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When I had my first miscarriage at 8 weeks, I had no idea what to expect. We don’t talk about the physical process of miscarriage enough, or how different it is at different points in pregnancy and for each individual.

Since 1 in 4 pregnancies end in miscarriage, it’s absurd that women don’t know more about what to expect when miscarrying. So I’m here to tell you. Whether you’re experiencing an early chemical pregnancy or a late-term loss, a spontaneous loss or a missed miscarriage, here’s what you can expect of the process.

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*Disclaimer: I am not a medical doctor; I have a PhD in English and have experienced recurrent miscarriage. This article is about your physical body: what to expect when miscarrying. It tells you things other people, including doctors, might not. But my advice should never replace that of a medical doctor. I’m here as an educated and experienced resource, never as a medical resource. For more information, read our full disclaimer.

What To Expect When Miscarrying

There are different types of pregnancy loss, so for the sake of simplicity, I’ll break them into 3 categories:

  1. Spontaneous–your body begins cramping and bleeding on its own
  2. Missed miscarriage–you find out at a doctors appointment, likely because of decreasing HCG levels (early miscarriage, before 6-7 weeks) or during ultrasound (later miscarriage, after 7-8 weeks).
  3. Ectopic pregnancy–an embryo implants in your fallopian tube instead of your uterus

This is, admittedly, an oversimplification, but it gives me a way to talk about the different possibilities. It also allows you to know where to scroll to, depending on what you’re experiencing.

I’ll talk about them in order.

One final thing you should know: the medical term for miscarriage is “abortion.” Be prepared, in case you see it on your chart.

1. Spontaneous Miscarriage

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This will likely be listed on your medical chart as “spontaneous miscarriage” or “spontaneous abortion.” I’ve had 2 of these.

What Does It Mean?

You’re pregnant, and you begin bleeding and cramping. Heavy bleeding is often a sign of miscarriage in early pregnancy, although it can be caused by other problems, like a subchorionic hemorrhage (SCH).

Note: An SCH increases your risk of miscarriages, but about 50% of women who develop an SCH carry successful pregnancies.

What Will Happen?

You will start cramping and bleeding. For me, the two came at about the same time. Some people cramp first; others bleed first.

Now, when I say bleeding, here’s what I mean, and I’m going to get graphic because there’s no other way.

I mean bright red blood, and gobs of it. You’re soaking through pads. (Never put in a tampon during a miscarriage).

It’s not just runny red blood. It likely contains clots and clumps of fleshy pieces.

*Note: If you’re experiencing red spotting; contact your doctor. This could be an early sign of a miscarriage. It could also be a sign of something else, like a subchorionic hemorrhage (SCH). SCH blood can gush, but rarely contains clots.

If the blood is brown, it could again be an early sign of miscarriage. It could also be something as common as implantation bleeding. Believe it or not, bleeding in healthy pregnancies is not uncommon.

Miscarriage at 6 Weeks Gestation

When you ask what to expect when miscarrying at 6 weeks pregnant, most people will tell you it’s “like a heavy period.” This is sort of, kind of, a little bit true.

Yes, it’s like an extremely painful heavy period, but probably with a fleshiness to it. Cramps are generally much stronger than menstrual cramps, although some women do report period-like cramps.

More than likely, the bleeding and cramping will last a few days, with the most serious parts happening within a few hours.

Over-the-counter pain medicine will likely suffice to manage pain, unless you have an unusual experience (always possible) or a very low pain tolerance (no judgment here. I’m right there with you.)

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For most women, an early miscarriage is not just a heavy period. It usually hurts worse, you bleed more, and there’s a lot more uncertainty.

Support people, please don’t compare this experience to a period and move on. That’s extremely unfair. Learn what not to say to someone who had a miscarriage.

When to go to the ER? If you soak through a menstrual pad in an hour, go to the emergency room. No one wants to risk passing out on their bathroom floor.

*NOTE: When I say pad, I mean a menstrual pad. Not a pantyliner or a small maxi pad. The big, thick things. I hate to say it, but I keep these on hand even though I don’t use them. Because if I ever get pregnant again and a miscarriage begins, I know this is my gauge. Go ahead and in the early weeks of pregnancy; you’ll need them postpartum anyway! The ones below are my favorite.

Miscarriage at 8 Weeks: What to Expect

At 8 weeks, you can expect a miscarriage to be bloodier, fleshier, and more painful than at 6 weeks. If you are open to pain medication, call your doctor, tell them what’s happening, and ask for a prescription.

Send someone to get it for you.

Do not drive.

You may be able to get away with over-the-counter meds, but honestly, I wouldn’t risk it. (This coming from someone who hates pain. If you can manage pain well, go for it!)

At 8 weeks, you’ll have cramps combined with a more minor version of contractions. Also, unless the fetus stopped growing earlier, you may see something that resembles a tadpole-like baby. Not everyone is prepared for this part, but it’s real. You’re birthing this tiny thing.

At this point, most women prefer to miscarry in the bathtub. It soothes the pain, provides a little comfort, makes cleanup easy, and you don’t need menstrual pads or heading pads.

But keep an eye on your bleeding and how you feel. Have someone vigilant around in case you start feeling lightheaded.

When to go to the ER? Again, If you soak through a menstrual pad in an hour, go to the emergency room. If you start feeling even a little lightheaded, go to the hospital, or call an ambulance if you’re alone. Do not risk passing out from blood loss in the bathtub!

Now, let me be clear, it’s not likely that you’ll pass out from blood loss. But it happens, which is why self-monitoring is so important. I never even came close. But I still know the signs to look for.

*Note: This advice is for the serious parts of miscarriage where you’re passing the baby. Bleeding and cramping can last for days or weeks, but there will be a more extreme time when you actually pass the fetus and gestational sac.

10+ Weeks Gestation

When miscarrying at 10 weeks, you can expect similarities to birthing at 8 weeks, but much more intense. You likely will have actual contractions. Not full on, 40-week labor contractions, but actual contractions. You have to give birth.

See all our notes about 8 weeks, and about bleeding at 6 weeks, but know that yours will be even more intense. At 12 weeks, it gets even more intense. 14 even more.

My recommendations for bathtubs and prescription pain meds get even stronger here.

And please don’t miscarry this late alone. If you’re alone, find someone to come over as support, or go to the hospital to be safe.

*Note: The timeframe of a spontaneous loss is extremely variable. My first natural loss lasted just over a week. I had 1 heavy night, thought the worst was over, until the next weekend when I actually, fully lost the pregnancy. But I cramped and bled in between–the in between was just like a period, but night 1 and weekend 2 were special beasts that in no way resembled my monthly menstrual cycle.

Second-Trimester Miscarriage

I have no experience here and would love for someone to write about it at some point. As such, I can’t tell you based on personal experience what to expect when miscarrying during the second trimester.

But my advice, based on people I know who’ve been through it, is to go to the hospital.

You’re giving birth. Your body goes through labor. Being medically supervised could be important.

2. Missed Miscarriage

What is a missed miscarriage?

With a missed miscarriage, you experience few to no symptoms. Everything seems to be going along fine.

Then, you go to the doctor, and you find out it’s not. This can be a real mindf***. I’m so sorry.

I am so, SO sorry.

With a missed miscarriage, you’re simultaneously in the best and worst of situations, given the circumstances in terms of what to expect when you miscarry.

It’s the best of situations because you get to choose how to proceed.

It’s the worst because you have to choose how to proceed.

Here are your choices.

Option 1: Dilation and Curettage (D&C)

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Trying to maintain a sense of humor before my D&C

A Dilation and Curettage (D&C) is a surgery in which your doctor will clean out the contents of your uterus.

I’ve had 1 of these.

What should you expect if you choose a D&C when you’re miscarrying? You schedule surgery, go in, come out, and recover. It’s a minor surgery with a minor recovery. At least physically. The emotional toll will vary greatly. If you’re in the US, it’s costly.

Talk to your doctor about the risks, pros, and cons, to help make this decision. Here are a few:

D&C Pros:

Control. This whole experience feels so out of control, but if you choose a D&C, you schedule the time, the place, and the doctor. You know what to expect.

Anesthesia. You’re put to sleep (if a doctor ever says they’ll do an epidural, please, probe as to why they aren’t fully anesthetizing you). You’ll wake up, and it’s over. Physically, at least. You may cramp and bleed for the next week or so, but minimally. Physically, I found this to be MUCH easier than natural losses.

D&C Cons

Anesthesia again. Being anesthetized is really scary for some people and certainly comes with inherent risks.

A medical experience over an emotional one. This method is extremely medical–if you need the closure of birthing and seeing whatever has grown of the little one you’ve been carrying, a D&C probably isn’t for you.

Scar tissue build-up (Asherman’s Syndrome). There is a very small risk of scar tissue buildup that can cause problems later, especially if you have multiple D&Cs. The risk is low, but if it happens, it can cause complications in later pregnancies, as well as with your menstrual cycle.

Cost: If you’re in the US, this procedure can be very expensive. Talk to your hospital about cost before moving forward with the procedure.

Option 2: Wait to Miscarry Naturally

If you make this choice for your missed miscarriage, go back to our discussion of #1: Spontaneous Pregnancy Loss, to learn more about what to expect.

My doctor strongly discouraged this option because my body was showing no signs of miscarrying on its own.

My HCG levels were rising, I was not cramping, not even spotting.

If you’ve been cramping and mildly spotting, or if your hormone levels are dropping, it might happen sooner for you.

Natural Loss Pros:

Confidence. You feel 100% confident that you did the right thing. I never questioned whether my diagnoses could’ve been wrong, but some women do. If you aren’t 100% certain that your pregnancy is over, waiting is essential.

Knowing Your Body Can Do This. Losing a pregnancy makes many women feel like their bodies have failed. A natural loss can often serve as an emotional reminder that your body is handling reproductivity on its own.

Natural Loss Cons:

Waiting. The emotional toll of knowing you’re pregnant with a non-viable pregnancy is hard. I wanted to wait for a natural miscarriage when I had my D&C. After 1 night at home, sobbing over a toilet while I dry heaved from pregnancy sickness and knew it was all for nothing, I changed my mind. I scheduled my D&C the next day, and I’m so thankful I did.

Risk of infection or other complications. If your body carries a non-viable pregnancy for too long, you risk developing very serious infections and other potential problems. Talk to your doctor about those risks. So, if you’re showing no sign of miscarrying naturally, it might be risky to wait it out.

Option 3: Medically-Induced Miscarriage

This means you take a medication like Misoprostol/Cytotec.

Your doctor may tell you to take it orally or may instruct you to insert it vaginally.

I have seen abundantly varying results with this option, which is why I have never chosen it. It’s also the hardest to tell you what to expect because it is so different for everyone.

(This is true of all types of losses and interventions, but especially of medically-induced miscarriage.)

For many women, it works beautifully and they miscarry quickly. In these cases, refer back to #1: Spontaneous Pregnancy Loss. Note that many do report experiencing heavier cramping with Misoprostol than with spontaneous losses.

For other women, however, this medication causes extreme pain, excess bleeding, and/or doesn’t lead to a full miscarriage, meaning they still end up needing a D&C. However, I don’t have statistics on this.

I have never chosen this route because I’m admittedly afraid of it. I know tons of people who thought it was an easy drug to take, but I know many others who experienced major complications with it.

If you choose this route, my suggestion would be to ask for prescription pain medicine in case you need it and to never take it alone. If you’re among the women who experiences complications, you’ll need a support person within quick ear’s reach.

Medicated Pros:

Choice/timing. You can choose the time you take it on your own terms, but be able to experience the actual loss at home. It’s a good in between option between waiting for a fully natural loss and having a D&C.

Cost. If the choice is medicated induction vs. D&C, you come out spending WAY less money with medication.

Medicated Cons:

Partial miscarriage. If the medication does not cause a complete loss, you may still end up needing a D&C.

Complications. Some women report excess pain and bleeding.

Social Judgment. When you read stories about about pharmacists refusing to give out “abortion pills,” this is what you’re reading about. I don’t personally know anyone who has experienced this, but I’m terrified of how hurtful it would be.

*Note: Complications with misoprostol are rare. My research suggests that a very small number of women who take it need a D&C or end up being hospitalized for hemorrhage.

Anecdotal evidence makes it seem like a larger number, likely because people who had bad experiences are more vocal. Thus, while I’m most hesitant about this option, research does not indicate that I actually should be.

maxi-pads-and-other-miscarriage-supplies-on-floor

3. Ectopic Pregnancy

This is a completely different scenario than any listed above, and it’s honestly much more serious. I have had 1 of these.

What to expect with this an ectopic pregnancy depends on how far along you are in your pregnancy. Look for the signs early, especially if you have a history of ectopic pregnancy. If you’re interested in ectopic pregnancy stories, you can read Beth’s here.

If you experience any signs of an ectopic pregnancy, please see your doctor immediately.

Signs include:

  • Extreme pain on one side of your abdomen. I don’t mean cramping; I mean a sharp, stabbing pain that comes and goes intermittently.
  • Plateaued HCG levels. If your doctor is monitoring your HCG levels and they plateau, request an ultrasound immediately. Even if you’re so early they say they won’t be able to see anything, ask for a “placement scan.” Do they see anything in your uterus? Do they see anything in either of your fallopian tubes?

Please be vigilant of the signs of ectopic pregnancy. In the worst-case scenario, your fallopian tube can actually rupture, which can cause your body to become septic. This is a life-threatening condition.

If an ectopic pregnancy is confirmed (or suspected while a nonviable pregnancy is confirmed), you have 2 options (that I know of), but less choice than with a missed miscarriage. It largely depends on how far along you are.

Ectopic Pregnancy Option 1: Methotrexate Injection

Methotrexate is an icky but important drug used to treat some types of cancers, psoriasis, and rheumatoid arthritis. It’s also extremely useful in the treatment of early ectopic pregnancy because.

I know this sounds so weird and terrible, it literally dissolves the contents of the pregnancy.

There are a lot of cons to methotrexate in terms of side effects, so talk to your doctor about it.

But here’s what I will say. If your ectopic pregnancy is discovered early enough, this drug can be tube-saving and life-saving.

But here’s the thing–those contents, products of conception, fetus, baby, whatever word you’re most comfortable using–is growing in your fallopian tube!

There is zero chance of its survival, and not taking care of the situation could cause you to lose your fallopian tube. It could even lead to maternal death.

Physically, this was my “easiest” loss. I went to the ER one night, had a confirmation scan, and was given a shot. I didn’t bleed, and I didn’t cramp. Physically (not emotionally), it was as if I’d never been pregnant at all.

Ectopic Pregnancy Option 2: Surgery

I’ve never experienced had surgery for an ectopic pregnancy, so I can’t speak personally about what to expect.

But if your ectopic pregnancy is discovered too late for methotrexate to be an option, your doctor may need to perform a surgical procedure to remove all the contents from your fallopian tube.

To read more about the experience of this surgery, check out Beth’s ectopic pregnancy story.

It’s possible they’ll need to remove the fallopian tube.

(If you lose 1 tube but have another, you can still get pregnant naturally, but we all know this is no one’s ideal scenario).

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Summary

Pregnancy loss sucks, and it’s different for everyone. I hope this rundown helps you understand what to expect your body to go through when you miscarry. I hope it can help those around you understand the same thing.

Your stories can really help others going through miscarriage understand what to expect. I’m especially curious to hear from those of you who have taken Misoprostol/Cytotec or who required surgery for an ectopic pregnancy, since I can’t speak to either of those personally. Let’s all  be open about our miscarriage experiences to help each other during tough times like these.

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What was miscarriage like for you? Share your story in the comments!

General FAQ: What To Expect When Miscarrying


When should I go to the emergency room for miscarriage?

Go straight to the ER if you soak through a menstrual pad in an hour, or if you start feeling lightheaded.

How do you know when a miscarriage starts?

It’s not always obvious. If you start bleeding bright red blood and cramping simultaneously, it’s likely you’re miscarrying.
Bright red bleeding or spotting without cramps could indicate miscarriage or a subchorionic hemorrhage (SCH). Contact your doctor if you’re concerned.

How many days does a miscarriage last?

It’s different for everyone. The major part of the miscarriage will usually happen within a day, but bleeding and cramping can last days or even weeks.

How does a miscarriage feel?

Early, it feels like heavy cramping, generally stronger than period cramps. Further along, you have actual labor contractions, although the intensity varies. In those situations, your stomach tightens (and cramps, but tightness is a better indicator), usually in varied intervals.

What happens if I have a miscarriage and don’t get cleaned out?

It is possible to miscarry and then retain tissue in your uterus. This is called an incomplete miscarriage, and it can lead to complications if not treated quickly. You’ll likely have to take Cytotec (misoprostol) or undergo another D&C to clean out the remaining contents of your uterus.

What to expect after miscarriage?

Pregnancy testing at home will continue to show positive tests as your human chorionic gonadotropin (HCG) levels decrease. Having your doctor follow your blood levels down to zero can be a good idea.

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