What Does a Miscarriage Feel Like? Experts Share What To Expect

On my youngest daughter's birthday, I wrapped up a special poem and, in front of family and friends, read the words aloud, breaking the happy news to everyone that her last "gift" was a new baby brother or sister on the way. We recorded all of the kids' reactions amid excited shouts and jumps for joy. My husband's grandma hugged me, and I smiled down at my loose pink tank top, concealing the teeniest of bumps.

Miscarriage wasn't even on my radar. But weeks later, I started bleeding.

Like many people, I had no idea what having a miscarriage would be like until I had one. I had a lot of questions along the way, like what miscarriage would feel like, how long the process would take, and what I should expect after.

Read on to get expert answers to questions about what it's really like to have a miscarriage, including what a miscarriage feels like and how long it can last.

What Does a Miscarriage Feel Like?

It's common to wonder what a miscarriage feels like. Miscarriage will feel different for everyone, but it can feel similar to a heavy period with cramping, bleeding, and pain. Typically, the further along the pregnancy was, the more physically intense the miscarriage experience is, but even very early miscarriages can be uncomfortable and even painful.

J. Daniel Woodall, DO, an OB-GYN at Spectrum Health Pennock in Hastings, Michigan, explains that miscarriage can be painless in the early stages when your body has not started the process of passing tissue. Once your body starts passing tissue, however, the physical symptoms will begin.

The most common physical symptoms of miscarriage include:

• Cramping
• Vaginal bleeding
• Pain in your abdomen, pelvis, or back

Cramping and pain

"Most of the pain associated with miscarriage is extreme cramping, [which can feel contraction-like] in nature, as the uterine muscle functions to get the products of conception out," he says.

Miscarriage can also feel a lot like labor, adds R. Renee Gaiski, MSN, CNM, a nurse-midwife with Spectrum Health Pennock in Hastings, Michigan. "The cramping can be very intense, usually in the lower abdomen but sometimes wrapping around to the back or down the thighs," she explains. "The pain often will come and go like contractions, but when the pain is most intense, it can feel constant."

Bleeding

Another physical symptom associated with a miscarriage is bleeding. Bleeding with a miscarriage can range from light spotting to heavy bleeding that requires pads or disposable underwear to manage.

Bleeding can also accompany tissue passing through the vaginal canal. The tissue is the contents of the pregnancy, which can include the uterine lining, gestational sac, and fetal and placental remains. While you may experience heavier bleeding during the initial miscarriage, lighter spotting and bleeding can last up to 6 weeks after a miscarriage.

According to the American College of Obstetricians and Gynecologists (ACOG), the most severe cramping and pain that accompanies passing tissue with a miscarriage typically resolves within several hours.

Decrease in pregnancy symptoms

Some people may also experience a decrease in pregnancy symptoms like morning sickness or breast tenderness with a miscarriage, but keep in mind that a change in symptoms alone is not an indication of miscarriage. Things like morning sickness and breast tenderness can fluctuate daily even in a progressing pregnancy.

It can take several weeks for pregnancy hormones to return to pre-pregnancy levels after a miscarriage, so it's not uncommon to still have nausea and other pregnancy symptoms through a miscarriage.

When Do Most Miscarriages Occur?

Miscarriage is the spontaneous loss of a pregnancy in the first 20 weeks. But most miscarriages occur during the first trimester, says Dr. Woodall. In fact, around 80% of pregnancy losses occur in the first 12 weeks.

Miscarriage is also common, occurring in about 10% of known pregnancies. In some cases, the loss happens so early that the pregnancy hasn't even been confirmed. When that happens, the menstrual cycle starts as expected or is a few days late.

So how do you know if you had a miscarriage? Dr. Woodall explains that you are most likely experiencing a miscarriage if you:

• Had a positive pregnancy test result
• Are in the first trimester
• Have bleeding like a heavier, painful period
• Pass obvious tissue

However, even if your miscarriage has clear symptoms, he still recommends getting evaluated by a health care provider to confirm that you have miscarried, ensure that all the tissue has safely passed, and get further testing if needed. "Whenever you suspect miscarriage, even if you're confident you passed everything, notifying your OB provider is always indicated," he says.

Can You Have a Miscarriage and Not Know It?

For some people, the first sign of a miscarriage is bleeding. But for others, there are no outward signs that the pregnancy has ended.

"Some miscarriages occur without symptoms and are found during an early ultrasound during routine prenatal care," Dr. Woodall explains. "In my practice, about half of all miscarriages I find during a routine first-trimester ultrasound, and the other half present with bleeding before 13 weeks."

The ACOG explains that outside of an ectopic pregnancy, there are two basic types of early pregnancy loss:

• An empty gestational sac where the embryo has failed to develop
• A gestational sac that has an embryo or fetus but no detectable cardiac activity

If a doctor finds you have an empty gestational sac or a fetus with no cardiac activity but you aren't having any miscarriage symptoms like bleeding or pain, it's called a missed miscarriage. That means that your body has not yet recognized that a loss has occurred and has not started the process of emptying the uterus on its own.

A missed miscarriage may not hurt at first because you haven't passed the sac or any other tissue. Your doctor will advise you on the next steps for treatment for a missed miscarriage, which can include medication to pass the pregnancy contents or removal with a procedure known as dilation and curettage (D&C).

How Long Do Miscarriages Last?

Dr. Woodall explains that, generally, when people miscarry and pass tissue spontaneously, the bulk of the process can take about 12 to 24 hours. This may be followed by normal period-type bleeding for several days. However, as S. Zev Williams, MD, PhD, director of Columbia University Fertility Center, explains, the length of time it takes for your body to begin that process can vary widely, from days to weeks.

According to ACOG, most people pass the sac and tissue within two weeks of a miscarriage diagnosis, but it can take longer. In those cases, a health care provider might recommend medication to start the process. Once the cramping and bleeding begin, the tissue usually passes within a few hours.

Sometimes, however, the body doesn't pass the sac and all of the tissue on its own. In that case, a health care provider may recommend a D&C procedure. During this procedure, a health care provider inserts a tool through your cervix to remove the tissue from your uterus.

What Is Physical Recovery Like?

While everyone is different, physical recovery after a miscarriage is usually pretty fast—most people feel physically able to resume usual activities within a couple of days after passing the sac and tissue or having a D&C. If your pregnancy symptoms didn't go away before your miscarriage, they usually do a few days after your miscarriage.

As you recover from a miscarriage, you should avoid putting anything in the vagina, including tampons, menstrual cups, sex toys, fingers, or genitals. You can use menstrual pads for bleeding in the meantime. Your period should resume within four to six weeks after the miscarriage.

Barring any complications, you can resume sexual activities and try for another pregnancy if you wish as soon as your next cycle. There is no evidence that waiting to get pregnant again has any outcomes on future pregnancy rates. And you are not more likely to have a miscarriage in the future if this is your first miscarriage.

How Do Miscarriages Affect Emotions and Hormones?

Just as the physical pain varies, the emotional pain of a miscarriage is very individual too. "Add the pain to the mental anguish of losing a pregnancy, it can hurt a lot," says Gaiski. That pain is often both physical and emotional.

Some people think that the emotional pain would be less if you had an empty sac and never "saw" a baby. However, for many, their heart doesn't care what's on an ultrasound screen—they love their babies from the very beginning as if they had already held them in their arms.

That said, not everyone processes miscarriage in the same way. For some, the emotional pain and grief are intense; for others, they are relieved. Still others have conflicting emotions. It's important to know that it's OK to feel OK after a miscarriage. However you feel, it's normal and valid.

In addition, an early pregnancy loss impacts your hormones. The abrupt change in hormones can trigger mental health symptoms, make it hard to manage your mood and emotions, and contribute to the emotional pain of miscarriage.

Does Miscarriage Mean You Did Anything Wrong?

It's normal to wonder what might have caused the miscarriage, but the truth is that a majority of miscarriages happen because of chromosomal abnormalities that cannot be prevented or predicted.

Most people who have one miscarriage go on to have a successful subsequent pregnancy. Though possible, recurrent miscarriage is rare, with just 5% of people having repeat miscarriages.

"While having a miscarriage does increase the risk of future miscarriage, the odds are overwhelmingly in favor of the next pregnancy being normal," Dr. Woodwall says.