What to Do After a Miscarriage at Home: A Step-by-Step Guide

If You're Actively Miscarrying Right Now

If you're reading this mid-crisis, here's what matters most.

Call 911 or go to the ER immediately if:

• You're soaking through two thick pads per hour for two consecutive hours
• You feel dizzy, faint, or your heart is racing at rest
• You have a fever above 100.4°F (38°C)
• You're experiencing severe one-sided abdominal pain (possible ectopic pregnancy)
• You've passed a large amount of tissue and the bleeding isn't slowing

If you're bleeding heavily but not at emergency levels, contact your OB or midwife's after-hours line promptly for guidance.

Supplies to Have Ready

Having these items on hand reduces the number of decisions you need to make while your body is in active crisis:

• Overnight or postpartum pads — pads make it easier to monitor bleeding; if you have been prescribed vaginal medication, follow your clinician's instructions
• Dark towels and dark sheets to replace your bedding
• A heating pad for cramping
• Pain relief recommended or approved by your provider — follow the label or your provider's dosing instructions
• Electrolyte drinks and bland snacks — dehydration compounds the dizziness
• A collection basin if your provider has discussed tissue testing — a clean container placed under the toilet seat works
• Sterile saline solution and a sterile container for tissue preservation (see below)
• Mesh or disposable underwear for comfort
• Blue absorbent bed pads to protect your mattress

Tracking Bleeding

Count the number of pads you saturate per hour. "Saturated" means soaked through — front to back, unable to absorb more. Light-to-moderate bleeding that requires changing a pad every one to two hours is within the expected range for an active miscarriage.

Keep a simple log: time, pad count, size of any clots passed. This information is invaluable for your follow-up appointment and helps your provider assess whether the process is completing normally.

Tissue Preservation If Testing Is Planned

If your provider has discussed chromosomal or cytogenetic testing — particularly relevant if you've had two or more losses — you may need to collect and preserve the tissue.

Gestational tissue looks different from blood clots. Clots are dark red, jelly-like, and soft. Pregnancy tissue is firmer, fibrous, and pinkish-grey or tan. If you're unsure, collect it and let the lab sort it out.

Place the tissue in a sterile container with sterile normal saline (not tap water, which destroys cells through osmotic lysis, and never formalin, which kills the cells and prevents chromosomal analysis). Refrigerate at 4 to 8°C. Do not freeze — ice crystals rupture cell membranes. Transport to the lab within 24 to 72 hours.

The First 48 Hours After

Once active bleeding has slowed:

1. Rest. Your body has gone through a physically demanding process. Expect fatigue, cramping, and intermittent lighter bleeding for days to weeks.
2. Monitor for infection. A low-grade temperature is common, but fever above 100.4°F, foul-smelling discharge, or worsening pain signals possible retained tissue or infection — call your provider.
3. Use pads rather than tampons while bleeding. Bathing or showering is safe; avoid swimming until bleeding stops, and follow your provider's advice about when to resume sex.
4. Delegate. If someone in your life can handle groceries, childcare logistics, or fielding phone calls, let them. This is not the week for self-sufficiency.

Your Follow-Up Appointment

Your provider will typically schedule a follow-up within one to two weeks to confirm the miscarriage is complete. This usually involves a transvaginal ultrasound and may include a blood draw to track declining hCG levels. If tissue has been retained, you may need medication (misoprostol) or a D&C procedure to complete the process.

Bring your bleeding log and any questions about when to expect your period to return (typically four to six weeks), when it's safe to try conceiving again, and whether any testing is recommended based on your history.

The After a Miscarriage toolkit includes a first-48-hours checklist, a bleeding tracking log, and tissue preservation instructions you can print and keep in your bathroom.