A miscarriage usually starts with vaginal bleeding. This could range from light spotting to heavy bleeding. In most miscarriages, you will also experience lower abdominal pain, which may feel like period pain, severe cramps, or even as severe as contractions. As a miscarriage progresses, you may also pass fluid and blood clots from your vagina.

It is normal to feel very upset if you think you are having a miscarriage. Everyone responds differently, and it can take a while to process what is happening. We recommend seeking support from your partner, family or a close friend if you are experiencing early pregnancy loss. Having a support system is valuable.

Unfortunately, nothing can be done to stop a miscarriage once it has started. Any treatment given is to reduce the chance of heavy bleeding or infection. During a miscarriage, your body will pass your baby and other pregnancy tissue, including a pregnancy sac and placenta.

How long the miscarriage process takes depends on how you and your provider decide to manage the miscarriage. Options include a 'wait and see' approach (expectant management), taking medication to help your body pass the baby and other pregnancy tissue (medical management), or a surgical procedure to remove the baby and other pregnancy tissue from your uterus (surgical management).

Expectant Management
Expectant management is when you wait to see what will happen naturally. When your miscarriage starts, you will notice spotting and cramping and then start bleeding more heavily. The cramps will usually become stronger as you pass the baby. If you read “What does a miscarriage look like?” below, you will find more detailed information about what you may experience based on your gestation. The process may take up to 2 weeks to start from when the baby dies. Some amount of bleeding can continue for up to 2 weeks after you pass the baby and other pregnancy tissue.

When choosing expectant management, it can be emotionally difficult to wait for the miscarriage to begin because you don't know when it will happen, but some mothers feel most comfortable allowing the process to happen as naturally as possible.

While you are waiting for the miscarriage process to finish, it's best to rest at home and do what feels right for you. If you are bleeding, use sanitary pads rather than tampons to reduce the chance of infection. If you have heavy vaginal bleeding (soaking more than 2 maxi pads per hour for 2 consecutive hours, passing clots larger than golf ball size, fever, chills, or intense pain, call your provider or go immediately to the nearest emergency department for evaluation and treatment.

Medical Management
Some women choose to have medical management because they don't want to wait for up to 2 weeks for their baby and other pregnancy tissue to pass naturally. Your doctor can prescribe medication, so the physical experience is sped up. The medication may cause you to have pain and bleeding like what you would experience naturally in a miscarriage, or it could increase your pain. The baby and other pregnancy tissue are likely to pass within 4 to 6 hours; however, sometimes, you will need more doses of medication.

Surgical Management
If your baby or other pregnancy tissue remains in your uterus, or you don't want to experience the pain or bleeding of miscarriage, you may choose to have a surgical procedure called a 'dilatation and curettage' (D&C). You may need to wait some time for your surgery. The procedure only takes 5 to 10 minutes under anesthesia, and you will usually be able to go home the same day.

In the first month of pregnancy, the developing baby is the size of a grain of rice, so it is very hard to see. You may pass a blood clot or several clots from your vagina, and there may be some white or grey tissue in the clots. The bleeding should settle down in a few days, although it can take up to 2 weeks.

At 6 Weeks
Most women can’t see anything recognizable when they have a miscarriage at this time. During the bleeding, you may see clots with a small fluid-filled sac. If you do see the baby, it’ll be about the size of the fingernail on your little finger and appear gray in color. A placenta might be seen inside the sac, and you might also notice something that looks like an umbilical cord.

At 8 Weeks
The tissue you pass may look dark red and shiny — some women describe it as looking like liver. You might find a sac with a baby inside, about the size of a small bean. If you look closely, you might be able to see where the eyes, arms and legs were forming.

At 10 Weeks
The clots that are passed are dark red and look like jelly. They might have what looks like a membrane inside, which is part of the placenta. The sac will be inside one of the clots. At this time, the developing baby is usually fully formed but still only a couple inches long. If you miscarry around this stage of gestation or later, some mothers say the cramps are more like labor contractions.

At 12 to 16 Weeks
A miscarriage at this stage may result in water (amniotic fluid) coming out of your vagina first, followed by bleeding, clots, and cramps and/or contractions. The baby will be a few inches long and fully formed. The baby might be inside or outside the sac, and may be attached to the umbilical cord and the placenta.

From 16 to 20 Weeks
In addition to delivering your baby, you might pass large shiny red clots that look like liver as well as other pieces of pregnancy tissue that look and feel like membrane. At this gestation, your cramps will likely feel more intense like labor contractions, and you might need pain relief in the hospital. Your baby will be fully formed but will fit in the palm of your hand.

After your baby and pregnancy tissue passes, you will likely still have some cramping pain and bleeding, similar to a period. It will get lighter over time and will usually stop within 2 weeks. Don’t put anything inside your vagina for at least 2 weeks after a miscarriage. This includes tampons and menstrual cups or discs. Schedule a follow-up appointment with your provider to discuss your recovery.

Signs of pregnancy, such as nausea and tender breasts, usually fade in the days after the miscarriage. If you had a later miscarriage, your breasts might produce some milk. This herbal tea can help stop milk production gently and naturally. Methods like wrapping your breasts tightly may also help, but can also cause discomfort or lead to an infection called mastitis. If you see any redness or feel hard lumps in your breasts, feel ill, or have a fever, contact your provider right away.

You will usually have your next period in 4 to 6 weeks. Remember, it is normal to feel many different emotions at this time.