Bleeding After Miscarriage (Light or Heavy) How Long does It Last?

Question: Is it normal to have light or heavy bleeding after miscarriage? How long does bleeding last after a miscarriage?

Having a miscarriage in early pregnancy can be depressing.

A miscarriage is a sudden loss of your pregnancy before the age of viability (20 weeks gestation), and there are many reasons a miscarriage can happen.

Most times, in the first trimester, it happens because of chromosomal abnormalities. Other times, things like advanced age of the pregnant woman, certain medications, uncontrolled chronic illnesses (such as poorly controlled diabetes or high blood pressure), smoking, and serious infections may increase the risk of a miscarriage.

Early signs you will experience when having a miscarriage are bleeding, cramping and the sudden disappearance of symptoms of pregnancy.

It’s not uncommon to have vaginal bleeding without the death of your baby. A threatened miscarriage can occur with light spotting, and it’s still possible that you will continue with your pregnancy.

On the other hand, if you are already experiencing heavy vaginal bleeding with blood clots, it’s normal you will be concerned. Heavy bleeding in early pregnancy can be a sign that your body is expelling the pregnancy, but sometimes the pregnancy can still continue, so it’s important to see your doctor or go to the hospital quickly if this happens.

If you’ve been diagnosed with a miscarriage, and yet you are still bleeding after 2 weeks, it’s possible something is wrong, especially if the blood is still bright red or heavy, and I recommend you see your doctor for advice.

Worst still, if you had a surgical procedure to remove remnant of conception, and then you start bleeding heavily, it could be a sign of complications from the procedure and needs urgent review.

Uterine infections, incomplete miscarriage, and (more rarely) injury to the womb or cervix during a procedure may cause you to bleed for a long time.

This article explains what’s normal after a miscarriage, types of miscarriage and bleeding duration you should expect, and when to worry if you are bleeding. 

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Types of miscarriage

If you are bleeding heavily after a miscarriage, you are not alone. Here’s an email I received from Sophia (one of my blog readers):

Hi, Doc, I’m 37 years old, and I have been experiencing light bleeding for about four days. Initially, I thought it’s nothing serious and wanted to wait till it stopped.

Unfortunately, it seems bleeding is getting worse, and I have excruciating cramps.

I’m six weeks pregnant, and I have never experienced this kind of bleeding in my other pregnancies. Last two weeks I informed my doctor about my pregnancy and there was nothing wrong with me.

Is the vaginal bleeding sign of a miscarriage or should I see my doctor earlier than scheduled?

Most times, when women have a miscarriage, they will experience light spotting from their vagina that lasts only a few days. Then after, a massive bleeding with severe abdominal cramps follows.

Depending on the type of miscarriage, the duration and severity of bleeding will vary. However, if you are bleeding past two weeks after a miscarriage, or if the bleeding is getting heavier, has clots or a bad smell, I recommend you see a doctor.

1. Bleeding after threatened miscarriage

As the name suggests, a threatened miscarriage means there is a risk you could lose your pregnancy, and this happens if you experience irregular light vaginal spotting (sometimes it can be a bit heavier), usually with a closed cervix on examination.

During a threatened miscarriage, you will experience pain in your lower abdomen and your back. This pain may be dull or sharp, and then, after vaginal examination by your doctor, your cervix is still closed.

The truth is, in most early miscarriages caused by chromosomal problems, there is nothing you or your doctor can do to stop it from occurring. Your body detects an abnormally formed baby in early pregnancy and washes it out from your womb. However, sometimes there are treatable causes (like low progesterone or infections), so you still need proper assessment. NCBI+1

Doctors once advised plenty of bed rest as this seemed to improve outcome, but current research shows bed rest does not prevent miscarriage and is not routinely recommended. Your doctor may simply advise you to avoid very strenuous activity and intercourse while you are still bleeding, mainly for comfort. NCBI+2PMC+2

2. Bleeding after inevitable miscarriage

An inevitable miscarriage is diagnosed when you have much heavier vaginal bleeding with an open cervix.

After your doctor’s examination, if your cervix is open, it means your womb is already preparing to expel its content, and there is little chance your pregnancy will continue.

3. Bleeding after complete miscarriage

A complete miscarriage is the total removal of fetal tissues from within your womb. This could happen spontaneously through contraction of your uterus or through treatment by your doctor.

Either way, if a miscarriage is complete, it’s still not abnormal that you will experience on and off bleeding that is light with mild cramping for a while.

If vaginal bleeding is lasting more than 2–4 weeks, especially if it is still fresh red blood or you feel unwell, you should inform your doctor so they can check that all the tissue has passed and that there is no infection. NHS Hull+1

4. Bleeding after incomplete miscarriage

An incomplete miscarriage means that your cervix is open and some parts of the fetus have already been expelled out of your womb. This means that there are remaining fetal parts inside the uterus.

If this happens, a heavier bleeding that lasts longer than your usual period is common and may continue until the womb is completely empty.

Frequently, it’s possible that without any treatment, your womb naturally contracts to expel its content completely. However, for quick relief and to reduce the risk of heavy bleeding or infection, you may require medical treatment with tablets (for example misoprostol) or a small procedure such as manual vacuum aspiration or dilation and curettage (D & C), depending on what is safest and available. PMC+2Tommy’s+2

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Bleeding after miscarriage – How long does it last?

If you are bleeding after a miscarriage, it’s difficult to know exactly how long bleeding will last. Some women experience spotting for one or two weeks that stops completely without any further complications.

Others experience light spotting for a while followed by a heavy bleeding that expels fetal tissues.

Having said that, if you have spotted more than 2 weeks from the start of bleeding, especially if it is still bright red or getting heavier instead of lighter, you should see your doctor for examination and other tests. ACOG+1

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How to stop bleeding after a miscarriage

If you are pregnant or have recently had a miscarriage and you notice vaginal bleeding, it should always be taken seriously. Some bleeding and small clots can be normal after a pregnancy loss, but if you are unsure, or if the bleeding is heavy, painful, smells bad, or lasts longer than your normal period, you need to be checked by your doctor.

Here are some tests that will be carried out by your doctor.

1. An ultrasound scan

At your clinic visit, your OB/GYN doctor will recommend an ultrasound. This will determine if your baby is alive, and also if there are fetal parts still in your womb.

Remember that vaginal spotting during pregnancy does not always mean you will have a miscarriage. So, your doctor will use a probe inserted into your vagina (transvaginal ultrasound) or placed on your abdomen (pelvic ultrasound) to know if there is a heartbeat or not. MSD Manuals

If you’ve already had a miscarriage and are still bleeding, your doctor may recommend treatment to help clean up your womb completely, such as medicines to help expel the tissue or a small procedure (vacuum aspiration or D & C). The choice depends on your symptoms, how much tissue is left and your general health. ACOG+1

2. Blood tests

At the clinic, you should expect other blood tests to be carried out. Your doctor will check hemoglobin level to determine if you’ve lost so much blood.

Another vital test to be carried out is human chorionic gonadotropin monitoring (HCG). This hormone will rise in early pregnancy, and if after 48 hours a repeat test shows your HCG levels are falling, it’s a sign of miscarriage or that the pregnancy is failing. NCBI+1

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FREQUENTLY ASKED QUESTIONS

1. Irregular bleeding after miscarriage, is it normal?

If you have an irregular bleeding after miscarriage, it’s normal that you will be concerned. But you shouldn’t, except if it’s lasting more than 2–3 weeks, becoming heavier, has clots, smells bad or you feel feverish or unwell.

Vaginal bleeding after miscarriage usually ceases after your womb is completely cleared. During this time you may see black blood, brown discharge or sometimes bright red blood.

Talk to your doctor if spotting does not subside in 2 weeks or if it is getting worse at any time.

2. Light bleeding after miscarriage, should I worry?

Light bleeding after a complete miscarriage is not abnormal and occurs as your womb contracts to constrict blood vessels and completely clear up your womb. So, DONT PANIC.

3. Heavy bleeding after miscarriage, is it normal?

Heavier bleeding and clots in the first few hours or days after a miscarriage can be expected as your womb is pushing out fetal tissue. However, if you are soaking through one pad every hour for several hours, passing very large clots, feeling dizzy or faint, or the bleeding is not slowing down, you must seek emergency medical care. ACOG+2University of Iowa Health Care+2

On the other hand, long lasting period-like bleeding after miscarriage may indicate some fetal parts are still within your womb. Talk to your doctor for assistance.

4. Bleeding after miscarriage stopped and started again

If you have light spotting that stopped and then started again, it’s still not abnormal after a miscarriage. Bleeding can come and go and is sometimes accompanied with belly cramps, as long as it is light and you feel well.

So, don’t panic if you get an on and off light bleeding after a miscarriage. You will usually feel okay in one or two weeks time. If the bleeding becomes heavy, painful, smelly or you feel feverish, see your doctor straight away.

5. Bleeding one week after miscarriage, is it normal?

If you are bleeding 1 week after miscarriage, it’s not abnormal. It takes some time for your womb to clean up itself completely. So, be patient.

If there is a sudden increase in bleeding, severe pain, or you feel weak or dizzy, contact your doctor or go to the hospital.

6. Bleeding 2 weeks after miscarriage, is it normal?

If you are still bleeding 2 weeks after a miscarriage, light spotting can be normal. However, if bleeding is still bright red, heavy, with big blood clots or visible fetal parts, you should see your doctor for examination and routine investigations.

7. Bleeding 3 weeks after miscarriage, should I be concerned?

Yes, you should. If you are still bleeding 3 weeks after miscarriage, then it’s possible you have an incomplete miscarriage or an infection. See your doctor.

Other causes of long-term bleeding after a miscarriage are vaginal infections, uterine infections, and, rarely, uterine and cervical wall perforation during surgical removal of the retained product.

8. Bleeding 4 weeks after miscarriage, what should I do?

If you had a miscarriage, and yet, after four weeks you are still bleeding, its time to see your doctor. Your doctor will look for the cause and may treat infection, give medicines or perform a small procedure if there are still retained products in your womb.