If you are pregnant and experiencing abdominal pain or vaginal bleeding, you may feel confused or scared that you are having a miscarriage.
It’s important to know that the symptoms of a miscarriage can overlap with the symptoms of a healthy pregnancy, so what you are experiencing may not be a miscarriage. But you’ll still want to call your doctor, OB-GYN, or midwife if you have questions so they can help you decide if you should go to the clinic.
In this post, we’ll go over what a miscarriage can feel like and when they typically occur. This information can help you understand what may be happening while you wait to be seen by a doctor.
What miscarriage symptoms may look and feel like
The symptoms of miscarriage can be different for each person. They can occur suddenly or gradually, so the first symptoms may not be noticed. But for women who notice signs of what could be a miscarriage, possible symptoms include:
- Pink, red, or brown vaginal spotting or bleeding
- Cramps or pain in the lower abdomen and back.
- Passage of tissue or blood clots from the vagina ranging from a light brown discharge to large blood clots.
Possible signs of an early miscarriage before 12 weeks of gestation
In the early stages of pregnancy, there may be no signs of miscarriage. Some miscarriages can occur even before some women know they are pregnant or before a detectable increase in hCG (human chorionic gonadotropin), the main pregnancy hormone.
Miscarriage is most common in the first trimester of pregnancy. After the first trimester, the chances of having a miscarriage drop to less than 5%.
For those who experience early miscarriage symptoms, signs may include:
- Vaginal spotting or bleeding
- Mild cramps or abdominal pain.
- Loss of pregnancy symptoms, such as breast tenderness or nausea.
Again, the type of miscarriage can determine the symptoms women may experience. For example, spotting or mild cramping are the most common symptoms of a chemical pregnancy (when fertilization of the egg occurs but not implantation) and of a ruined egg miscarriage (when implantation occurs but no further growth occurs).
In an ectopic pregnancy, when an embryo implants outside the uterus (usually in a fallopian tube), unilateral abdominal pain, usually on the wrong implantation side, is a more commonly associated miscarriage symptom. Ectopic pregnancies are a medical emergency and need immediate attention, so seek care if you experience any sharp, stabbing pain in your abdomen or back.
The first symptoms of a healthy pregnancy can be confused with a miscarriage
It is important to know that vaginal spotting does not always mean miscarriage. Vaginal spotting can be a common sign of early pregnancy. In fact, up to 25% of women report bleeding and spotting in early pregnancy. Mild cramps may also be common and not necessarily be a sign of miscarriage. But always call your doctor, OB-GYN, or midwife if you experience any of these symptoms.
Possible symptoms of a second trimester miscarriage
Once a pregnancy reaches 13 weeks of gestation, the second trimester begins.
Occasionally, a baby may stop developing after a heartbeat is seen during the dating ultrasound or first trimester scan. This is called a missed miscarriage or MAB. This type of miscarriage is diagnosed when no heartbeat is heard on Doppler or seen on ultrasound after 7 weeks of gestation, but there is no vaginal bleeding or clots.
Signs of second trimester miscarriage usually involve vaginal bleeding or pain, which may include:
- Heavy vaginal bleeding (without spotting) or blood clots
- Cramps or abdominal pain that may come and go.
- A trickle or gush of clear fluid from the vagina, which could be a sign that the amniotic water sac opened too soon.
Bleeding during the second trimester doesn’t always mean a miscarriage, but it does mean you should get care as soon as possible.
Bleeding in the second trimester is less common and may be a sign of a more serious condition, such as placenta previa or preterm birth. These conditions can be controlled and treated, and that does not mean that a miscarriage will occur. But it is very important to seek medical attention immediately to protect your health and that of your baby.
Pregnancy tests are not reliable in telling you if you have had a miscarriage
After a miscarriage, hormones need time to return to pre-pregnancy levels. The amount of the pregnancy hormone hCG may still be high enough to cause a positive pregnancy test result for several weeks after a miscarriage. If a miscarriage is suspected, your doctor will advise you on the next steps.
What to do if you think you are having a miscarriage
If you think you are noticing signs of miscarriage, such as bleeding, spotting, or cramping, call your doctor, OB-GYN, or midwife right away. Your care team will guide you to the best next steps, including helping you schedule an appointment when recommended.
If you experience heavy bleeding, stabbing abdominal pain, or regular contractions, go to the nearest emergency room.
