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Miscarriage: what happens, your options, and support

If you need help right now

Go to an emergency room, or call 911, if you have sudden, severe pain in your belly or pelvis, shoulder pain, or weakness, dizziness or fainting. These can be signs of a ruptured ectopic pregnancy, which is an emergency [1].

Call your provider right away if you have very heavy bleeding (soaking through more than 2 maxi pads an hour for more than 2 hours in a row), a fever, chills or severe pain [2]. If you can’t reach them, go to an emergency room.

The short answer

We’re so sorry. If you’re reading this, you may be in the middle of it, or waiting to know.

  • Miscarriage is the loss of a pregnancy in the first 13 weeks. It happens in about 10 in 100 known pregnancies [2].
  • It’s almost never caused by anything you did. About half happen because the embryo didn’t develop properly, often because of a chromosome problem [2]. Exercise, work, stress, arguments, sex and morning sickness don’t cause it. An everyday fall almost never does [2].
  • You usually have three options: wait for it to happen naturally, take medicine, or have a short procedure [2][3].
  • Your body often recovers in weeks. Grief can take much longer, and that’s normal.
  • You don’t have to go through it alone. Support lines and groups are listed at the end.

Signs of a miscarriage

Bleeding or spotting, cramping, low back pain, a gush of fluid, and passing tissue are the common signs [2][4]. Bleeding in early pregnancy doesn’t always mean a miscarriage. Call your provider about any bleeding, and they’ll check with an ultrasound and sometimes blood tests [2].

Sometimes there are no signs at all, and the loss is found on a scan. That can be a particular shock.

Your three options

Your provider will talk you through what’s right for you. Every option is safe for most people. The choice is often yours [2][3].

Option What it is What to expect
Waiting (expectant management) Letting the pregnancy pass on its own It can take days to weeks. Bleeding and cramping can be heavy for a few hours. Sometimes you’ll need medicine or a procedure afterward if it doesn’t complete [2][3]
Medicine Pills that help the uterus empty: misoprostol, sometimes with mifepristone first Bleeding and cramping usually start within hours, at home. Adding mifepristone makes it more likely to work [3]. Mifepristone isn’t available everywhere. Your provider will tell you what they can offer
Procedure (uterine aspiration, sometimes called a D&C) A short procedure that empties the uterus, in a clinic or hospital It’s quick and done in one visit. It’s recommended if you have heavy bleeding or signs of infection [2]

Ask about pain relief for any option. If your blood type is Rh negative and you were 12 weeks or further along, you’ll be offered an Rh immune globulin shot. Before 12 weeks, it’s often not needed. Talk it through with your provider [5].

Afterward

  • Bleeding is usually heaviest at first, then gets lighter. Some people spot for up to 3 or 4 weeks [4].
  • Don’t put anything in your vagina for 1 to 2 weeks, including tampons and sex, to help prevent infection [2].
  • Your period usually comes back in 4 to 6 weeks [6].
  • Pregnancy tests can stay positive for several weeks, sometimes 1 to 2 months, as hormone levels fall [6].
  • Call your provider right away for heavy bleeding, fever, chills, severe pain or bad-smelling discharge. These can be signs of infection or tissue left behind [2][7].
  • If you were 16 weeks or further along, your breasts may make milk. A well-fitting sports bra and cold packs can help it dry up. Ask your provider before taking pain medicine. Some people choose to pump and donate their milk [8].

Your feelings

There’s no right way to feel. Grief, numbness, guilt, anger, relief, jealousy of other pregnant people: all of it is normal. Your partner may grieve differently, or on a different timeline.

Some people find it helps to name the baby, mark the due date, or keep a scan photo. Some don’t. Both are fine.

If sadness or anxiety lasts for weeks, or gets in the way of daily life, tell your provider. Depression and anxiety after pregnancy loss are common and treatable [9]. The National Maternal Mental Health Hotline, 1-833-TLC-MAMA (1-833-852-6262), offers free, confidential support 24/7 by call or text, before, during and after pregnancy [10].

Trying again

  • You can get pregnant as soon as 2 weeks after an early miscarriage. Talk with your provider about when to try again. Some people wait for one period, which makes the next due date easier to work out [2].
  • If you don’t want to get pregnant yet, use birth control from now [2].
  • One miscarriage doesn’t usually mean you’ll have another. Most people who have a miscarriage go on to have a healthy pregnancy [2].
  • After 2 or more losses, ask about testing for a cause [11].
  • Being ready emotionally can take longer than being ready physically. Both count.

Work and leave

The Pregnant Workers Fairness Act covers miscarriage. If you work for an employer with 15 or more employees, you can ask for reasonable accommodations, including time off to recover [12]. You may also qualify for FMLA leave [13].

Support

  • Postpartum Support International: support for pregnancy and infant loss, including online groups. HelpLine 1-800-944-4773. A trained volunteer calls or texts you back. It isn’t a crisis line [14].
  • Share Pregnancy & Infant Loss Support: support for families after a loss, with groups across the US. Call 1-800-821-6819 [15].
  • National Maternal Mental Health Hotline: call or text 1-833-TLC-MAMA, 24/7 [10].
  • If you have thoughts of harming yourself, call or text 988 [10].

If you’d like to stop getting pregnancy emails from us, use the link at the bottom of any email. It stops everything at once and deletes your date. You don’t need to tell us why.

For partners, family and friends: how to support someone after a pregnancy loss.

Sources

  1. American College of Obstetricians and Gynecologists, “Ectopic Pregnancy.” acog.org
  2. American College of Obstetricians and Gynecologists, “Early Pregnancy Loss” (patient FAQ). acog.org
  3. American College of Obstetricians and Gynecologists, Practice Bulletin No. 200, “Early Pregnancy Loss” (2018, with 2019 update on mifepristone). acog.org
  4. Cleveland Clinic, “Miscarriage.” clevelandclinic.org
  5. American College of Obstetricians and Gynecologists, “The Rh Factor: How It Can Affect Your Pregnancy” (FAQ027). acog.org. ACOG Clinical Practice Update, “Rh D Immune Globulin Administration After Abortion or Pregnancy Loss at Less Than 12 0/7 Weeks of Gestation,” Obstet Gynecol 2024;144(6):e140–e143. doi.org
  6. March of Dimes, “Miscarriage.” marchofdimes.org
  7. MedlinePlus (National Library of Medicine), “Miscarriage.” medlineplus.gov
  8. Indiana Department of Health, “Lactation After Loss.” in.gov
  9. Farren J, et al., “Posttraumatic stress, anxiety and depression following miscarriage and ectopic pregnancy: a multicenter, prospective, cohort study,” American Journal of Obstetrics and Gynecology 2020;222(4):367.e1–367.e22. doi.org
  10. Health Resources and Services Administration (HRSA), “National Maternal Mental Health Hotline.” mchb.hrsa.gov, and 988 Suicide & Crisis Lifeline. 988lifeline.org
  11. American College of Obstetricians and Gynecologists, “Repeated Miscarriages.” acog.org
  12. US Equal Employment Opportunity Commission, “What You Should Know About the Pregnant Workers Fairness Act.” eeoc.gov
  13. US Department of Labor, “Family and Medical Leave Act.” dol.gov
  14. Postpartum Support International, “Loss & Grief in Pregnancy & Postpartum.” postpartum.net
  15. Share Pregnancy & Infant Loss Support. nationalshare.org

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