What Does Miscarriage Bleeding Look Like?

Vaginal bleeding is one of the most common symptoms of miscarriage, which is the spontaneous loss of a baby in the first 20 weeks of pregnancy. But blood isn't a definitive sign you're miscarrying.

Indeed, about 20 to 30% of people bleed a little in early pregnancy, and only half of those experience a miscarriage, says Jeanne Faulkner, RN, author of Common Sense Pregnancy: Navigating a Healthy Pregnancy and Birth for Mother and Baby. Other benign causes—such as implantation or cervical irritation—could also cause the bleeding.

So how can pregnant people identify miscarriage blood? And is it possible to have a miscarriage without any vaginal bleeding? We spoke with experts to answer your most pressing questions.

What Does Miscarriage Blood Look Like?

While pregnancy loss presents differently for everyone, miscarriage bleeding might have the following characteristics:

• Pink, bright red, or brown appearance
• Light spotting, sudden heavy bleeding, or a mix of both
• Bleeding that gets progressively heavier
• Blood clots that look larger than ones you pass during your monthly period; these may also contain fetal tissue
  

Miscarriage bleeding may begin as light spotting and increase in intensity as the uterus empties. It could also start suddenly and heavily, especially if you're further into pregnancy. (That's because the fetus is bigger so you'll have more miscarriage tissue to expel.) A miscarriage with multiples typically comes with greater amounts of blood than singleton pregnancies.

Is It Miscarriage Bleeding or Your Period?

It can be difficult to discern the difference between a miscarriage and your period. In fact, if you don't realize you're pregnant, you might believe that miscarriage bleeding is part of your monthly menstrual cycle. Here are some differentiating factors:

• Miscarriage bleeding is generally heavier and lasts longer than your period
• During a miscarriage, you might notice fetal tissue and large blood clots
• Miscarriage blood might be a different color than your period; it generally presents as pink, red, or brown

Does Bleeding Always Indicate Miscarriage?

Although bleeding during pregnancy is always cause for concern, it doesn't necessarily indicate a miscarriage. Other causes of bleeding in pregnancy might include cervical irritation, infection, hormonal changes, subchorionic hemorrhage, and implantation (when the egg implants into the uterine lining).

That said, keep in mind that uterine cramping and bleeding are the most common miscarriage symptoms, says Joshua Hurwitz, MD, a board-certified OB-GYN and infertility specialist. They're caused by contractions that expel the contents of the uterus. A miscarrying person may also pass large blood clots and fetal tissue.

How Long Do You Bleed After a Miscarriage?

The amount and duration of miscarriage blood depends on your pregnancy. However, you can expect the heaviest bleeding for several hours after the miscarriage begins, as your body expels most of the tissue.

You might also have lighter bleeding after the miscarriage for an additional one or two weeks. Your health care provider can inform you about the expected timeline and give tips for managing the bleeding.

Can You Have a Miscarriage Without Bleeding?

Miscarriage symptoms vary for everyone and bleeding isn't always present, says Jennifer Jolley, MD, assistant professor of maternal-fetal medicine at the University of Washington in Seattle.

Some people don't experience any symptoms of miscarriage at all. This is often called a "missed miscarriage," and it's only detected through fetal ultrasound.

Other people have some combination of cramping, bleeding, uterine pain, white-pink mucus, miscarriage clots, and loss of pregnancy symptoms. Always visit your doctor for any unusual or worrisome changes in your pregnancy.

I Might Have Miscarriage Bleeding—Now What?

Dr. Hurwitz advises anyone who's bleeding during pregnancy to visit their health care provider. Be prepared to answer a few questions. For example: What color is the blood? When did the bleeding start? How much are you bleeding? Use a panty liner or pad (never a tampon) to keep track.

Your doctor or midwife will run blood tests and conduct ultrasounds to determine if you're having "normal" bleeding or miscarriage bleeding. If they detect a miscarriage, the process is usually completed by the body without complications. Sometimes a drug can be given to stimulate contractions.

But "if there is concern the [person] could continue to bleed heavily without effective passage of the tissue, the recommendation is usually to proceed with quick evacuation of the uterus—a dilation and curettage," says Dr. Jolley. "Otherwise, it can become dangerous."

Dilation and curettage, or D&C as it's commonly called, is a surgical procedure to complete the miscarriage. Dilation will open the cervix, if it's still closed, and curettage removes the contents of the uterus using a variety of suction and scraping instruments.

The Bottom Line

Although the presence of spotting does not always indicate a miscarriage, it's a sign that something abnormal may be going on in your pregnancy. "Even if everything looks normal, the fact that the patient had spotting will be kept in the back of our minds throughout her pregnancy, says Helain Landy, MD, professor and chair of the Department of Obstetrics and Gynecology at Georgetown University Hospital.

If you end up having a miscarriage, try not to feel guilty. The majority of miscarriages are random events that can't be prevented or predicted. Indeed, some research estimates that 50%–70% of miscarriages result from chromosomal abnormalities that make the fetus incompatible with life.

Miscarriages also don't affect your future fertility in most cases, and your subsequent pregnancies have a very good chance of progressing without a hitch.