What Does a Miscarriage Look Like?

Miscarriage Versus Heavy Menstruation

Woman suffering from abdominal pain
Getty Images/BSIP/UIG

The frequency and quality of your menstrual cycle can change due to stress, short-term illness (like the flu), chronic medical conditions, dietary changes (weight loss or gain), and hormonal changes.

If your period is heavier than usual with thick clots or gray tissue, your brain may jump to the conclusion that you are having a miscarriage. While this may be true in some cases (especially if you had a positive pregnancy test before the bleeding started), in other cases it may just be a heavy period.

Tissue Appearance From a Miscarriage

The tissue from an early miscarriage may not be obvious to the naked eye. Many early miscarriages simply look like heavy menstrual periods, sometimes with tiny blood clots in the discharge. If the miscarriage happened with development beyond four or five weeks gestational age, it is possible that there may be a small, transparent gestational sac with the rudimentary beginnings of a placenta on its edge.

If your miscarriage happened beyond six weeks, you may pass an identifiable embryo or fetus in the early stages of development, which may be as small as a pea or larger than an orange depending on how far along you were when the baby stopped growing. It is a good idea to see a doctor if you are miscarrying, especially if you are in the later part of the first trimester or beyond. Sometimes even in a later first-trimester miscarriage there may not be recognizable tissue.

Sometimes the baby stops growing and begins to deteriorate before the onset of the miscarriage bleeding.

If You Aren't Sure You Are or Were Pregnant

If you are taking any form of contraceptives or practicing birth control methods, a heavy flow is less likely to be a miscarriage. If you recently started a new hormonal therapy like progestins or a combined oral contraceptive pill, you may notice changes in your flow.

Some people have a rare reaction to these therapies and their bodies expel a decidual cast—a piece of tissue that is the shape and size of the uterine cavity. Decidual casts can also occur in women with ​ectopic pregnancies.

A heavy flow can also be caused by certain medical conditions such as fibroids and hypothyroidism.

What to Do If You Think You Are Having a Miscarriage

If you think you are having a miscarriage, call your doctor to find out whether or not you need to be evaluated for treatment. Over the phone, your doctor should be able to give you an educated guess as to the cause of the bleeding. If you are concerned and cannot get in touch with your doctor, you can go to the emergency room or urgent care.

Your doctor may want to see you for a checkup or they may recommend you go straight to the emergency room if you are bleeding heavily. Your doctor may also ask for a sample of the tissue so that they can have it tested. If you already have a history of miscarriages, your doctor may be able to test for chromosome abnormalities that might explain what happened.

A Word From Verywell

Most miscarriages are one-time events that occur because of random chromosome abnormalities in the baby and not because of anything you did or did not do.


American Pregnancy Association.​ (2016).  Concerns Regarding Early Fetal Development

Internet Scientific Publications. (2013). Decidual Cast.