Pregnancy Loss Physical Recovery Cramping and Pain Is Normal During a Miscarriage By Krissi Danielsson Krissi Danielsson Krissi Danielsson, MD is a doctor of family medicine and an advocate for those who have experienced miscarriage. Learn about our editorial process Updated on October 09, 2019 Medically reviewed Verywell Family articles are reviewed by board-certified physicians and family healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Rachel Gurevich, RN Medically reviewed by Rachel Gurevich, RN Facebook LinkedIn Twitter Rachel Gurevich is a fertility advocate, author, and recipient of The Hope Award for Achievement, from Resolve: The National Infertility Association. She is a professional member of the Association of Health Care Journalists and has been writing about women’s health since 2001. Rachel uses her own experiences with infertility to write compassionate, practical, and supportive articles. Learn about our Medical Review Board Print PhotoAlto/Frederic Cirou / Getty Images Table of Contents View All Table of Contents Miscarriage Other Causes of Bleeding Ectopic Pregnancy Management Miscarriage Odds Causes Cramping and some pain is normal during a miscarriage, but how much is too much? The amount of cramping during a miscarriage tends to vary by the person and how far along the pregnancy was at the time of the loss. Miscarriage Bleeding may also be an indicator of miscarriage. The amount of bleeding and cramping that you experience may vary depending on how far along you are in the pregnancy. Before 5 Weeks Most miscarriages happen before 10 weeks gestation. In a very early miscarriage before five weeks, also called a chemical pregnancy, your cramping will probably be only slightly heavier than in a menstrual period. Some women may not have a difference in the amount of cramping. Later In the First Trimester Bleeding and cramping can also vary if the pregnancy is further along. If you have a miscarriage in the middle to late first trimester, your cramping can be anywhere from barely noticeable to heavy and intense. Heavy cramping during a miscarriage is usually not a sign of a medical emergency, but if you are concerned, it is wise to check with your doctor to rule out complications. Your doctor should also be able to recommend an appropriate painkiller. Other Causes of Bleeding While cramps accompanied by vaginal bleeding is symptomatic of miscarriage, it could be an indicator of something else. Some things that may cause bleeding include: Implantation: You might have light spotting for a few days when the fertilized egg attaches to the uterus.Pregnancy hormones: You might have spotting after a cervix exam or after sex because pregnancy hormones cause the cervix to bleed easily.Non-cancerous growths: While usually not a problem, polyps and fibroids can cause bleeding.Placenta problems: If your placenta tears away from the uterus or grows too close to your cervix, your doctor may recommend bed rest until the bleeding stops. Is It Normal to Bleed During Your Pregnancy? Cramping Without Bleeding It's normal to have cramps during the first few weeks of your pregnancy because your uterus is growing. The feeling is similar to having your period. If you have any vaginal bleeding with your cramps, contact your doctor or midwife immediately. Ectopic Pregnancy An ectopic pregnancy occurs when the fertilized egg has implanted outside the uterus, usually in the fallopian tubes. Along with normal pregnancy symptoms, an ectopic pregnancy may cause cramping on one or both sides of the lower abdominal area and some women experience vaginal bleeding or spotting. An ectopic pregnancy that has ruptured will cause severe pain in the abdominal area and possibly dizziness or fainting. Some women also have shoulder pain. If you have any concerns that you might have an ectopic pregnancy, you should go to the emergency room. High, Moderate, and Low Risk Factors of Ectopic Pregnancies Medical Management of Miscarriage Once a doctor makes a miscarriage diagnosis, they may recommend medical management so you can completely pass the pregnancy. During this process, the medicines typically cause cramping and bleeding, similar to the miscarriage or your period. You may receive additional medication to deal with the cramping. In some cases, your doctor may recommend having a D&C, or dilation and curettage. An outpatient surgical procedure, a D&C removes tissue from inside the uterus to clean it out following a miscarriage. It also may result in less intense physical pain for a miscarriage later in the first trimester. How a D&E Differs From a D&C What Are the Chances I Will Have a Miscarriage? Miscarriage occurs in 10% to 20% of early pregnancies. There is a 1% to 4% percent chance of having two miscarriages in a row. Having three or more miscarriages in a row is very rare and referred to as a recurrent miscarriage. In the event of recurrent miscarriage, your doctor will order additional tests to determine if there is a problem, such as a blood clotting disorder. What Do Miscarriage Statistics Really Mean? Causes of Early Miscarriage While almost nothing you do can intentionally cause an early miscarriage, there are certain behaviors or health conditions that increase your chances of loss. Some factors that can increase the risk of early miscarriage include: An under- or over-active thyroidCocaine useHeavy cigarette smokingPhysical problems with your uterus, such as fibroids or abnormalitiesPoorly controlled diabetes The Truth About What Increases the Risk of Miscarriage Was this page helpful? Thanks for your feedback! Get diet and wellness tips delivered to your inbox. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 0 Sources Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Feodor Nilsson S, Andersen PK, Strandberg-Larsen K, Nybo Andersen AM. Risk factors for miscarriage from a prevention perspective: a nationwide follow-up study. BJOG. 2014;121(11):1375-84. doi: 10.1111/1471-0528.12694. Luise C, Jermy K, May C, Costello G, Collins WP, Bourne TH. Outcome of expectant management of spontaneous first trimester miscarriage: observational study. BMJ. 2002;324(7342):873-5. DOI: 10.1136/bmj.324.7342.873 Mayo Clinic. Miscarriage. mayoclinic.org/diseases-conditions/pregnancy-loss-miscarriage/symptoms-causes/syc-20354298 UC Davis Health System. Understanding Early Miscarriage. health.ucdavis.edu/obgyn/services/FP/early_misccariage.html