Bleeding and lower abdominal cramps can be signs of an early miscarriage, but they can also occur in a pregnancy that continues. Symptoms alone cannot confirm a loss. If you notice bleeding, contact your GP or midwife straight away, even if it is light.
When to seek urgent help
In Australia, call triple zero (000) for an ambulance if you have heavy bleeding, severe abdominal pain, fainting, collapse or feel very unwell. Do not drive yourself if you feel faint or unwell.
Go to an emergency department immediately if bleeding is increasing, you have shoulder-tip pain, one-sided or worsening abdominal pain, dizziness, fever, chills or unusual-smelling vaginal discharge. Shoulder-tip pain and faintness can be signs of internal bleeding from an ectopic pregnancy, even without heavy vaginal bleeding. Do not wait for a scheduled scan if symptoms change.
Pregnancy, Birth and Baby provides guidance on getting help during miscarriage.
What might an early miscarriage feel like?
In Australia, miscarriage means pregnancy loss before 20 weeks. Early miscarriage happens in the first trimester. Possible signs include:
- Vaginal bleeding, ranging from spotting to heavier bleeding.
- Cramping or pain in the lower abdomen.
- Passing clots or pregnancy tissue.
Some miscarriages cause few or no symptoms and are found on ultrasound. This is sometimes called a missed miscarriage. Changes in nausea or breast tenderness do not, by themselves, establish whether a pregnancy is continuing. Nor can the colour of blood reliably tell you the cause.
How will my clinician check what is happening?
You may be offered an examination, ultrasound and blood tests. A vaginal ultrasound can give a clearer view in early pregnancy. Ask for an explanation before any examination and tell the clinician if you need a pause.
Sometimes it is too early for a scan to give a definite answer. Not seeing a heartbeat on a very early scan is not automatically a miscarriage. Your team may arrange another scan and repeat hCG blood tests before making a diagnosis.
If the pregnancy has not been located, follow-up is important to exclude an ectopic pregnancy. Passing clots or having bleeding that stops does not replace that follow-up. Before going home, ask for a written plan covering your next tests, results and emergency contact.
If a miscarriage is confirmed
If the pregnancy tissue has already passed completely, you may not need further treatment, although your care team will advise about follow-up. Otherwise, your team will discuss whether to wait for the tissue to pass, use prescribed medicine or have a procedure to remove it. The safest options depend on the findings, your symptoms and your preferences. Heavy bleeding or infection may require urgent treatment.
Ask about pain relief, what bleeding to expect and how completion will be checked. If you are recovering at home, sanitary pads can help you monitor bleeding. Seek help for the warning signs above rather than assuming worsening symptoms are an expected part of recovery.
Did I cause it?
Most early miscarriages are related to problems with the pregnancy’s development, often involving chromosomes. Usually, it is not because of something you did or failed to do. Sex does not cause miscarriage in an otherwise uncomplicated pregnancy; follow individual advice if your clinician recommends restrictions.
There is no reliable home remedy that can guarantee prevention or reverse a confirmed pregnancy loss. Rest can help you feel more comfortable, but you do not have to earn a healthy pregnancy by staying perfectly still or keeping every worry under control.
Support after a loss
You may feel grief, shock, numbness or a mixture of feelings. Your partner may respond differently. Ask your GP, midwife or hospital team for pregnancy-loss support or counselling when you need it. You can also use Pregnancy, Birth and Baby’s miscarriage information and support links.
For symptoms that have not been diagnosed, see bleeding in early pregnancy.
Sources and further reading
- Pregnancy, Birth and Baby: Miscarriage
- Pregnancy, Birth and Baby: Medical management of miscarriage
- The Royal Women’s Hospital: Miscarriage
- The Royal Women’s Hospital: Treating miscarriage
- The Royal Women’s Hospital: Pain and bleeding in early pregnancy
- Queensland Health: Having a miscarriage
- Queensland Health: Pain and bleeding in early pregnancy
- RANZCOG: Miscarriage, recurrent miscarriage and ectopic pregnancy (clinical guideline)
This is general information for Australian readers, not a diagnosis or individual treatment plan.
