How to know if you’re having a miscarriage (& what to do)

When something feels ‘off’ during your pregnancy, it can be really scary. Keep in mind, there are plenty of weird but normal bodily sensations involved in growing a baby – so cramping, bleeding, and general strangeness aren’t always cause for panic. But it IS important to understand the signs of miscarriage, in case you’re one of the 1 in 4 women who go through it.

An Important Note: The word ‘miscarriage’ may imply that you’ve made a ‘mistake’ or ‘carried’ your baby incorrectly. We don’t love the word. Mama, miscarriage is not your fault.

So let’s look at how to know when you’re having a miscarriage, and what to do if it happens.

What is a miscarriage?

A miscarriage is when a pregnancy spontaneously ends before 20 weeks gestation. After this, it’s considered a ‘stillbirth’. 

No matter what stage you’re at, though, it’s still considered ‘pregnancy loss’. An early miscarriage can be devastating, particularly if you’ve been experiencing fertility problems. Miscarriage is alarmingly common, with 10–20% of all confirmed pregnancies being lost, most often in the first trimester.

What does a miscarriage feel like?

Some women don’t feel anything at all, and may not notice they’ve been pregnant and miscarried. Other women experience cramping – anything from menstrual-like cramps, to full-blown contractions with intense pain every 5–20 minutes.

What does a miscarriage look like?

Signs of an early miscarriage (in the first six weeks’ gestation) may look like a very heavy period. Later on, it’s likely to include large clots. Miscarriage blood can be bright red, brown, or even black-ish in colour if it’s been in your uterus for a while.

The American Pregnancy Association notes that the heavy bleeding tends to be over within three to five hours of when it starts, but that lighter bleeding may continue for a week or two.

Common signs of miscarriage

Sometimes pregnancy loss will fly under the radar with no noticeable signs, but the most usual miscarriage symptoms include the following.

  • Bleeding – Miscarriage blood will look like a heavy period, potentially with some large blood clots. (Note: Light spotting in early pregnancy could be ‘implantation bleeding’, which is totally normal.)

  • Pain – This may be similar to menstrual cramps in your abdomen or lower back.

  • Decline in pregnancy symptoms – You may simply notice that your pregnancy symptoms, like sore breasts or morning sickness, start to fade. In saying that, it’s normal for symptoms to decrease as you enter your second trimester.

What causes miscarriages?

In most cases, miscarriage is NOT caused by things within your control. You should NOT feel responsible for it. In about 50% of cases, it’s just down to an obscure chromosomal abnormality. It’s not caused by exercise, stress, sex, eating spicy foods, or jinxing it. 

Things that cause miscarriage can include:

  • Chromosomal abnormalities – These are completely random, but are more common in pregnancies of women over 35.

  • Some medical conditions – Uncontrolled diabetes, fibroids or thyroid problems can increase the likelihood of miscarriage.

  • High fever – The common cold won’t cause a miscarriage, but a serious infection or illness could cause high fevers, increasing the chances of pregnancy loss.

  • Some early pregnancy tests – These are rarely performed and your doctor should outline the risks to you, but some tests such as chorionic villus sampling (CVS) and amniocentesis, carry a small risk of miscarriage. They involve a small needle being inserted into the uterus.

If you’re wondering how to prevent miscarriage from happening, the best things you can do are not smoke, avoid alcohol, reduce your caffeine intake (it’s only for nine months mama!), and avoid people with infectious illnesses like the plague – because you never know, they might actually have the plague.

If you’re doing those things, taking your prenatal vitamins, and eating a healthy pregnancy diet, you’re doing all you can do.

What to do if you think you’re miscarrying

Take two deep breaths. This is scary, but you’re going to be OK.

The first step is to call your care team for advice. Try your obstetrician or midwife, or failing that, give your GP a call. If you can’t get onto anyone and feel worried, go to the hospital.

Your doctor may examine you and run some tests, such as an ultrasound and blood test. They’ll assess your miscarriage symptoms, and advise what sort of treatment (if any) you need. This will depend on what sort of miscarriage you’re experiencing.

The different types of miscarriage include:

  • Threatened miscarriage – This is when you experience miscarriage symptoms like bleeding and cramping, but your cervix isn’t dilated and your baby is still OK. In some cases, you may go on to deliver your baby as normal, but it could lead to pregnancy loss. Further testing, rest, and progesterone supplements may be advised.

  • Complete miscarriage – This is when your uterus has passed the pregnancy entirely and all the tissue has been expelled.

  • Incomplete miscarriage – This is when the pregnancy has ended, but you’ve only passed some of the tissue from your uterus. In some cases, your doctor may prescribe medicine to help it pass, or perform a minor operation (known as a ‘curette’) to remove it.

  • Missed miscarriage – This is when the pregnancy has ended but the tissue is still in your uterus. You may opt to wait for it to pass naturally, or your doctor may recommend medicine or surgery to help it pass.

  • Septic miscarriage – This is when there’s an infection in your uterus, which requires immediate care.

There’s no way to stop a miscarriage from happening once it’s started. So if you find yourself in this situation, call your partner/mum/friend/sister and make sure you’ve got someone there for support.

What to do after a miscarriage

Get medical attention if you feel unwell

It’s normal to bleed for a few days following a miscarriage. You can manage pain with paracetamol, and use pads for the bleeding (not a tampon). 

Go to hospital straight away if you experience fever or chills, feel faint, or your pain or bleeding ramps up. This could be a sign of infection.

Take it easy for a while

Don’t launch straight into marathon training. Please. And if work feels a bit too much, take some time off. (Did you hear? The federal government last year amended the Fair Work Act so parents are entitled to two days’ Compassionate Leave after miscarriage. It’s not huge, but it’s a step in the right direction for acknowledging what women have to go through.)

Beyond the physical recovery, you’ll probably have a whole lot of processing to do. Don’t rush this. Pregnancy loss often needs to be grieved. You may feel a range of emotions. Give yourself time and space to heal, and seek out professional support if you need it.

Get support

Miscarriage is incredibly common, but it’s never easy.

Some women find it helps to talk about their story openly, and share it on social media. Others find this too painful and need to deal with it more discreetly. There’s no right or wrong here, as long as you’ve got some sort of support.

If you can’t find a way to open up to your partner, friends or family, consider chatting to a psychologist. There are also some amazing free services you can reach out to.

SANDS offers Miscarriage, Stillbirth and Newborn Death Support (call the free 24hr Australia-wide hotline on 1300 072 637). You can also access resources on their website, and request an early loss of pregnancy certificate, as a beautiful way to commemorate your pregnancy.

Try again when you’re ready

It may be comforting to learn that 85% of women who experience miscarriage go on to have a successful pregnancy in future. So when you and your partner are ready to try again, there’s a good chance you’ll make it to full-term this time. But there’s also no rush. You may never feel ready to try and conceive again.

If you’re concerned about your fertility, discuss your options with your doctor. Multiple miscarriages could be worth investigating as there could be a medical reason, which can be treated.

Read next: We need to talk about pregnancy loss

The Royal Women’s Hospital, Miscarriage

Mayo Clinic, Miscarriage

The Royal Women’s Hospital, Treating miscarriage

Verywell Family, What to Do If You’re Having a Miscarriage

Planned Parenthood, How do I know if I’m having a miscarriage?

Verywell Family, Signs and Risks of a Threatened Miscarriage

Government of Alberta, Miscarriage: Care Instructions

Verywell Family, Symptoms and Signs of an Impending Miscarriage

American Pregnancy Association, Signs of Miscarriage

Verywell Family, Miscarriage and Stillbirth Causes

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