Positive pregnancy test after a miscarriage: what it can mean and what to do

Seeing a positive test after a miscarriage can be confusing and painful. Often it’s simply because the pregnancy hormone takes a while to leave your body. But sometimes a positive result needs checking, so here’s what it can mean and what to do.

Why tests can stay positive

Pregnancy tests look for hCG, a hormone your body makes in pregnancy. After a miscarriage, it takes a while for hCG to leave your body, so a test can stay positive for some time afterwards.

That’s why hospitals usually ask you to wait a few weeks before testing. A test done in the first days after a miscarriage is likely to be positive, and can be upsetting without telling you much.

When to test

If you were looked after by a hospital or early pregnancy unit, follow the advice they gave you. Many ask you to do a urine pregnancy test about 3 weeks after the miscarriage, or 3 weeks after taking medicine to complete it. Some ask you to test after 2 weeks.

A negative test at that point usually means the miscarriage is complete. If your test is negative but you still have bleeding, pain or a high temperature, contact the hospital or your GP.

If you miscarried at home without seeing anyone, you can still contact your GP or early pregnancy unit for advice and follow-up.

What a positive test can mean

NICE guidance says that if your test is still positive 3 weeks after medical treatment for a miscarriage, you should be seen again, to check for pregnancy tissue left in the womb, or a molar or ectopic pregnancy. These are the main possibilities.

Your hCG is still coming down

Sometimes levels just take longer to fall. Home tests can’t show whether hCG is falling, because they don’t measure how much there is. Blood tests taken a couple of days apart can show the trend.

Some pregnancy tissue is still in your womb

If the miscarriage isn’t complete, you may be offered a scan to check whether your womb is empty. Bleeding that’s heavy or doesn’t settle, and pain, can be signs. If tissue is left, you may be offered more time, medicine or a small procedure to remove it.

A molar pregnancy

This is rare, affecting about 1 in 600 pregnancies in the UK. In a molar pregnancy, the cells that would normally form the placenta grow abnormally, and hCG can stay high. Signs include bleeding or a brownish-red discharge, and sickness that’s worse than usual. It’s often found when tissue from a miscarriage is checked in a lab.

If you have a molar pregnancy, you’ll be followed up by one of 3 UK specialist centres (in London, Sheffield and Dundee), usually by sending blood or urine samples every 2 weeks until your hCG is back to normal, and then for a while afterwards, depending on the type of molar pregnancy. You’ll be advised not to try for another pregnancy until follow-up has finished. The chance of another molar pregnancy is low, about 1 in 100.

An ectopic pregnancy

An ectopic pregnancy grows outside the womb, usually in a fallopian tube, and can also cause bleeding. It’s one of the reasons a positive test after a suspected miscarriage needs checking, especially if you have pain on one side, pain in the tip of your shoulder, or feel faint.

A new pregnancy

You can ovulate before your first period after a miscarriage, so it’s possible to get pregnant again quickly. If you’ve had a negative test and then a positive one, it could be a new pregnancy. Tell your GP or early pregnancy unit about your recent miscarriage, as they may want to check with blood tests or a scan.

What to do

Test on the date your hospital gave you, or about 3 weeks after the miscarriage if no date was given.
If it’s still positive, contact your early pregnancy unit or the hospital that treated you. Your GP can help if you weren’t seen in hospital.
If you think you might be pregnant again, tell whoever you speak to about your recent miscarriage.
Avoid sex and tampons until the bleeding has stopped, to lower the risk of infection.

Signs to get checked straight away

Some bleeding and mild cramps are normal for up to 2 to 3 weeks after a miscarriage, and the bleeding should get lighter. Contact your early pregnancy unit or the hospital where you were treated straight away, or NHS 111 out of hours, if you have:

heavy bleeding, or bleeding that goes on for a long time
smelly vaginal discharge
tummy pain that’s getting worse
a high temperature or flu-like symptoms
being sick
pain when you wee
a painful, swollen, red leg. Call 999 if you also feel short of breath or have chest pain.

Call 999 or go to A&E if you’re soaking through a pad within an hour, passing large clots, feel faint or dizzy, or have pain you can’t control.

Questions people ask

How long after a miscarriage will a test be negative?

It varies from person to person. That’s why hospitals usually ask you to test at around 3 weeks, and to get checked if it’s still positive then.

Can I be pregnant again 2 weeks after a miscarriage?

It’s very unlikely. You can ovulate before your first period, but a new pregnancy wouldn’t show on a test this soon. A positive test 2 weeks after a miscarriage is almost always hCG that hasn’t cleared yet. If you’re not sure, speak to your GP or early pregnancy unit.

Should I keep testing every day?

It can be hard not to. But home tests can’t tell you whether your hCG is falling, so daily testing can add worry without answering the question. A blood test can show the trend.

Does a positive test mean I’m still pregnant?

Not necessarily. After a miscarriage it’s usually hCG that’s still clearing. Read can you get a false positive? for other reasons a test can be positive.

When to get help

Mild cramps that ease with rest are usually nothing to worry about. But if you’re pregnant, or think you could be, get urgent advice from your maternity unit, an early pregnancy unit or NHS 111 if you have:

any bleeding or spotting, even if it’s light
tummy pain that’s severe, on one side, or hasn’t eased after resting for 30 to 60 minutes
pain in the tip of your shoulder

Call 999 if you have bleeding along with severe tummy pain, pain in your shoulder, or feeling sick, faint or dizzy, or if the bleeding is heavy (soaking a pad soon after putting it on). Also call 999 if you have sudden, sharp and intense tummy pain and you feel very dizzy or faint, feel sick or look very pale. These can be signs of an ectopic pregnancy or a miscarriage that need treating straight away.

Support

Miscarriage UK (formerly the Miscarriage Association): 0303 003 6464, 9am to 8pm on Monday, Wednesday and Friday, and 9am to 4pm on Tuesday and Thursday. It also runs support groups, including for pregnancy after loss.
Tommy’s midwives: 0800 0147 800, Monday to Friday, 9am to 5pm.