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What Does a Miscarriage Look Like? What to Expect with Bleeding and Symptoms

miscarriage bleeding patterns

Essential Takeaways

  • Miscarriages are a commonly occurring natural process whereby the body gets rid of a fetus if there are any abnormalities.
  • A miscarriage can look and feel like a heavy period but with some abnormalities.
  • The only way to confirm a miscarriage is through an ultrasound of the uterus by a doctor and/or measurement of hCG hormones.

In this article, we will discuss what a miscarriage looks like and feels like. Before we get into the details, we want to acknowledge that miscarriages could be a significant and traumatic event. You may be having a lot of feelings right now and that is natural and perfectly okay. You do not have to face these feelings alone; here is a list of resources that can help with pregnancy loss. Here at Ava, we want to make sure you have the most reliable and scientific information. 

A miscarriage is defined as a spontaneous loss of pregnancy of a fetus before it is viable—usually defined as 20 weeks old. The vast majority (80%) of miscarriages happen in the first trimester of pregnancy (up to 12 weeks). Miscarriages are part of a natural process whereby the body gets rid of a fetus if there are any abnormalities such as in the number or structure of chromosomes. 

Miscarriages are quite common; approximately 20% of known pregnancies (clinically confirmed by ultrasound) and approximately one-third of pregnancies end in loss. You probably know someone who has had a miscarriage. Unfortunately, since it is still a taboo topic, you may think that this is only happening to you. 

If you’ve taken a pregnancy test and it was positive, and you’re experiencing heavy bleeding, then most likely you are experiencing a miscarriage. However, if you did not take a pregnancy test then it is not so obvious. How can you tell if you’re having a heavy period or if you’re having a miscarriage?

What does a miscarriage look like and feel like?

Miscarriage signs and symptoms vary greatly from woman to woman. Miscarriages also look and feel differently based on the age of the fetus and the miscarriage type

An early miscarriage, a loss of up to 12 weeks of pregnancy, looks different than a late miscarriage, which is a loss between 12 – 20 weeks of pregnancy. Early miscarriages may look like a heavy period with or without any small tissue or products of conception. Late miscarriages may have blood flow with a more developed and identifiable embryo or fetus. 

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Below is a table that outlines the different types of miscarriages and what they look like and how they feel like. It may seem that the signs and symptoms overlap and vary; that is because every woman is different and studies show a variety of experiences by women. The only way to confirm whether or not you had a miscarriage is through ultrasound and measurement of hCG pregnancy hormones. 

Type of Miscarriage What it looks like How it feels
Complete – all pregnancy tissues are expelled from the body Heavy bleeding and passage of tissue and products of conception that settles down Abdominal pain that settles down
Incomplete – some pregnancy tissues are passed and some are retained in the body Active bleeding and passage of tissue and products of conception Abdominal pain
Threatened – there is a risk of a miscarriage Mild symptoms of bleeding or spotting in early pregnancy Little to no abdominal pain
Inevitable – a miscarriage is happening and inavoidable Heavy bleeding with clots Abdominal pain
Missed – the whole embryo or fetus is still in the body With or without vaginal bleeding and persistent brown discharge Early pregnancy symptoms such as vomiting may or may not have decreased or disappeared, but no abdominal pain 

It is important to note that lower abdominal cramping seems to be a norm in early pregnancy and should not be cause for alarm on its own. However, when paired with vaginal bleeding, then it may be a sign of a miscarriage or something serious.

What does a miscarriage looks like on an ultrasound?

The gold standard for a miscarriage diagnosis is for a doctor to perform a vaginal ultrasound. If a woman does not want a vaginal ultrasound, a doctor will perform an abdominal ultrasound but the diagnosis will not be as accurate. 

To diagnose a miscarriage on an ultrasound, doctors will look for a missing heartbeat, bleeding in the uterus including hematomas (crescent-shaped dark mass of clotted blood), an empty uterus, a uterus that still has retained products of conception or even the presence of a fetus or embryo that hasn’t grown over time.

What are bleeding patterns during a miscarriage?

As mentioned in the table above, bleeding patterns during a miscarriage vary widely. You can have no bleeding at all or persistent brown discharge in a missed miscarriage. Light spotting or bleeding is characteristic of a threatened miscarriage, and heavier bleeding with clots, tissue, and other products of conception could mean an inevitable, incomplete or complete miscarriage.

Miscarriage or period: how to tell the difference

The main difference between having a miscarriage or being on your period is whether or not you are pregnant. It is not possible to be pregnant and still get your period at the same time

Spotting during early pregnancy is usually nothing to worry about. In fact, spotting or vaginal bleeding during pregnancy occurs in 10 – 15% of all pregnancies. Additionally, in all pregnancies with any kind of bleeding, only 14% resulted in a miscarriage. 

However, if you are pregnant and are having heavy bleeding that you think is a period, it may be a sign of a miscarriage. 

How long does a miscarriage last?

Contrary to popular belief, a miscarriage is not a one-time event. Depending on the type of miscarriage, it could take about two or more weeks from the time of diagnosis to the ending of symptoms such as bleeding and abdominal pain. 

The length of time also depends on whether you and your doctor decide on passing a miscarriage without any interventions, managing it with medicine such as misoprostol, or with a surgical procedure such as Dilation and Curettage (D&C). Medical or surgical interventions will speed up the duration of the miscarriage.

Does a heavier period or clots mean a miscarriage?

Normal menstrual bleeding patterns when a woman is not pregnant include regular periods of less than 8 days in length, that happen every 24-38 days. The typical volume of blood loss is less than 80 milliliters. Any variation outside of that is abnormal. Abnormally heavy bleeding is if you soak one or more tampons, menstrual cups, or pads every hour for several hours. 

Abnormal changes in your period, when not pregnant, can be due to changes in the hormonal levels that regulate menstruation. For example, for some women, trying a new birth control can change their hormonal levels so much that it prompts their body to release a decidual cast (a tissue in the shape of their uterus).

However, if you are sure you are pregnant and you are experiencing heavy bleeding and clots, you may be experiencing a miscarriage.

What Next?

Unfortunately, most information online on miscarriages is not very accurate in terms of diagnosis and treatment of miscarriages. While we aim to bring you the latest scientific and accurate information, a doctor with access to your medical history and ability to perform diagnostic tests on you will be able to give you a more definitive answer regarding whether or not you experienced a miscarriage. Certain factors such as age, history of miscarriage and more can increase your likelihood of a miscarriage

Furthermore, while there are no proven strategies to reduce the risk of future miscarriages, talk to your doctor about managing some risk factors such as high blood pressure, weight extremes, or smoking. 

View sources

Sapra, K. J., Joseph, K. S., Galea, S., Bates, L. M., Louis, G. M. B., & Ananth, C. V. Signs and Symptoms of Early Pregnancy Loss: A Systematic Review. Reproductive Sciences, 24(4), 502–513. (2017)

K.J. Sapra, G.M. Buck Louis, R. Sundaram, K.S. Joseph, L.M. Bates, S. Galea, C.V. Ananth, Signs and symptoms associated with early pregnancy loss: findings from a population-based preconception cohort, Human Reproduction, Volume 31, Issue 4, Pages 887–896. April 2016

Katherine Ehrenreich, Rebecca Kriz, Daniel Grossman, Miscarriage information available on the internet: a content analysis of leading consumer websites, Contraception: X, Volume 1, 2019.

Dugas C, Slane VH. Miscarriage. [Updated 2019 May 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-.

Vikram Sinai Talaulikar and Mushi Matjila. Miscarriage and recurrent miscarriage in Sabaratnam Arulkumaran, William Ledger, Lynette Denny, Stergios Doumouchtsis (Eds.). Oxford Textbook of Obstetrics and Gynaecology. Oxford University Press, Dec 23, 2019.

Sally Kidsley and Najia Aziz. Management of Miscarriage in Anne Connolly, Amanda Britton (Eds.) Primary Care in Women's Health in Primary Care. Cambridge University Press, Apr 6, 2017. [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Heavy periods: Overview. [Updated 2017 May 4].

Sarah Ismail, MPH

Sarah Ismail earned her Master of Public Health degree in Maternal and Child Health from UC Berkeley. She is a data storyteller and public health consultant who consults on reproductive health, education, and environmental projects around the world. Prior to that, she was a UC Berkeley lecturer. When she is not consulting, she enjoys traveling, teaching yoga, and participating in drop-in improv classes.

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