach 100 degrees. Again, infection is a possibility.
• Cramps beyond endurance. You may need a pain medication or a D&C.
• Bleeding that comes heavy and fast, soaking a pad every few hours, for more than three days. If the bleeding does not slow down after that, you may have tissue that is causing hemorrhaging, and you will need a D&C.
• Bleeding that lasts longer than two weeks. A D&C may be necessary.
• Bleeding that starts and stops and starts and stops for weeks. Some tissue is still causing hormones to be created, and you will need intervention.

You will feel some of the following as the days and weeks wear on:

• A mild start and stop bleeding pattern up to two weeks. You should have a new cycle, unrelated to the first bleeding, between 4 and 7 weeks after the miscarriage. I didn’t get a fresh cycle until the last day of the 7th week, so don’t panic if you are still waiting. A few women need a Provera shot to jump start their cycle, but this is not terribly unusual. Call your doctor if you go much longer than 7 weeks, just for your peace of mind. You may want to start charting your temperatures after the bleeding stops to see where you are. Remember that you can get pregnant that first cycle, so use contraceptive. For more information, see the section on trying again.
• Snappy, unhappy, angry feelings. Wanting to be left alone or wanting to talk about what happened with everyone you know.\
• A sense that it isn’t real, that it never happened.
• Hypersensitivity to sad TV or reading materials, being revolted or angry about happy scenes of families, seeing symbols in everything you do, from gardening to dreams to what you eat.
• Anger at the baby, wishing you never knew about the pregnancy, wanting to throw out all the baby reminders, or clinging to the little angel you lost, thinking about him/her nonstop, wanting everyone to recognize that the baby was real.
• Anger and/or jealousy of other pregnant women, even friends and family, to the point you don’t want to even talk with them. This is okay. I felt this way for several months.