A miscarriage is defined as the spontaneous loss of a pregnancy before the 20th week of gestation. This physical process involves the uterus naturally expelling the contents of the pregnancy. It is a common event that involves bleeding, cramping, and the passage of material, which often includes blood clots and tissue. Understanding that this discharge is a normal and expected part of the body’s response can help in navigating this difficult time.
Understanding the Discharge Components
The material passed during a miscarriage is a complex mix of components, including liquid blood resulting from the shedding of the uterine lining. This bleeding may be heavier and more prolonged than a typical menstrual period.
The discharge also contains blood clots, which form when blood pools and coagulates rapidly as it exits the body. These clots are distinct from tissue and are composed solely of congealed blood. Their presence indicates a heavier flow, as the body’s natural anticoagulants cannot dissolve the blood quickly enough.
The expelled material also includes pregnancy tissue, often called the products of conception. This tissue may appear grayish, white, or dark red, and can sometimes look stringy or membrane-like. This material is composed of the decidua, the thickened uterine lining, and potentially the gestational sac.
Typical Range for Clot Size and Frequency
The size and frequency of clots are highly variable, depending primarily on the gestational age of the pregnancy. In very early miscarriages (before six weeks), the material passed may resemble a heavy period with small clots, such as those the size of a dime or a grape. The overall volume of tissue expelled is minimal.
As the pregnancy progresses, the amount of tissue and corresponding blood loss increase. It is common to pass several large clots during the most active phase, which often lasts for a few hours. Clots approximately the size of a plum or a large strawberry are within the expected range for a first-trimester loss.
The passage of multiple large clots in quick succession can be alarming but often signals that the uterus is effectively emptying itself. This heavy phase typically subsides after the bulk of the tissue has been expelled. The flow should be manageable with standard-sized absorbent pads.
Warning Signs Requiring Immediate Medical Care
While passing clots is normal, certain signs indicate excessive blood loss or infection requiring immediate medical attention. Concerning bleeding is measured by the rate of pad saturation. If you soak through two or more maxi pads in one hour for two consecutive hours, it indicates dangerously heavy bleeding.
The size of individual clots is also a warning sign. Clots consistently larger than a golf ball or a lemon suggest significant blood loss. This volume can quickly lead to hemorrhage, which may cause symptoms like dizziness, fainting, or a rapid heart rate due to low blood pressure.
Signs of infection, which can occur if tissue remains in the uterus, include a fever of 100.4°F (38°C) or higher. Other indicators of a potential septic miscarriage are persistent chills, foul-smelling vaginal discharge, and severe, unrelenting abdominal pain. If any of these symptoms occur, seek emergency care immediately.
Emotional and Physical Recovery After Miscarriage
The physical recovery phase begins once the body has expelled the pregnancy tissue. Bleeding and spotting may continue intermittently for up to one to two weeks following the heaviest phase. Uterine cramping should also gradually diminish during this time.
Hormonal changes are a major part of the physical recovery, as levels of human chorionic gonadotropin (HCG) begin to decline. This drop can take several weeks, and a follow-up appointment is recommended to ensure HCG levels have returned to a non-pregnant state. Most people will see their normal menstrual cycle resume within four to six weeks.
Emotional healing often takes much longer than physical recovery. The sudden drop in pregnancy hormones like estrogen and progesterone can contribute to feelings of sadness, anxiety, or mood swings. Seeking professional mental health support, such as counseling or grief therapy, helps manage the complex emotions that follow a pregnancy loss.