Understanding Post-Miscarriage Spotting: Causes & What to Expect

Question
Hi. My case is a bit complicated. I just had my fifth m/c at 10 weeks. Everytime, doctors have found no explaination. The previous four m/c were between 5-7 weeks. I had several ultrasounds after m/c and they said all products of conception had passed. I stopped bleeding after about 10 days. Then I got a very light period, almost no blood, with no clots a week after. Now I am spotting pink again and Im pretty confused.

Answer
Dear Athena,

You didn't note how long it had been since the miscarriage, but the first period after a miscarriage is rarely "normal". It can be heavier than normal, lighter than normal, have some clots, be very crampy or not crampy at all. One thing that is certain is that your first period will not resemble anything you've had before. To make sure it is really your first period, make sure it has been at least four weeks since your miscarriage AND you have had about 20 days of no bleeding or spotting. For the estrogen threshold to be met, you should not be bleeding anymore for that amount of time. Otherwise the lining is not being rebuilt, and you are still experiencing progesterone withdrawal.

Technically, when things go perfectly, your first period will not arrive until 4 weeks after your hCG levels reach zero. Since most women will not be tested all the way to zero (which on your forms would show as "less than 5"), you will not know exactly when this will happen. In a normal recovery, it takes three weeks for the hormone chain to fire up again, and it will not be marked by bleeding or any physical symptom. You will only know that the new cycle worked by having a period at the end of it, between five and seven weeks after your miscarriage.

More than likely you did have a complete miscarriage. I would say that it was simply the abnormal period that comes after a miscarriage. Please note that because your hormones are still trying to get back into a regular pattern again and your body is still healing, the general recommendation is to wait through 2 normal menstrual cycles before getting pregnant again.

I hope this has helped you and answered your question. I wish you well.

Brenda