Miscarriage
A GoodRx guide to symptoms, types, causes, and more
What is a miscarriage?
The term “miscarriage” is most commonly applied to the loss of a pregnancy in the first trimester. For many, it is an isolating experience. It is not often discussed and can be shocking when you are the one going through it. It is a unique loss and can be difficult to process.
At least 1 in 10 confirmed pregnancies end in miscarriage.
But miscarriage is common: 1 in 10 confirmed pregnancies end in a reported miscarriage. The risk is even higher in the first trimester, and in those aged 45 years and older. Typically, there is nothing that could have been done to prevent a miscarriage. The most common reason for a miscarriage is a problem with the baby’s chromosomes, which doesn’t allow it to develop properly.
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What does a miscarriage feel like?
A miscarriage can present in many ways. Even the same individual can have two miscarriages that feel very different within their lifetime. For example, one person may have no symptoms during a miscarriage; another might get heavy, painful bleeding.
It is common for a miscarriage to start with cramping. The cramping is often like that of menstrual cramps, but sometimes the pain is more severe. The cramping is usually over quickly, but it can last for several hours.
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In addition to cramping, you may also experience:
Diarrhea
Bloating
Nausea
Bleeding — anything from spotting, to pink discharge, to large blood clots
Not “feeling pregnant” anymore
Sometimes, a miscarriage can happen without any symptoms at all, which is called a missed miscarriage. In this situation, you won’t know you’ve had a miscarriage until the first ultrasound. The sonographer may see an amniotic sac without a fetus or a fetus without a heartbeat.
What factors can increase the risk of miscarriage?
While there are factors that can increase the risk of miscarriage, unfortunately, every pregnancy is at risk. One in 10 confirmed pregnancies end in a reported miscarriage. But it is believed the number is much higher, possibly as many as 1 in 4 pregnancies.
People 40 years and older have a 1 in 3 chance of miscarriage.
Most miscarriages occur for unknown reasons, but there are some things that can increase the risk. The two strongest risk factors for miscarriage are:
Age: Being older than 35 increases the risk of miscarriage. The risk increases even further after age 40.
Prior miscarriage: The risk of miscarriage increases if you’ve had a miscarriage in the past. It increases further with two previous miscarriages, and further still with three previous miscarriages.
Black, Indigenous, and other people of color also have an increased risk of miscarriage at almost every age compared with white people. This is most likely due to cumulative and longstanding socioeconomic inequalities and systemic racism, rather than biological causes.
Here are some other situations that increase the risk of miscarriage:
Being exposed to certain chemicals during pregnancy, such as PFAs (which are commonly found in cookware, clothing, and carpet)
Having an underlying condition such as thyroid disease or diabetes
Having excess weight or obesity
Alcohol and substance abuse
Infections, such as cytomegalovirus and the flu
What causes miscarriage?
After a miscarriage, it is very normal to question why it happened. Unfortunately, most of the time it is impossible to say what the cause was. The most common reason is a problem with the baby’s chromosomes. Essentially, the cells within the fertilized egg do not divide correctly and cannot develop into a baby.
Smoking and alcohol may be linked to miscarriage. This is one of the reasons why drinking alcohol and smoking while you’re pregnant or trying to get pregnant are not recommended.
It is normal to wonder if you did something wrong. Typically, there is nothing you have done to cause a miscarriage, or that you could have done to avoid it. Sex, exercise, and working do not cause miscarriages.
Is this a miscarriage?
If you begin to bleed in your pregnancy, it can be difficult to know what’s happening. But not all vaginal bleeding in pregnancy is a bad sign. This happens in the first trimester of as many as 24% of pregnancies, and it’s usually not serious.
Most miscarriages (8 in 10) happen in the first trimester. The risk of miscarriage in the second trimester is less than 1%.
That said, heavy bleeding is a common sign of miscarriage. Here are some signs that your vaginal bleeding could be a miscarriage happening:
You are passing blood clots that are the size of a quarter or bigger. This is blood that has clumped together and is gel-like. You may notice blood clots in your underwear or the toilet when using the restroom.
You are having cramps or pain.
Sometimes, you will notice that you don’t feel pregnant anymore. In other words, you might feel less nauseous or tired, and your breasts may no longer feel tender.
How long does a miscarriage last?
A miscarriage can happen very quickly — within a few hours or less. Other times, it can take days or even weeks.
It can be normal for a miscarriage to happen within a single day and feel like the first day of a painful period. Afterward, the bleeding will gradually lighten. Less commonly, you may have light bleeding afterward that lasts a few weeks. Once your bleeding is done, it is a good idea to take a home urine pregnancy test. If it is negative, this is a sign that your miscarriage is complete.
Getting help
Most of the time, a miscarriage can occur safely at home. Sometimes, though, you should seek medical help. If the bleeding is really heavy, it can be dangerous. Or your pain might be overwhelming. In either case, you can benefit from medical support and careful monitoring.
Seek help right away if:
You have heavy bleeding that fills a pad per hour for 2 consecutive hours. The blood is usually red, and you may also notice blood clots.
Your pain is so bad that you feel nauseated or dizzy.
To confirm a suspected miscarriage, your provider will probably run a few tests:
They will use an ultrasound scan to look at your uterus and assess the pregnancy.
Blood work will check the level of the pregnancy hormone human chorionic gonadotropin (hCG), so your provider can see if your hCG level is appropriate for how far along you are. Results of this test can be compared with previous hCG levels (if any) to determine if you are having a miscarriage. This number can also help rule out other rare situations, such as an ectopic pregnancy and other complications.
Blood work can also identify your Rhesus (Rh) blood type (the “+” or “–” after your blood group). This test is commonly done when there is bleeding in pregnancy, if it hadn’t been done before bleeding started. If you are Rh negative, but your baby is Rh positive, this can be dangerous and may lead to miscarriage. If you know you are Rh negative, then treatment is available to stop you from making antibodies that might harm the baby during pregnancy.
Aftercare
It is a good idea to see your medical provider after a miscarriage is confirmed. Your provider may want to repeat the above tests, to make sure the miscarriage is complete.
Your follow-up visit is a good time to discuss your feelings and ask any questions you may have about your miscarriage. If you’re struggling with your feelings or worried that you don’t have a good support system, please ask for help. Losing a pregnancy — no matter how early — is a very real loss. Often, your feelings will take much longer to heal than your body.
What is recovery like after a miscarriage?
Bleeding after a miscarriage is normal. Sometimes, the bleeding will be heavy for a few hours and then will gradually lighten. Irregular spotting and bleeding can happen in the weeks and months that follow, and it can take a few months for your period to get back to normal. After the initial cramps caused by miscarriage, it’s not normal to have ongoing pain that lasts more than a few days — so if you are, that should prompt a phone call or a visit to your provider.
Emotionally, everyone experiences a miscarriage differently. Some accept it more easily than others. For many, it causes devastating grief. It is normal to need weeks or months to process the loss of a pregnancy — no matter how long you were pregnant for. Depression symptoms (such as lack of hope or not feeling joy) can happen after the loss, too.
As many as 43% of women who’ve had successful births have experienced at least one first-trimester miscarriage.
You might find it helpful to talk with others who have been through a similar situation, or a grief counselor. Talking to a therapist about how you are feeling can also help, and this can even be done online.
There are wonderful resources to help individuals who have experienced a miscarriage. Here are some good places to start:
Supporting a friend
If a friend or loved one has experienced a miscarriage, it can be hard to know how to support them. You may worry that you won’t know what to say or how to act. Here are some general tips for how to be a good friend:
Listen more than you talk.
Accept your friends’ feelings as they are. There are many normal emotions that can occur, such as numbness, guilt, and sadness. It can also be normal for your friend to feel relief.
Let them know you care. Spend time with them, call them, or even just send a text message. Sometimes, it is appropriate to send a card or gift. Ask if bringing over a meal would be helpful.
Avoid making suggestions about what they should do or shouldn’t do, unless you’re asked for advice.
Avoid talking about your own experience of miscarriage, or other peoples’ miscarriages, unless you’re asked specifically.
Don’t be offended if your friend turns you away — it’s not personal.
Keep checking in, even after the first few days and weeks have passed.
Give them the space to talk about their feelings, but don’t force it on them if they don’t want to talk.
Be sensitive when discussing the topic of pregnancy with a friend who has undergone a miscarriage.
Consider sharing the resources listed above.
Common concerns (FAQs)
Most local communities have support groups for mending after the loss of a pregnancy. If you don’t find what you need here, consider asking your primary care or obstetric provider for suggestions.
A large study suggests there may be an increase in the likelihood of miscarriage with antidepressant use. However, the risk is low, and treating depression is commonly advised as the benefits may outweigh the risk. Consider discussing this further with your obstetric provider, as each situation is different.
Also, be sure to speak with them about medications and supplements you’re taking. They can help you find alternative treatments that are safe during pregnancy, if needed. It’s usually helpful to have a discussion about benefits versus risks of medications, especially when it comes to pregnancy.
Physically, it’s safe to start trying again after you have had one normal period. Emotionally, you might feel different. Give yourself plenty of time to grieve and heal before your next pregnancy. How much time you need will vary from person to person.
For most people, a miscarriage does not affect the chance of getting pregnant next time around. After having two miscarriages, as many as 65% of people go on to have successful pregnancies. However, you should speak to your provider if you have had three miscarriages in a row. They can help you figure out if something else is going on.
More information and resources
Why trust our experts?
ACOG. (2019). Bleeding during pregnancy.
ACOG. (2020). The Rh factor: How it can affect your pregnancy.
Almeida, N. et al. (2016). Risk of miscarriage in women receiving antidepressants in early pregnancy, correcting for induced abortions. Epidemiology.
Cohain, J. S., et al. (2017). Spontaneous first trimester miscarriage rates per woman among parous women with 1 or more pregnancies of 24 weeks or more. BMC Pregnancy and Childbirth.
Giakoumelou, S., et al. (2015). The role of infection in miscarriage. Human Reproduction Update.
Greenwood, M. (2020). Commonly used chemicals associated with miscarriage, Yale School of Public Health study finds. Yale School of Medicine.
Hasan, R., et al. (2011). Patterns and predictors of vaginal bleeding in the first trimester of pregnancy. Annals of Epidemiology.
Magnus, M.C., et al. (2019). Role of maternal age and pregnancy history in risk of miscarriage: Prospective register based study. British Medical Journal.
Wilcox, A. G., et al. (1988). Incidence of early loss of pregnancy. New England Journal of Medicine.
Wyatt, P. R., et al. (2005). Age-specific risk of fetal loss observed in a second trimester serum screening population. American Journal of Obstetrics and Gynecology.
