WARNING — This article contains some graphic descriptions of what you might see during a miscarriage.

A miscarriage requires prompt medical care. If you think you are having a miscarriage, call your doctor or midwife for advice and support. Go to the Emergency Department if:

• you are bleeding very heavily (soaking more than 2 pads per hour or passing clots larger than golf balls)
• you have severe pain in your tummy or shoulder
• you have a fever (a temperature above 38 degrees C)
• you are dizzy, fainting or feel like fainting
• you notice fluid coming from your vagina that smells bad
• you have diarrhoea or pain when you have a bowel motion (do a poo)

Miscarriage is a very unfortunate and sad outcome of pregnancy that takes a significant emotional and physical toll on a woman. It also happens more frequently than many people think. It's important to recognise that there's no right or wrong way to feel about a miscarriage.

Despite close to one in 5 pregnancies ending in miscarriage, what actually happens and what a woman needs to know and do when faced with a possible miscarriage are subjects that rarely get discussed.

This article aims to give you an idea of what happens and what a woman needs to know and do at different stages in her pregnancy.

Please call Pregnancy, Birth and Baby on 1800 882 436 if you have any concerns or wish to discuss the topic further.

What might I feel during a miscarriage?

Many women have a miscarriage early in their pregnancy without even realising it. They may just think they are having a heavy period. If this happens to you, you might have cramping, heavier bleeding than normal, pain in the tummy, pelvis or back, and feel weak. If you have started spotting, remember that this is normal in many pregnancies — but talk to your doctor or midwife to be safe and for your own peace of mind.

Later in your pregnancy, you might notice signs like cramping pain, bleeding or passing fluid and blood clots from your vagina. Depending on how many weeks pregnant you are, you may pass tissue that looks more like a fetus, or a fully-formed baby.

In some types of miscarriage, you might not have any symptoms at all — the miscarriage might not be discovered until your next ultrasound. Or you might just notice your morning sickness and breast tenderness have gone.

It is normal to feel very emotional and upset when you realise you’re having a miscarriage. It can take a while to process what is happening. Make sure you have someone with you, for support, and try to be kind to yourself.

What happens during a miscarriage?

Unfortunately, nothing can be done to stop a miscarriage once it has started. Any treatment is to prevent heavy bleeding or an infection.

Your doctor might advise you that no treatment is necessary. This is called 'expectant management', and you just wait to see what will happen. Eventually, the pregnancy tissue (the fetus or baby, pregnancy sac and placenta) will pass naturally. This can take a few days or as long as 3 to 4 weeks.

It can be very hard emotionally to wait for the miscarriage because you don’t know when it will happen. When it starts, you will notice spotting and cramping and then, fairly quickly, you will start bleeding heavily. The cramps will get worse until they feel like contractions, and you will pass the pregnancy tissue.

Some women opt to have medicine to speed up the process. In this case, the pregnancy tissue is likely to pass within a few hours.

If not all the tissue passes naturally or you have signs of infection, you may need to have a small operation called a ‘dilatation and curettage’ (D&C). You may need to wait some time for your hospital appointment. The operation only takes 5 to 10 minutes under general anaesthetic, and you will be able to go home the same day.

While you are waiting for a miscarriage to finish, it’s best to rest at home — but you can go to work if you feel up to it. Do what feels right for you. You can use paracetamol for any pain. If you are bleeding, use sanitary pads rather than tampons.

What might I see during a miscarriage?

In the first month of pregnancy, the developing embryo 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 will settle down in a few days, although it can take up to 2 weeks.

At 6 weeks

Most women can’t see anything recognisable when they have a miscarriage at this time. During the bleeding, you may see clots with a small sac filled with fluid. The embryo, which is about the size of the fingernail on your little finger, and a placenta might be seen inside the sac. 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 an embryo 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 tiny and difficult to see.

At 12 to 16 weeks

If you miscarry now, you might notice water coming out of your vagina first, followed by some bleeding and clots. The fetus will be tiny and fully formed. If you see the baby it might be outside the sac by now. It might also be attached to the umbilical cord and the placenta.

From 16 to 20 weeks

This is often called a 'late miscarriage'. You might pass large shiny red clots that look like liver as well as other pieces of tissue that look and feel like membrane. It might be painful and feel just like labour, and you might need pain relief in hospital. Your baby will be fully formed and can fit on the palm of your hand.

After the miscarriage

You will have some cramping pain and bleeding after the miscarriage, similar to a period. It will gradually get lighter and will usually stop within 2 weeks.

The signs of your pregnancy, such as nausea and tender breasts, will fade in the days after the miscarriage. If you had a late miscarriage, your breasts might produce some milk. You will probably have your next period in 4 to 6 weeks.

Remember, it’ll be normal to feel very emotional and upset at this time.

More information

Read more about miscarriage:

• What is a miscarriage?
• What happens after a miscarriage
• Emotional support after miscarriage
• Fathers and miscarriage
• Experiencing a pregnancy loss