by Katherine Brind’Amour, PhD
Miscarriages are very common, but that does not make them less distressing. They are the unintended loss of a pregnancy before 20 weeks gestation. More than 2 in every 10 pregnancies in the United States is believed to end in miscarriage. That number goes up to about 4 in every 10 once very early miscarriages are included (before the fifth week of pregnancy), but most of those miscarriages occur without women even knowing because the signs of miscarriage are not very clear at that stage. (1, 2)
If you or a loved one has experienced a miscarriage, it is helpful to know ways to help the body and emotions recover. Read on to learn about the signs of miscarriage as well as some natural ways to start the healing process.
What Is a Miscarriage?
A miscarriage is a pregnancy that ends on its own before the 20th week. It can take place any time after conception, and most miscarriages take place in the first several weeks of a pregnancy. Since some women may not even know they are pregnant in those first few weeks, an early miscarriage can easily be mistaken for a regular menstrual cycle rather than signs of miscarriage. These unnoticed miscarriages are very common.
- Between weeks six and nine of pregnancy, about 14 percent or 15 percent of pregnancies end in miscarriage.
- For weeks 10 to 15 of pregnancy, the risk drops to 6 percent to 8 percent.
- The risk of miscarriage goes down the further along a woman gets in her pregnancy, and the overall risk of miscarriage is under 2 percent in weeks 16 to 19 of a pregnancy. (1)
The risk of miscarriage changes based on many factors, including the mother’s age, pregnancy history, health conditions and method of conception. Most women go on to have healthy future pregnancies after a miscarriage. However, some women have more than one miscarriage. These are called recurrent miscarriages, and they have many causes. You may need to have some fertility testing or tissue testing done to find out why you have miscarried, in these cases.
Regardless of the cause of miscarriage, you should seek immediate medical attention for any signs of miscarriage. Please know that you may experience some signs of miscarriage without one actually taking place. It’s important for a medical professional to confirm what happened.
Signs of Miscarriage
Your signs of miscarriage may vary by the stage of pregnancy you are in.
- Signs of early miscarriage (before five weeks of pregnancy) may include: (2)
- Cramping and bleeding, similar to a regular period. You may also experience pain, aching and spotting or a slight difference in blood flow compared to a normal menstrual cycle. Other times, the first signs of miscarriage very early in a pregnancy may include only cramping, spotting, or a change in symptoms, such as not feeling pregnant anymore.
- No signs of miscarriage at all. You may not even know you have had a miscarriage until a routine prenatal care visit. An ultrasound may find no embryo or may find one without a heartbeat.
- Further into a pregnancy, signs of miscarriage may include: (3, 4)
- Steady or heavy blood flow of bright red blood
- Other fluid passing from the vagina, such as white-pink mucus
- Passing tissue or blood clots
- Contractions that are very painful, every five to 20 minutes
- Decreased activity of the baby
- Change in pregnancy symptoms (for example, no more nausea)
During a Miscarriage
From the time a miscarriage starts to the time it completes, your body is basically undergoing labor. Most of your signs of miscarriage result from contractions and cervix dilation to help your uterus clear itself out.
Signs of miscarriage vary by how far into the miscarriage you are. If you are past the first trimester of pregnancy, your miscarriage symptoms may be severe and alarming.
- Early signs of miscarriage at any stage of pregnancy may include spotting and cramping, similar to a menstrual period.
- As the miscarriage progresses, pain and cramping will likely worsen, particularly if you are in the second trimester.
- Pain can affect your belly, pelvic area or lower back.
- Cramping may be sharp and severe or dull and achy.
- If you are past the first few weeks of pregnancy, blood flow will start to increase. It usually becomes heavy and bright red.
- Signs of miscarriage may include blood clots or bits of tissue passing, particularly after the first trimester.
- Bleeding may continue for several days, with additional pain and cramping.
After the miscarriage is complete, you may notice some spotting and cramping for up to a week, even if you took medication or had surgery to complete it.
Miscarriage Causes & Risk Factors
There are many possible causes for a miscarriage. In some women, the cause is never known because the miscarriage occurs very early.
According to the American Pregnancy Association, common causes of early miscarriages include: (4)
- Chromosomal abnormalities
- A problem with the egg or sperm cell
- A problem with cell division soon after conception
In addition, miscarriages throughout the first 20 weeks of pregnancy can be caused by: (4)
- Chromosomal or genetic abnormalities
- Hormone problems
- Maternal health conditions such as uncontrolled diabetes or thyroid problems
- Malnutrition in the mother
- Smoking or drug use
- Excessive caffeine intake (more than 300 milligrams per day)
- Exposure to toxins or radiation
- Ectopic pregnancy or improper implantation of the egg
- Trauma to the mother
There are other possible causes as well. However, the factors listed above are the most common problems associated with miscarriage in the United States.
Risk Factors for Miscarriage
Even among healthy women, the chance of a miscarriage is up to 20 percent. However, some factors put you more at risk for miscarriage: (5)
- Age 35 to 45 (20 percent to 35 percent chance of miscarrying)
- Age 45 or older (50 percent to 80 percent chance of miscarrying)
- Prior miscarriage (25 percent chance of miscarrying)
- Chronic health conditions, particularly if they are not well treated
- Problems with the uterus or cervix, such as weak tissue or abnormalities
- Smoking, drinking alcohol or using street drugs
- Being very underweight or overweight
- Certain prenatal tests, such as chorionic villus sampling and amniocentesis, since they are invasive and may interfere with the baby or supporting tissue
When you have any signs of miscarriage, you should contact your doctor. Expect to be asked about your specific symptoms and signs of miscarriage, including the appearance and amount of bleeding. You may be told to come in for evaluation if your blood flow is heavy or lasts more than a day or two, or if your pain is severe or lasting.
When you come in for a visit to check for signs of miscarriage, you can expect:
- An ultrasound to check for the heartbeat and fetal development, or to look for any tissue that may be remaining if the miscarriage has already taken place
- A series of questions about other symptoms, including cramping and pain
- An internal evaluation to see if your cervix has dilated
- Blood tests to check your pregnancy hormone levels and blood iron level, blood type and more
- Tissue or chromosomal tests, particularly if you’ve had previous miscarriages; these can help you learn potential causes for the miscarriage
After a miscarriage, you may have a follow-up appointment to check that your uterus is clear. If any tissue remains, you may be offered a procedure to help complete the miscarriage. This also reduces your risk of infection.
If you come in for a visit and the miscarriage is incomplete, you may be offered a few options: (6)
- You can often go home and wait for the miscarriage to complete.
- If you’ve had no symptoms or only minor spotting or cramping, it may be several days to a couple of weeks before your body actually completes the miscarriage.
- Early miscarriages are often completed at home and don’t require any medication or procedure.
- Managing the miscarriage at home can be painful and very difficult emotionally. Health care providers usually recommend that you have a support person with you once the miscarriage progresses.
- You may wish to take over-the-counter pain medications during a miscarriage to help with pain from cramping and contractions.
- You can take pills or get medication inserted to help your body complete the removal of the tissue. This usually works within 24 hours.
- You can opt for a minor surgical procedure. It is an outpatient operation so you can go home the same day. You may or may not need anesthesia.
- The doctor will dilate your cervix. Then they will go in through the vagina to remove tissue from inside the uterus using suction. They will likely use an ultrasound to check that everything is removed.
- If you have heavy bleeding or signs of an infection, surgery may be the only option recommended by a doctor.
Overall physical recovery may take from a few hours to a few weeks. The further along you were in your pregnancy or the more severe your signs of miscarriage, the longer it may take for you to heal.
If you have any signs of infection after the miscarriage is complete — such as fever, chills, foul-smelling discharge, or continuing bleeding or belly pain — call your doctor.
Recovering from a Miscarriage
Miscarriages can be traumatizing due to both the physical and emotional experience of losing a baby. You can try many natural strategies for soothing your body and mind after a miscarriage. In addition, there are many resources available to help you recover, and many women you can speak with who can understand the pain you may feel.
You can try many different things to find something that works well for you, and in time you can expect the physical pain to heal and the emotional pain to fade. Consider some of these tips:
- Rest, stay hydrated and eat well
- Soothe your physical pain
- Grieve your own way
- Speak with people who understand
- Relieve stress
- Make a plan
Rest, stay hydrated and eat well
In many cases, signs of miscarriage include physical pain, cramping, bleeding and more. You may feel tired, emotionally drained, achy and fatigued for several days after the miscarriage ends. Even if you have medication or surgery to complete the miscarriage, you may have some spotting or cramping for a full week after it is over. Some pregnancy hormones will remain in your blood for up to another month or two, even though your period can return in just a few weeks.
Consider these ways to give your body some time and tools to recover:
- Take time off of work if you can and would like to.
- Enlist a friend or family member to help take care of your older children, if you have any. This will allow you time to sleep if needed but will also give you some privacy to grieve.
- Avoid sexual intercourse for at least two weeks.
- Drink plenty of water.
- Continue your prenatal vitamins for at least another week. This may help you avoid anemia from the blood loss.
- Alternatively, you can take an iron supplement or eat a diet rich in iron. Foods with iron include dark chocolate, pistachios, spinach, lentils, beef and more.
- Eat a healthy, balanced diet. Your body may require plenty of nutrients to help heal tissue and give you more energy.
- Turn to nourishing comfort foods, including homemade soups, which provide great nutrients and make it easy to get plenty of veggies in your diet.
- Remember that a miscarriage is a totally valid reason for a dietary splurge or two — ice cream, a glass of wine, you name it. Just try to keep the bulk of your diet nutrient-dense and balanced with plenty of hydration until you have recovered (and afterwards!).
- Don’t exercise until you feel fully recovered and your doctor gives you the OK. When you do start back, start slowly.
- Don’t use tampons until you get your next period. This helps reduce your risk of infection.
Soothe physical pain
It’s not unusual to feel pain during and for a few days after a miscarriage ends. You may wish to try some of these natural approaches to pain relief:
- Massage. During a miscarriage that is confirmed and inevitable, you or a partner can massage your back, belly, or anywhere else you feel massage may help relieve pain, tension and stress. In addition, you can try a “postpartum” massage from a trained professional, informing them that you experienced a miscarriage. According to the American Pregnancy Association, these massages can help: (7)
- Relieve pain
- Reduce anxiety and depression
- Relieve stress
- Improve hormone regulation
- Decrease swelling and inflammation
- Improve sleep
- Aromatherapy. It can help reduce pain during and for at least 30 minutes after using it, according to a clinical study of women going through labor with or without jasmine and salvia aromatherapy. (8)
- Lavender aromatherapy during contractions and cervix dilation may also help relieve pain. (9)
- Natural pain relievers, herbs, and supplements may be useful during your physical recovery. Before you take anything internally (supplements or teas, for example), be sure to check with your health care provider, as some natural substances may interact with medications or may cause side effects that could aggravate certain symptoms you may have. You may wish to consider:
- Evening primrose oil (Dr. Axe recommends 1,500 milligrams) to relieve cramping
- Lavender and peppermint oil aromatherapy or mixed into a carrier oil and rubbed into skin to relieve pain and stress
- Epsom salt bath (talk to your doctor first since baths may be off-limits until several days after the miscarriage) to soothe sore muscles
- Angelica root (Angelicae Sinensis radix or Angelica archangelica) to help your body complete the miscarriage and start its return to normal (based on studies in animals and use in traditional medicine) (10, 11)
- Black cohosh (Cimicifuga or Actaea racemosa) may provide relief from fertility-related complaints and offer some pain relief. It may also help the miscarriage complete by stimulating the uterus. (12, 13)
- Acupuncture or acupressure. Some people find this process helpful during painful contractions or afterward, to both relieve pain and reduce stress or depression symptoms. However, research is mixed for its use for this purpose and there is virtually no formal research on its use following completed miscarriages.
- Heat and ice. Apply cold packs or heating pads as needed throughout the day for temporary pain relief in your muscles. Apply them for up to 15 minutes at a time.
- If you have vaginal pain, ask your health care provider about disposable ice packs that fit in your underwear.
- If you have breast discomfort, engorgement or leaking, the pain usually subsides within a week. Ice packs and a sports bra can help ease the pain in the meantime.
Grieve your own way
There is no right or wrong way for you to feel after a miscarriage in terms of your emotions. Many women find themselves surprised at how sad and upset they feel, while others may not feel much emotional pain at all. If you are upset, it’s all right to grieve however you feel comfortable. Common ways you can express your grief may include:
- Starting with the basics. The emotions that come with a miscarriage can be overwhelming. They may range from disappointment and guilt to anxiety and fear. Cry, sleep, talk with your partner, binge-watch a season of your favorite show, take a hot shower or do whatever feels most comforting to you, even if it’s not what you think others would expect of you.
- Spirituality. Prayer, meditation, yoga, speaking with a spiritual advisor or simply connecting with your thoughts and feelings can give you some emotional space to start processing your grief.
- Memorialize. Some women feel a desire to acknowledge, in a lasting or visible way, the grief they feel and the baby they lost. You may wish to:
- Plant a tree or flowering bush
- Hold a prayer vigil
- Frame a poem that is meaningful to you
- Create a memory book, including due date info, planned names, ultrasound images or whatever else gives you peace
- Get a piece of jewelry that commemorates the baby
- Go on a retreat
- Spread the word (or don’t). You may worry about how to tell people the news about your miscarriage if your pregnancy was known. Alternatively, you may wonder whether you should tell anyone at all if you hadn’t already announced the pregnancy. Consider these options:
- Start slowly. You don’t have to tell everyone at once.
- Tell only those who you actually want to speak with.
- Tell people only when you feel ready or when it’s absolutely necessary.
- Have a few trusted people talk for you to spread the news among your work colleagues, extended family, or circle of friends if they knew about your pregnancy.
Speak with people who understand
Miscarriage is very common. Many women find support and healing by sharing their own experience and talking about it with other women. Speaking with others can also be a great way to get perspective and advice for your road to recovery.
Specific options for getting support through talking or the sharing of experiences include:
- Cognitive behavioral therapy (CBT). This is talk therapy that also teaches strategies for relieving depression and anxiety. Clinical research in women with prior miscarriages found that it can help ease depression and anxiety. (14)
- Online and in-person support groups. You can find digital support groups online that work like forums. You can take part by just reading, posting, responding to others or any combination you like. You may also be able to find local support groups that meet in person by searching for them online or by asking your health care provider.
- Phone therapy. Many private insurance plans or employer insurance plans offer a certain amount of free counseling on the phone. You can also call the American Pregnancy Helpline at 1-866-942-6466 to discuss your miscarriage or to get assistance finding other resources to help you cope after a miscarriage. (15)
- Family and friends. If you do wish to share the news, you may find that many women you know have also miscarried. It’s not unheard of to find out that even close friends and family members had miscarriages and never told you. Many women are very willing to discuss their experiences — and yours — with you if you reach out. At the very least, they can offer a comforting shoulder to cry on or stick with you to help you get back into your groove.
- Read or write (or both). By reading other people’s miscarriage stories online or in books, you may not even need to open your mouth to find some sense of solidarity and support. You can also share your story in a written forum, blog or paper journal to help put words to the pain or other emotions you feel.
Going through the signs of miscarriage and the actual end of your pregnancy can be very stressful, as can the aftermath. Miscarriage is a loss, no matter how far along in the pregnancy you were. It is normal to feel sad, empty, confused, anxious or guilty after a miscarriage.
Anxiety, depression, irritability and stress are all possible after a miscarriage. You may also experience sleeplessness, loss of appetite, a restless feeling, lack of energy or frequent crying. (16) In most cases, these fade with time as you return to your routine. You should speak to a health care professional if your symptoms interfere with your daily life or last for more than a few weeks.
To help manage stress after a miscarriage, try some of these natural strategies:
- Exercise. When you feel physically ready for it, you may wish to start an exercise routine. Exercise helps boost mood and regulate hormones. It also gives you a new physical sensation to focus on rather than your recent physical pain.
- Start a hobby. Keeping your mind focused on something enjoyable and new gives you some mental breathing room. It also makes your brain work in different ways. As a bonus, even hobbies that allow your mind to wander — like coloring or knitting — give you time to work through stress and emotions without the pressure of focusing exclusively on how you feel. Baking, model building, scrapbooking and other hobbies also have the benefit of giving you something to keep at the end to enjoy the products of your creative efforts. (18)
- Laugh. Laughter therapy has been shown to significantly improve mood. It may also boost feel-good hormones and lower your cortisol levels, which are raised in your body when you’re stressed.
- Try watching comedies, listening to jokes, watching a clown, spending time with amusing friends or taking part in laughter yoga or laughter qigong classes.
- Journaling. This hobby has positive impacts in several ways. (19)
- It provide an outlet for your negative emotions and the personal details of your experience that you may not wish to share out loud.
- It can give you time to process what you’re feeling and work through it on paper, no matter how you feel that day.
- You can express yourself somewhere and then literally close the book on those thoughts, giving you some distance and relief.
- It can help you memorialize your experience so that, if you wish, you can always look back on how you felt and what you experienced.
- Music. Music therapy is a well-established treatment for people with a wide range of conditions, from autism to dementia to post-trauma rehabilitation.
- Your insurance may offer access to a formal music therapy session. You may also be able to pay out of pocket.
- If home-based music therapy is more your style, you can still find some stress relief benefits by playing your favorite music, songs that give you comfort, uplifting classical music and songs that reflect your recent experiences: grief, loss, healing and more.
Make a plan
Many women who experience a miscarriage try to get pregnant again very quickly. Your body may be physically capable of getting pregnant just weeks after a miscarriage. However, you may wish to take some time to be sure that you are truly ready to move forward. You can also benefit from the positive action of planning things out — taking your time to be intentional and prepared.
To prepare yourself for a future pregnancy or to give yourself more time to make a decision, consider the following:
- Talk with your doctor. Depending on the cause and difficulty of your miscarriage, your doctor may recommend that you wait before getting pregnant again.
- He or she may also wish to order tests to check for possible causes of the miscarriage, particularly if you have certain health conditions or if you had prior miscarriages.
- If you wish, your health care provider can also give information about contraception and can discuss whether any prior contraception use may have led to your miscarriage (for example, if you had an IUD in place).
- Prepare for a healthy future pregnancy. In most cases, miscarriages have nothing to do with your overall fertility or health. They do not necessarily reduce your chances of having a healthy pregnancy down the line. However, you can certainly plan to maximize your chances.
- If you have certain risks for infertility, you may be able to start taking steps to improve your likelihood of a healthy conception and pregnancy. For example, check out Dr. Axe’s natural remedies for infertility.
- Your health care provider can give advice about pregnancy planning to give you the best chance at a healthy future pregnancy. This can be in the form of a customized conception plan, which should give you specific steps you can try to follow before you conceive. (20)
- If you wish to get pregnant again soon, continue taking your prenatal vitamins and following a healthy pregnancy diet.
- Get your risk factors under control. To minimize your risk of miscarriage, you can start by avoiding certain known miscarriage risk factors.
- Get your chronic health conditions under control. If you have diabetes, thyroid problems or other health conditions, such as mental health concerns or malnutrition, take the time to take care of yourself. Once your health is in good shape, your risk of miscarriage goes down.
- Maintain a healthy weight.
- Eat a healthy, well-balanced and nutrient-dense diet.
- Avoid smoking, alcohol and street drugs.
- Talk with your physician about any medications you are taking. Also be sure to mention any herbs or supplements you take, since there may be drug interactions or side effects that impact your ability to have a healthy pregnancy.
- Fever, foul-smelling discharge, chills, pain and tenderness in the lower belly may indicate an infection. Call your doctor if you have any of these symptoms after a miscarriage.
- Depending on the severity of your symptoms, your doctor may say it’s all right to try treating your fever at home. However, follow his or her instructions for when to come in for an office visit.
- Do not attempt to self-diagnose a miscarriage. Signs of miscarriage like bleeding, cramping, pain and even passing tissue can be caused by other health problems or other pregnancy complications, some of which can be life-threatening. Seek medical advice immediately.
- Depression after a miscarriage shouldn’t be dismissed. It usually passes within a year of the miscarriage and may or may not require professional counseling or medical treatment. It can be as severe as any other form of depression, including risks for suicide, substance abuse and other serious impacts on your life and ability to function. If you or a loved one seem to be experiencing post-miscarriage depression, seek assistance from a health care professional. (21)
- Some herbs and supplements can increase your risk of bleeding or cramping. Depending on where you are in terms of a miscarriage, this can be dangerous. Always discuss herbs and supplement use with your health care provider prior to starting something new, particularly if you are actively bleeding.
Key Points About Signs of Miscarriage
- Miscarriage is the unexpected or unintentional loss of a pregnancy before 20 weeks.
- Miscarriage is very common. It affects at least 20 percent of all pregnancies and in some cases can happen without the mother even being aware.
- Signs of miscarriage depend on how far along in the pregnancy you are, but usually include bleeding, cramping and pain. Most women also pass some clots of blood or tissue.
- Infection risk is lower with early miscarriages. However, all women who miscarry have some risk of infection. Health care providers may recommend medication or an outpatient surgery to remove everything from inside the uterus and reduce infection risk.
- Physical recovery can take from a few hours to a few weeks. However, many women deal with grief and loss afterward, and emotional healing can take quite some time.
6 Natural ways to Help with Recovering from a Miscarriage
- Rest, stay hydrated and eat well
- Soothe your physical pain
- Grieve your own way
- Speak with people who understand
- Relieve stress
- Make a plan
Read Next: 7 Steps to Balance Hormones Naturally
The post Signs of a Miscarriage (+ 6 Ways to Help Ease Recovery After a Miscarriage) appeared first on Dr. Axe.
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