Miscarriage Symptoms: 8 Signs & When to See a Doctor

Miscarriage symptoms may include vaginal bleeding or spotting, cramping or pain in the lower abdomen or back, and passing fluid, blood clots, or tissue from the vagina. Some miscarriage symptoms, such as heavy bleeding, severe pain, fever, or foul-smelling discharge, require urgent medical evaluation.

A miscarriage is pregnancy loss that occurs before the 20th week of pregnancy and can happen for many different reasons, including changes in fetal development, infections, trauma, or certain health conditions. Miscarriage symptoms can vary depending on the stage of pregnancy and whether the pregnancy tissue has been completely expelled from the uterus.

Miscarriage symptoms are usually evaluated with a pelvic exam, ultrasound, and sometimes hCG blood tests to confirm pregnancy loss. Treatment depends on the type of miscarriage and may include monitoring, medication, or procedures to remove retained pregnancy tissue and help prevent complications.

Signs of miscarriage

The main miscarriage symptoms are:

1. Vaginal bleeding, which may start as spotting or brownish discharge
2. Cramping or pain in the lower abdomen, similar to intense menstrual cramps
3. Passing blood clots or tissue from the vagina
4. Fluid leaking from the vagina, with or without pain
5. Fever and chills
6. Foul-smelling vaginal discharge
7. Severe or constant headache
8. Reduced or absent fetal movement later in pregnancy

If a miscarriage is suspected, seek medical care as soon as possible and tell the doctor about all symptoms you are experiencing.

How to confirm

A miscarriage is usually confirmed with a transvaginal ultrasound after the doctor evaluates the symptoms and performs a pelvic exam.

The OB-GYN or Certified Nurse-Midwife may also order a quantitative beta-hCG blood test, especially when the ultrasound is inconclusive or when no pregnancy can be seen.

Miscarriage vs late period

In some cases, it can be difficult to tell the difference between bleeding from a late period and bleeding from a miscarriage.

With a miscarriage, bleeding may start as spotting and become heavier over time. It may also be accompanied by cramping, lower abdominal or back pain, and passing blood clots, fluid, or grayish tissue from the vagina.

According to the American College of Obstetricians and Gynecologists (ACOG), symptoms such as cramping, abdominal pain, or passing tissue may increase concern for miscarriage. However, a medical evaluation may be needed to confirm the cause of bleeding.

How to prevent a miscarriage

Not all miscarriages can be prevented, and many happen due to factors outside a person’s control. However, some steps may help support a healthy pregnancy, such as avoiding alcohol and only taking medications that have been approved by a doctor.

Pregnant women should also follow their doctor’s guidance on physical activity, which may include light or moderate exercise or exercises specifically recommended during pregnancy. Regular prenatal care is also important to monitor the pregnancy and complete any tests requested by the OB-GYN or midwife.

Some women may have a higher risk of pregnancy loss due to medical history or health conditions. In these cases, closer follow-up with an OB-GYN may be recommended.

Types of miscarriage

A miscarriage may be classified based on whether the pregnancy tissue has been completely expelled from the uterus, partially expelled, or remains in the uterus. The main types include:

• Incomplete miscarriage, when only part of the pregnancy tissue is expelled or the membranes rupture

• Complete miscarriage, when all pregnancy tissue is expelled

• Missed miscarriage, when a miscarriage has occurred but the pregnancy tissue is still inside the uterus

Miscarriage can also be classified as early, when the pregnancy loss happens before the 12th week of pregnancy, or late, when the pregnancy loss happens between the 12th and 20th weeks of pregnancy.

What to do after a miscarriage

After a miscarriage, a doctor may perform an exam, ultrasound, or other tests to check whether any pregnancy tissue remains in the uterus. If retained tissue is found, treatment may be recommended to help prevent complications such as infection or heavy bleeding.

Depending on the situation, treatment may include medication to help expel the remaining tissue or a procedure, such as uterine aspiration or dilation and curettage (D&C), to remove it.

Potential complications

After a miscarriage, some people may experience emotional effects, such as grief, guilt, anxiety, depression, or changes in behavior and quality of life.

Physical complications after a miscarriage are uncommon, but they can occur, especially if pregnancy tissue remains in the uterus. Possible complications include:

• Heavy bleeding
• Infection
• Retained pregnancy tissue that may require medication or a procedure to remove it

The risk of complications may increase without proper medical follow-up. Seek urgent care if symptoms such as heavy bleeding, severe pain, fever, chills, or foul-smelling vaginal discharge occur.