Cramping and Pain Is Normal During a Miscarriage

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.

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.

Bleeding Doesn't Always Signal a Miscarriage

While cramps accompanied by vaginal bleeding is symptomatic of miscarriage, it could be an indicator of something else, including:

• 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.

Miscarriage 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.

Miscarriage Later In the First Trimester

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.

Additionally, your doctor should also be able to recommend an appropriate painkiller.

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 concern that you might have an ectopic pregnancy, you should go to the emergency room.

Medical Management of Miscarriage

Once a doctor makes a miscarriage diagnosis, she 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.

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 3 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.

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, including:

• cocaine use
• heavy cigarette smoking
• poorly controlled diabetes
• an under- or over-active thyroid
• physical problems with your uterus, such as fibroids or abnormalities