Early Miscarriage or Chemical Pregnancy Overview

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An early miscarriage can be a difficult situation, but they are a frequent occurrence. Estimates vary on exactly how common they are, but a conservative estimate is that at least 1 in 10 pregnancies ends in an early miscarriage. If it happens to you it can be both physically and emotionally traumatic.

Symptoms of Miscarriage at 4 Weeks or Earlier

Symptoms of an early miscarriage include vaginal bleeding, cramping, or the sudden loss of pregnancy symptoms you had been experiencing, such as morning sickness or fatigue. These symptoms do not always mean that you are having a miscarriage, however. You can also have an early miscarriage without experiencing any of these symptoms.

When to See a Doctor

Even though it can be an emotionally draining experience, an early miscarriage isn't always a medical emergency. You should always go to the emergency room if you are having very heavy bleeding (such as soaking through a menstrual pad in under an hour) or if you're having symptoms of ectopic pregnancy, such as severe pain in the abdominal area, dizziness, or fainting.

In other cases, call your doctor's office and let them know what symptoms you're having. The follow-up will depend on how far along you are in your pregnancy.

Treatment

How you and your doctor respond to an early miscarriage usually depends on the timing.

Within a Week of a Missed Period

With a very early miscarriage, you may not need to visit your doctor. If the bleeding begins within a day or two of getting a positive pregnancy test and looks like a slightly heavy menstrual period, you may wish to just repeat the pregnancy test in a few days.

A negative pregnancy test usually means that you are no longer pregnant. You would most likely not require any kind of treatment after this kind of miscarriage (which is often termed a chemical pregnancy—one that occurs before an ultrasound reveals a gestational sac).

That being said, you should always see a doctor whenever you're in doubt, or if you have any questions or concerns at all. Your doctor will be able to give you the answers you need.

Many women find it helpful to talk to their doctor about the emotional aspects of an early miscarriage or about the risk of a repeat miscarriage.

More Than One Week After a Missed Period

If you think you are having a miscarriage and more than a week has passed since your missed menstrual period, the best course of action is to call your family practitioner or OB/GYN (assuming you have no emergency symptoms). Your doctor will be able to order an hCG blood test and/or an early ultrasound in order to give you an idea of what's going on.

Your doctor may offer you treatment for the miscarriage: a surgical procedure called a D&C or medicine (usually misoprostol) can induce bleeding or deal with an incomplete miscarriage. If you are early enough, and your doctor gives you the OK, expectant management is also a sensible option—this means you wait to pass the fetal tissue naturally at home. 

Can You Stop an Early Miscarriage?

It's important to understand that there is no way to stop an early miscarriage that is in progress. Doctors can only make sure that your own health is not in danger as a result of the miscarriage and offer you advice on how to move forward.

Early miscarriages, especially if they are one-time-only rather than recurrent miscarriages, are frequently related to chromosome defects in the fetus. In some ways, it can be considered "nature's way" of dealing with a baby who has a condition incompatible with life. Knowing that, however, is of little help as you cope with the emotions of miscarriage.

While you may feel somewhat reassured that there is nothing you did to cause the miscarriage, it doesn't ease the pain of losing your pregnancy.

A Word From Verywell

Feeling emotionally shaken by an early miscarriage is normal. Suddenly losing a pregnancy can be traumatic, especially if you had been trying to get pregnant (but also if you haven't). Be sure to give yourself permission and time to grieve the miscarriage as much as necessary.

As you are healing, talk to your doctor about when it is safe to try again after the miscarriage. It is an old wives' tale that you must wait after a miscarriage to become pregnant again, and many people find it healing to begin trying again.

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.

By Krissi Danielsson
Krissi Danielsson, MD is a doctor of family medicine and an advocate for those who have experienced miscarriage.