Miscarriage is fairly common in the first trimester. It happens in about 10 percent of known pregnancies.

In some cases, miscarriage can occur before you know you’re pregnant. If this happens, you might not notice anything different from your usual period.

The further along you are in a pregnancy, the less likely it is that a miscarriage will feel like a period.

Continue reading to learn more about early miscarriage, including specific symptoms to watch for, when you should see a doctor, and more.

The most common symptoms of early miscarriage are cramping and bleeding.

However, spotting or light bleeding during early pregnancy aren't always a sign of miscarriage. If this happens, watch for any other unusual symptoms.

Other symptoms of miscarriage

  • cramping in your abdomen or lower back (This could start out like period cramps, but the pain typically worsens over time.)
  • nausea
  • diarrhea
  • passing fluids, larger-than-normal blood clots, or tissue from your vagina

Timing

A miscarriage can happen any time after fertilization. If you didn’t know you were pregnant, it would be easy to mistake it for a period.

Both a period and a miscarriage can cause spotting to heavy bleeding.

After the first eight weeks or so, it’s less likely that you’ll mistake a miscarriage for a period.

Duration

You know how long and heavy your typical period is.

During a miscarriage, bleeding gets heavier and lasts longer than a period.

As your cervix starts to dilate, cramping may become more painful than typical period cramping.

Characteristics

Bleeding during miscarriage can appear brown and resemble coffee grounds. Or it can be pink to bright red.

It can alternate between light and heavy or even stop temporarily before starting up again.

If you miscarry before you’re eight weeks pregnant, it might look the same as a heavy period. Later, you’re more likely to notice fetal or placental tissue.

Menstruation products

Heavy bleeding, pieces of tissue, or large blood clots on your menstruation products could mean that you’re having more than a heavy period.

See a doctor if you’re soaking through a tampon or pad every hour for more than two consecutive hours.

You should call a doctor or other healthcare provider any time you experience unexpected pain or excessive bleeding.

These symptoms can result from an ectopic pregnancy. This occurs when a fertilized egg has implanted outside the uterus, possibly inside a fallopian tube. It's a medical emergency.

You should also call a doctor if you experience bleeding alongside:

If you believe you’re having a miscarriage, ask your doctor the following:

  • Should I collect a sample of blood or tissue? (This isn't always necessary.)
  • Should I go to an emergency room or make an office appointment?
  • Is it fine to drive myself, or do you recommend against it?

If it appears that you’ve had a miscarriage, your doctor will want to perform a physical exam.

Be sure to discuss all your symptoms, including the amount of:

  • bleeding
  • clotting
  • pain
  • any tissue that may have been expelled

Testing may include:

There’s no way to stop a miscarriage in progress. If your doctor determines that you've experienced a miscarriage, they’ll want to check for:

  • signs of infection
  • uncontrollable bleeding
  • tissue that may be left in your uterus

It can take two weeks or more to completely expel the tissue naturally. Your doctor will review with you typical bleeding patterns to expect. If you have heavy bleeding lasting several days or any signs of infection, you may need medical treatment.

If your doctor isn't sure that all of the pregnancy tissue has been cleared from your uterus, they may order an ultrasound to confirm.

Your doctor can prescribe medication, such as misoprostol (Cytotec), to increase uterine contractions to help you expel the tissue.

You’ll experience cramping and bleeding as you pass tissue and blood.

Most people pass the tissue within 24 hours after taking the drug. For others, it can take a few days to complete. Either way, it doesn’t require a hospital stay.

Your doctor may be able to prescribe pain medication to help ease your symptoms.

If your blood type is Rh negative, you'll need an injection of Rh immunoglobulin. This may help prevent complications in a future pregnancy.

There are also a few surgical options to remove tissue from the uterus. This includes:

  • Vacuum aspiration. Your doctor inserts a thin tube that contains a suction device into your uterus. This can be done with local anesthesia in your doctor’s office.
  • Dilation and curettage (D&C). Your doctor dilates your cervix, and then uses an instrument called a curette to scrape your uterine lining. This can be done at a surgical center or operating room on an outpatient basis. Regional or general anesthesia can be used.

Both of these treatments have been well-studied and are considered safe. They each carry a very small risk of serious complications.

If you've experienced a miscarriage, it's important to understand that it isn't your fault.

In many cases, doctors are unable determine the cause. Here are some things that can contribute to miscarriage:

During the first trimester

As many as 80 percent of miscarriages occur in the first trimester.

When a miscarriage occurs in the first five weeks after fertilization, it’s called a “chemical pregnancy.” It’s so early that you might not have known you were pregnant.

Although your period may seem heavier than usual, there might not be any other noticeable sign of miscarriage.

Miscarriages in the first trimester often have to do with chromosome abnormalities that interfere with normal development. Missing or extra chromosomes are linked to 50 percent of all miscarriages.

Sometimes, a fertilized egg simply doesn’t develop into an embryo (blighted ovum).

It may help to know that having sex, exercising, morning sickness, and previous use of oral contraceptives don't cause miscarriage. Even an accidental fall doesn’t necessarily cause it.

According to the American College of Obstetricians and Gynecologists (ACOG), smoking and alcohol consumption in the first trimester may result in a slightly higher risk of miscarriage. But the research on this is mixed.

It's also worth noting that drinking less than 200 milligrams of caffeine per day doesn't appear to increase the risk of miscarriage.

Some things that may increase the risk of early miscarriage are:

During the second trimester

About 2 to 3 percent of miscarriages occur during the second trimester.

Some things that may increase the risk are:

During the third trimester

Losing a pregnancy starting from the 20th week of pregnancy and into the third trimester is considered stillbirth, not miscarriage.

In general, the risk of stillbirth increases with maternal age.

If you’ve experienced a miscarriage, it doesn’t mean you’ll have another, and it doesn’t mean you can’t have children.

Most people who experience a miscarriage can go on to have a successful pregnancy.

Miscarriage shouldn’t affect your ability to get pregnant. You can ovulate and become pregnant within two weeks of an early miscarriage.

If you don’t want to become pregnant again, you should use birth control right away.

About 1 percent of people have multiple miscarriages. If you’ve experienced several miscarriages, your doctor might recommend special testing.

Even if you’ve had three miscarriages in a row, there’s a 70 percent chance your next pregnancy will be successful.

Your doctor will probably advise you to avoid sex, tampons, and douches for two weeks. This will help prevent infection.

They may also want you to take a pregnancy test after about two weeks. This can help them determine whether your hormone levels are back to normal.

In the meantime, call your doctor if you:

  • are bleeding heavier than expected or notice that the blood stays bright red
  • are soaking through more than two maxi pads an hour for more than two hours
  • notice a foul-smelling discharge
  • experience abdominal tenderness or severe pain
  • have persistent cramping
  • develop a fever or chills

For the first few days, you may notice blood clots and tissue passing, but this should taper off after about a week. It will take about four to eight weeks for your regular period to return.

Mild exercise following an early miscarriage is usually fine, but check with your doctor. It may depend on how far along you were, as well as your overall health.

There are many emotions a person might have following a miscarriage. Some feel anger, sadness, or profound loss. Others might feel relieved.

These feelings may have to do with whether you knew you were pregnant or if you were trying to have a baby.

Pregnancy and miscarriage also cause hormone fluctuations, which can affect your emotions.

Everyone is different, so there’s no correct way to feel about experiencing a miscarriage. It may take some time for you to process everything.

You may find it helpful to talk to your partner, family, or friends about what you’re going through.

You may also consider looking into support groups for people who have experienced miscarriage. Sometimes it helps to talk to others who have been through the same thing.

Here are a few places to seek support:

If grief continues to worsen after a few weeks, talk to a doctor about your options for treatment. You may benefit from grief counseling or treatment for depression.

Miscarriage isn't your fault.

Physical recovery generally takes a few weeks. Everyone has their own timetable for emotional recovery.

There’s no need to rush yourself or to pretend to “get over it” for anyone else’s sake.

And if you need it, reaching out for support is a reasonable thing to do. You aren't alone in this.