After a miscarriage: recovery, your first period and trying again

Bleeding after an early miscarriage can go on for one to two weeks, and your first period may take several weeks to return. What follows is the stretch after the loss itself: how your body settles, contraception, and what UK and US guidance says about trying again, if you want to. If you’re still waiting for care or a diagnosis, the article on miscarriage covers that part.

How bleeding and pain settle

RCOG, the UK body for obstetricians and gynaecologists, says you can bleed for one to two weeks after a miscarriage. It’s often like a heavy period for the first day or so, then lighter, and it may turn brown. The NHS describes bleeding or spotting that may last for up to 2 weeks, and tummy pain that may last for a few days.

Physical recovery varies. You may feel better after a few days or weeks, the NHS says, but it can take longer. Rest when you need to. Paracetamol can help with pain, and your pharmacist can advise on what suits you.

While you’re bleeding, pads are the better choice. Tampons could increase the risk of infection, according to RCOG, and you can go back to them once your next period arrives. ACOG, the US college of obstetricians and gynaecologists, advises not putting anything in your vagina for 1 to 2 weeks. That includes sex with penetration. The NHS says not to have sex until your symptoms have gone, because of the risk of infection. RCOG’s wording is that you can have sex when you feel physically and emotionally ready, once pain and bleeding have eased a lot.

Checking that the miscarriage is complete

In the UK, RCOG says you’ll usually be asked to do a home urine pregnancy test three weeks after the miscarriage. If it’s still positive, contact your healthcare professional or early pregnancy unit (EPU) the same day for further care. In the US, ACOG suggests a follow-up visit with your ob-gyn a few weeks after a miscarriage. An ultrasound or a blood test for the pregnancy hormone hCG may be used to check that all the tissue has passed.

If your team has given you a different plan, go with theirs, and ask them what to do if the test result or your symptoms aren’t what they said to expect.

Your first period afterwards

The NHS says it can take up to 8 weeks before you have a period again, and a few months for your periods to go back to what’s usual for you. RCOG says that if your periods are usually regular, the next one will usually come in four to six weeks. MedlinePlus, from the US National Library of Medicine, says women usually get their cycles back within 4 to 6 weeks after treatment.

The first period arrives at different times for different people. It may feel different from the periods you had before, and the next few cycles may take a while to find your old pattern.

If you use Ruva, it pauses period estimates for a while after a pregnancy ends, because the first cycles can be irregular and an estimate based on your old pattern could mislead you. Logging bleeding, your first period and how you feel still builds a record you can share with a doctor or nurse.

Contraception if you’re not trying

You can get pregnant before your first period comes. Ovulation can happen first, RCOG explains, so pregnancy is possible in the first month after a miscarriage. ACOG says you can get pregnant again as soon as 2 weeks after an early miscarriage. If you don’t want to get pregnant yet, or at all, use contraception from when you start having sex again. A GP, sexual health clinic or pharmacist can help you choose.

When you can try again

UK and US sources put this differently, so each one is given in its own terms.

Source	What it says
NHS (UK)	You can try when you feel ready, after your symptoms have gone.
RCOG (UK)	You can try as soon as you (and your partner, if you have one) feel physically and emotionally ready.
ACOG (US)	Talk with your ob-gyn about timing, and take time to recover first. You may want to wait for a period so the due date is easier to work out.
MedlinePlus (US)	It suggests waiting one menstrual cycle before trying again.

ACOG’s point about waiting for a period is a practical one: a due date is easier to work out when you know when your last period started. Waiting longer, for whatever reason, is a fair choice too.

If you’re planning another pregnancy, the article on preconception health covers the general steps, such as folic acid and looking at your medicines with a doctor.

The chances next time

RCOG says one or two early miscarriages don’t put you at higher risk of another, and that there’s a good chance of a healthy pregnancy in the future. The NHS says most women who’ve had a miscarriage go on to have a successful pregnancy, and ACOG says the same about most women after an early pregnancy loss.

Tests are offered at different points depending on where you live. The NHS suggests talking to a GP if you’ve had 3 or more miscarriages. RCOG’s guideline for doctors also uses three or more, but encourages them to consider tests after two if they suspect an underlying cause. ACOG says testing can be done after two or more. If you’ve had two, you can ask your GP what applies to you. The article on recurrent miscarriage explains what those tests can look for.

When trying again brings up fear

Many people find the next pregnancy, or the idea of one, brings worry alongside hope. You might dread a positive test as much as you want one, or feel unsure whether you want to try at all. RCOG notes that some people come to terms with a loss within weeks, while for others it takes longer, and some feel intense grief. ACOG says emotional healing often takes longer than physical healing, and that a partner’s grief may look different from yours.

There’s no timetable for any of this. Talking it through with someone you trust can help, and so can telling your GP, doctor or midwife how you’re feeling. The NHS says your GP surgery or pregnancy unit can tell you about counselling and other support, including for partners. If you get pregnant again, you can say that you’ve had a loss before and ask what extra support is available.

In the UK, Miscarriage UK, which used to be called the Miscarriage Association, runs a support line on 0303 003 6464 on weekdays.

Getting help after a miscarriage

Call 999 now (UK) or 911 (US), or your local emergency number, if you have severe tummy pain (you can’t do daily tasks or focus because of it), pain in your shoulder, feel faint or dizzy or pass out, the bleeding is heavy (soaking a pad soon after putting it on), or you feel very unwell.

Contact your GP, early pregnancy unit or NHS 111 today (UK), or your ob-gyn right away (US), if your bleeding isn’t easing or goes on longer than expected, or you have smelly discharge, fever or chills, sickness, pain that painkillers don’t ease, or you feel unwell. RCOG says these symptoms can be a sign of infection in the womb lining, or that some pregnancy tissue is still there.

If grief or anxiety is getting harder to manage, you can call Samaritans on 116 123 in the UK. In England, you can call NHS 111 and choose the mental health option. In the US, call or text 988. Call 999 (UK) or 911 (US), or your local emergency number, if you can’t keep yourself safe.