Symptoms of a miscarriage

On this page you will find four categories of miscarriage symptoms: definite signs of a forthcoming miscarriage, possible signs, signs that might scare you but are really okay, and unusual periods that are not necessarily miscarriages.

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Definite Signs of a Miscarriage

You are having a miscarriage if you have already had a positive pregnancy test, then get these symptoms:

• Heavy bleeding that soaks a pad in a few hours or less and does not stop.
• Strong cramps that make you double over or breathe in a huffy way and leads to bleeding.
• Passage of tissue, resembling large thick blood clots in the earliest weeks up to pinkish/grayish material, with or without cramps or pain.

A certain amount of bleeding is pretty common in pregnany, but call a doctor. It could just be a complication, not a loss.

Small darting cramps, even if they hurt, are also okay, usually they just signal the body stretching and pulling to accommodate the growing baby. Lie down and drink some water (dehydration causes cramps), and the cramps will usually go away within the hour.

These symptoms can be other things rather than a loss of pregnancy, however, if you are not sure you are pregnant. Check the “I’m not sure I was pregnant” section.

What should you do?

If it is during doctor’s regular working hours, call your regular doctor first. They will give you instructions. If it a night or weekend, first call your regular doctor’s after-hours number. Usually this will be on their answering machine or with their answering service. The nurse or doctor on call who calls you back will help you decide if you need immediate attention or not. Don’t feel like you are bothering them needlessly; this is a natural and expected part of any OB practice.If you can’t get through, don’t have a doctor, and you are afraid, then go to an emergency room.

Be prepared for some possibly insensitive treatment. While some hospitals are well equipped for handling this situation and do a good job, often you are left alone in a room for hours, or told to sit on a toilet and catch tissue, or just sent back home because “there is nothing they can do.” It may be worth the trip, though, if they draw blood for an hCG test or give you a sonogram.

When I began bleeding heavily on an airplane on a Friday afternoon, I still waited until Monday to see my doctor. I did not want some total stranger telling me the baby had died, or to have a sonogram in an emergency room and be told to “call my doctor for the results.” While I was sad about the possible loss of the pregnancy (turns out I lost one of a set of twins at 10 weeks), I was resolved to wait for a comforting, familiar doctor’s office.

There is not really a risk to waiting until Monday or the next morning if you are in your first trimester. There is no magic way to stop an early miscarriage at the hospital. What is going to happen will happen. If you are farther along than 12 weeks, though, and you are merely in labor and not bleeding, then you should take quick action to see if labor can be stopped.If you are passing tissue at home, and it is your first miscarriage, it is not necessary to catch the tissue and take it in. You may do this if you choose, however, and you can store it in a sealed plastic bag in the refrigerator until you get to a doctor. However, it is rare that tissue caught this way will be usable. Tissue from first miscarriages is rarely tested, since it is assumed your miscarriage was due to a genetic defect. The best way to ensure testable tissue is to have a D&C.

Possible Signs of a Miscarriage

Sometimes, but not always, there may be signs that a miscarriage is pending. None of these things means a miscarriage is certain, but usually you will want additional monitoring if they happen.

Bleeding: Bleeding that starts and stops and starts and stops can be a sign that your hormone levels are falling. While you may still be okay, you need to have your blood hCG pregnancy hormone levels monitored. Heavy bleeding that soaks a pad in an hour is sometimes a sign that a miscarriage may be beginning. Keep in mind that while bleeding is always scary, 60% of all pregnancies have bleeding at some point. Both of my normal pregnancies had bleeding, heavy and red. And the one I lost at 20 weeks never even spotted.

Cramping: You are going to feel a lot of random cramping down there the whole pregnancy, front and back. The only time cramping is a concern is if you are breathing in a labor-like huff, or if you also begin bleeding with the cramps. Most cramps subside with water and rest.

Loss of pregnancy symptoms: This is a question I get all the time. While the complete and sudden loss of pregnancy symptoms can signal a pending miscarriage, usually it is not the first sign. You will have many days where you don’t feel pregnant, when the nausea abates for a day or two, or your breasts are less sore. This is expected and not a concern at all. Around weeks 10 to 14, this is completely normal, as your hormone levels even out and the placenta takes over. The loss of pregnancy symptoms during a miscarriage is usually something you see in hindsight, not ahead of time.

A pregnancy test that fluctuates between positive and negative: If you have tested super early, this is normal. However, if you are a couple weeks in, this could mean an ectopic pregnancy. Often you may also see spotting. If you have taken a pregnancy test that is positive, then another one a few days later that is negative, alert your doctor immediately. You want to rule out an ectopic or take care of it before you have to go the surgical route. If you are taking the tests in the same day, though, you might be right on the edge of a positive result, and urine later in the day may not be concentrated enough to keep the test positive. Test again the next morning to be sure.

You should always call your doctor when you are worried, however; because it is better to call for something that does not turn out to be a problem than to stay up half the night worrying about it.

When You’re Okay

Whether it’s your first pregnancy or you have already been through a loss, one thing we all have in common is worry, worry, worry. This is okay, but remember that 90% of pregnancies end with a squawling baby, regardless of the turmoil the mom has gone through to get there. Here are the most common things you will fret over, and why they are not really a problem.

Bleeding: Small amounts of brown blood (which means it’s old) are expected when the egg implants in the uterus (7-10 days after ovulation) and sometimes at the point when you would have expected your period. You may also bleed slightly after having sex, but this is probably NOT from the baby. Your cervix is soft and filled with blood, so it may bleed a little from sex. This is not considered by many doctors to be a problem, but if it alarms you, call. Up to 70% of all pregnancies have bleeding.

You will be especially scared if you see bright red blood. If you are between 10 and 12 weeks, or if it is a time you would have expected your period, do not panic. Remember that until you are quite far along, much of your uterus is not involved in nourishing the baby, and can bleed with a minor hormone fluctuation. If you are not cramping, call your doctor to let them know, stay lying down on your left side, and hopefully it will slow down, start to turn brown, and eventually stop. If you push the issue, your doctor might schedule a sonogram to put your fears to rest.

When bleeding is a problem: If it is heavy enough to make you change pads or bright red, call your doctor right away. If you begin to have cramps with the bleeding, follow the instructions under “Definite Signs” above.

Cramping: You are going to feel a lot of random cramping down there the whole pregnancy. Most of the time it is caused by the round ligaments expanding to accommodate your growing baby and uterus. If it goes away after a few pains or after you sit down and rest a bit, then you are probably all right. Cramping is a sign you are growing to accommodate the baby and sometimes a sign that you are overdoing it and should rest.

When cramping is a problem: If it continues or gets worse or if you start bleeding too, call your doctor immediately. If you begin to have labor-like breathing or a gush of fluid or blood, follow the instructions under “Definite Signs.”

Inability to eat or keep food down. This is normal! Remember that the baby is the size of a grain of rice and not exactly demanding steak dinners. When the baby starts to need the extra 300 calories a day, you will be eating fine. Just do the best you can with your saltines and soda, and remember that the more severe your morning sickness, the better your hormones are functioning.

Few or no pregnancy symptoms. Not everyone spends each day throwing up or sleeping all the time. Many people have symptoms that are light or nonexistent. This does not mean you will miscarry. Each pregnancy is different, and usually pregnancies after the first will be easier on your body. I had so few pregnancy symptoms the third time around that I actually ordered a margarita at a restaurant before my husband said, “Aren’t you forgetting something?” This never would have happened with Emily, when I spent every non-working hour sleeping or bawling over a migraine.

You should always call your doctor when you are worried, however; because it is better to call for something that does not turn out to be a problem than to stay up half the night worrying about it.

Unusual Periods that Are Not Necessarily Miscarriages

There are many things that can happen in a cycle to make you wonder if you were pregnant and lost a baby, but you never took a test to know for sure. For information on this topic, click on “I’m not sure I was ever pregnant.”

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