After the diagnosis of a miscarriage your medical team will discuss treatment options.
There might be no further treatment if the scan confirms nothing remains in your womb.
If the scan shows the pregnancy remains in your womb, you might need further treatment.
There are 3 options for further treatment your doctor or midwife might recommend:
- expectant management
- medical management
- surgical management
Expectant management
Expectant management means waiting and allowing the remains of the pregnancy to leave your body naturally through bleeding. This is successful in about 50% of women who choose this option. If unsuccessful, you would need to use medical management or surgical management.
It can take some time for the bleeding to start, and the bleeding can continue for up to 3 weeks. With a missed miscarriage, the pregnancy may not start to come away for a few weeks.
You may be offered a follow-up appointment after 2 weeks. If the bleeding and pain has stopped by then, the pregnancy has probably completely left your body. You may be asked to do a urine pregnancy test one week later to make sure the pregnancy has left your body.
If you still have pain and bleeding after 2 weeks, you may be offered another ultrasound scan to check if any of the pregnancy is still in your body.
Medical management
Medical management involves inserting medication into your vagina, or swallowing tablets.
This medication helps the neck of the womb (the cervix) to open to allow the miscarriage to occur.
Pain after taking tablets
You may begin to get cramp-like tummy pains and bleeding from your vagina after taking the medical management tablets. Sometimes you may need to take painkillers for the pain.
If you're not allergic to them, you can take:
- paracetamol - take 2 500mg tablets 4 times per day
- ibuprofen - take 400mg 3 times per day
The bleeding may become heavier and it might include blood clots. This should settle down but you may have bleeding like your usual periods for another 1 to 2 weeks.
Urgent advice: Contact your maternity hospital if:
- the pain is severe
- the bleeding is heavy
- you are feeling weak
Tampons
Do not use tampons because these could cause an infection. It is safe to use pads or sanitary towels.
Follow-up appointment
Your maternity hospital will usually offer you an appointment after about 2 weeks. You may need a repeat scan to make sure the pregnancy has left your body.
Operation
About 1 in 10 women who have medical management need to have an operation to remove the pregnancy.
Surgical management
You might need to have an operation to remove the pregnancy.
This is called an ERPC (evacuation of retained products of conception). Some people call it a 'D&C' (dilatation and curettage).
You will be under either local or general anaesthetic during the surgery.
The operation is safe, but like any surgery there are some risks. These include:
- bleeding
- infection
- damage to your womb
You might need a repeat operation to make sure the pregnancy is fully removed from your body.
What happens to the baby
The baby will usually leave your body when you are bleeding (unless you have had an operation). You may not be able to identify when this has happened.
The earlier the miscarriage, the smaller it will be. It can be disturbing to see blood and not know if it contains the tissue of your baby.
Burying your baby
A laboratory may test any blood clots or tissue from your body to see if they can identify a baby. Most of the time, the laboratory cannot identify a baby.
If the lab does identify a baby, the hospital may contact you to discuss your wishes in relation to burial - you may choose to arrange a burial yourself or the hospital can arrange this for you.
