What does a miscarriage feel like? What to know and when to seek help

It’s common for any pregnant mama to wonder: what does a miscarriage feel like? Some cramping and spotting can be normal during pregnancy, but they can also signify the beginning of a miscarriage. 

Unfortunately, up to 26% of pregnancies end in miscarriage, including up to 10% of known pregnancies. Although there is overlap between pregnancy loss symptoms and trimesters, there are some differences in how a miscarriage may feel depending on how far along you are. 

While educating yourself is important, if you are pregnant or think you might be pregnant, it is crucial to reach out to your healthcare provider if you are experiencing any miscarriage symptoms. 

A sweet note: Many mamas worry about bothering their healthcare providers too much and may feel embarrassed to call yet again with another question or concern. Rest assured, your healthcare provider wants you to call with questions. 

What does having a miscarriage feel like in the first trimester?

According to the American College of Obstetricians and Gynecologists (ACOG), the most common symptom of a miscarriage is vaginal bleeding.

Additional symptoms may include:

• Pain that feels like menstrual cramps
• Feeling a gush of fluid come from your vagina
• Noticing tissue pass

ACOG explains that miscarriages are most common during the first trimester, meaning through week 13 of pregnancy, and that nearly 80% of all miscarriages happen during the first trimester. 

While it can be worrisome to notice bleeding at any time during pregnancy, a 2019 journal article in American Family Physician explains that about 25% of all pregnant women will experience bleeding during the first trimester. They note that the combination of pain with heavy bleeding increases the risk of experiencing early pregnancy loss. 

Related: It took until week 27 for my bleeding during pregnancy to resolve, but my son is perfect

Some common symptoms of a first trimester miscarriage overlap with other early pregnancy complications, such as an ectopic pregnancy (when a fertilized egg implants outside of the uterus, such as in the fallopian tube) or molar pregnancy (unusual growth of cells). 

Both ectopic pregnancies and molar pregnancies require treatment by a medical professional.

What does having a miscarriage feel like in the second trimester?

UC Davis Health explains the risk of a second trimester miscarriage is around 2-3%. While there is some overlap of symptoms between first and second trimester miscarriages, there are also slight differences. 

Symptoms of a second trimester miscarriage include:

• Bleeding: Bleeding during the second trimester may be due to a miscarriage or other causes. Bleeding during the second trimester is most often due to issues with the placenta. However, it can also be due to problems with the cervix, such as cervical insufficiency. Cervical insufficiency is the term used for a cervix that begins to open too early, which can cause bleeding.
  
• Cramping: Similar to first trimester miscarriage symptoms, there may be cramping in a second trimester loss. 
  
• Not feeling the baby move: Unlike in the first trimester, there is a chance that by the second trimester, you may have begun to feel your baby move. If you notice a decrease in your baby’s movement or don’t feel the baby move, this could signify a miscarriage. 

Bleeding and cramping in the second trimester may also be due to causes that aren’t due to miscarriage and can be managed by your healthcare provider. For example, if the bleeding is due to cervical insufficiency, your healthcare provider may perform a cervical cerclage alone or in combination with other therapies. 

Third trimester fetal loss

After 20 weeks, a pregnancy loss is considered a stillbirth. The symptoms of losing a pregnancy during the third trimester are very similar to those of the second trimester. 

Evaluation of a stillbirth includes whether or not the patient has experienced the following:

• Abdominal pain
• Vaginal bleeding or discharge
• Pelvic pressure
• Changes in fetal movement

If you are not feeling your baby move, or if there is a change in how your baby moves, reach out to a healthcare provider immediately. They can guide you on performing kick counts (a way to determine fetal movement) and advise if you should be seen immediately. 

You know your body and your baby’s movements best, and your medical team is there to help ensure you and your baby are doing OK and intervene if necessary.

Where to seek medical care if you think you may be experiencing a miscarriage

If you are concerned you may be experiencing symptoms of a miscarriage, there are several places you can seek care or advice depending on the time of day and whether or not your healthcare provider’s office has an after-hours nurse line.

What to do if you think you may be having a miscarriage:

• If it is during regular business hours, you can often call your healthcare provider’s office and get a same-day appointment and advice. 
  
• If you are experiencing symptoms and haven’t been to your first prenatal appointment, or it is after hours and your provider’s clinic is closed, you can often call the birth center of the hospital you plan to deliver. The nurses may provide advice over the phone and advise if you need to seek medical care immediately.
  
• Many labor and delivery nurses can also advise if you should go to the emergency department or if you can come to the birth center for care, depending on how far along you are in your pregnancy. Additionally, some hospitals have specially designated obstetric emergency departments. 

A note from Motherly on miscarriage anxiety and miscarriage

Concerns about what a miscarriage feels like and if your symptoms indicate a miscarriage are common worries many pregnant women feel. But even being evaluated for a possible miscarriage is upsetting. If you are feeling miscarriage anxiety and are still pregnant, consider reaching out to a mental health professional (or taking steps to reduce your anxiety, like deep breathing, walks and more).

Experiencing a miscarriage can unleash waves of grief, as well as a wide range of other emotions. Regardless of when the miscarriage happens in pregnancy, it is a loss.

If you are struggling to cope, reach out to your healthcare provider. They may be able to help you directly or refer you to a therapist who can provide support. 

If you have experienced a pregnancy loss, please know it’s not your fault and you are not alone. If you are struggling to cope and need immediate assistance, the Substance Abuse and Mental Health Services Administration has a hotline that provides help for those experiencing a mental health crisis 365 days a year, 24/7. They can be reached by calling or texting 988 or starting an online chat at 988lifeline.org.

Sources:

Hendriks E, MacNaughton H, MacKenzie MC. First Trimester Bleeding: Evaluation and Management. Am Fam Physician. 2019;99(3):166-174.