Introduction
Losing your baby is a very sad and difficult time. You may be facing difficult choices at a distressing time. This booklet contains some very basic information about treatments available for miscarriage which you may find helpful.
How is miscarriage managed?
There are 3 ways of treating your miscarriage.
- No treatment / Natural Miscarriage
You do not have to have any treatment for your miscarriage. It will happen on its own in the end but we do not know when. It is a very safe way of managing your miscarriage with very little risk. These risks are:
- Less than 1% risk of severe bleeding – 1 to 2 women in every 1000 (1-2:1000) may require blood transfusion following a miscarriage regardless of their chosen treatment.
- 3% risk of infection.
It can sometimes take several weeks for the miscarriage to complete itself. If it is taking too long or the bleeding and pain is too bad, you may need different treatment such as medical or surgical management which are explained below. This happens in 50-80% of cases.
During the miscarriage, you will have bleeding with clots and bad tummy pains. Sometimes the bleeding is very heavy with large clots and really bad tummy pains like contractions. Sometimes you may pass the pregnancy sac, tiny baby and placenta. After this you will still have bleeding and mild pains on and off for up to 3 weeks.
You should do another pregnancy test 3 weeks after you think the miscarriage has happened. If your pregnancy test is still positive, please contact your Gynaecology Ward or Early Pregnancy Unit on the telephone number on the front of this booklet.
Medical Treatment
We can give you tablets to speed up the miscarriage. This is very much like a natural miscarriage without the waiting. The tablets used are called Mifepristone and Misoprostol.
Mifepristone is a synthetic steroid which stops the supply of hormones that maintain the womb during pregnancy. Misoprostol is a drug normally used for the treatment of stomach ulcers. However, research has proved it is also very effective at causing contractions and is commonly used with the mifepristone to induce labour and treat miscarriages. Although Misoprostol is unlicensed by the manufacturer for this treatment, it is recommended by the Royal College of Obstetricians and Gynaecologists and is safe to use in this procedure.
Misoprostol is very effective at causing the contractions that are needed to speed up the miscarriage process. Because it causes contractions, it will cause tummy pains that often start within an hour of taking the tablets.
It is a very safe way of managing your miscarriage with very little risk. These risks are:
- Less than 1% risk of severe bleeding and needing a blood transfusion.
- 3% risk of infection
- Common side effects of Misoprostol include nausea, vomiting, diarrhoea, chills or feelings of going very hot then cold, headaches, skin rash.
What happens
The treatment works in 85% of cases but may sometimes fail.
The miscarriage usually happens within 1-14 days of taking the tablets. Most people prefer to go home to wait for this to happen. Some people prefer to stay in hospital for a few hours.
After taking the tablets you will have bleeding with clots and bad tummy pains. Sometimes the bleeding is very heavy with large clots and really bad tummy pains like contractions. Sometimes you may pass the pregnancy sac, tiny baby and placenta. After this you will still have bleeding and mild pains on and off for up to 3 weeks.
If it is taking too long or the bleeding and pain is too bad, you may need different treatment such as surgical management which is described below.
You should do another pregnancy test 3 weeks after you think the miscarriage has happened. If your pregnancy test is still positive, please contact your Gynaecology Ward or Early Pregnancy Unit on the telephone number on the front of this booklet.
- Surgical Treatment
This is a small operation to remove all the pregnancy tissue through the cervix and vagina. It does not involve any cuts in your tummy. It works 95% of the time, rarely some pregnancy tissue can be left.
Surgical treatment for miscarriage is done by a doctor. The operation involves opening the neck of your womb (cervix) and gently sucking out the pregnancy sac, tiny baby and placenta.
Surgical treatment can be done in 2 ways:
- While you are asleep with a general anaesthetic. This usually means spending a full day and possibly overnight in hospital. Your tummy needs to be empty for the anaesthetic to be safe. Therefore, you will be told not to eat or drink for up to 6 hours before the operation. Although the operation only takes 15 minutes, you may need to stay in hospital overnight.
- While you are awake with a local anaesthetic. This is also called Manual Vacuum Aspiration (MVA) A separate information booklet is available about this operation. This is usually done in a clinic room and takes about 15 minutes. You can usually go home within 1-2 hours.
Risks of surgery include severe bleeding which may result in a blood transfusion, infection (3:100), treatment failure / pregnancy tissue left behind (5:100 women), scarring tissue of the endometrium / lining of the womb (10 -30:100), perforation of uterus (5:1000 women), injury to other pelvic organs, trauma of cervix.
You should do another pregnancy test 3 weeks after your treatment. If your pregnancy test is still positive, please contact your Gynaecology Ward or Early Pregnancy Unit on the telephone number on the front of this booklet.
What are the benefits and risks of the different treatments?
| Type of treatment | Benefits | Risks |
| Natural | Comforts of being at home Privacy Family support Childcare may be easier | Can take a long time. Heavy bleeding with clots and severe tummy pain Treatment can fail. 1% risk of unsafe amount of bleeding 3% chance of infection |
| Medical treatment at home | Comforts of being at home Privacy Family support Childcare may be easier | Side effects of tablets – nausea, vomiting, diarrhoea, chills / fever, rash, headache. Heavy bleeding with clots and severe tummy pain Treatment can fail. 1% risk of unsafe amount of bleeding 3% chance of infection |
| Medical treatment in hospital | Can feel safer Access to expert care and advice Access to pain killers | Side effects of tablets – nausea, vomiting, diarrhoea, chills / fever, rash, headache. Heavy bleeding with clots and severe tummy pains Treatment can fail (no pregnancy tissue passed) 1% risk of unsafe amount of bleeding 3% chance of infection |
| Surgical while asleep | Miscarriage is completed quickly Can eat and drink normally Less time in hospital | Mild pain Risk of injury from surgical instruments Treatment can fail (not all pregnancy tissue removed) 1% risk of unsafe amount of bleeding 3% chance of infection |
Funeral Arrangements
You may wish to arrange some form of funeral for your baby’s remains. We can help you with this. There is another booklet that explains the different options. Please ask your nurse or doctor for more information.
What happens when I go home?
Bleeding and Pain
Regardless of the treatment you chose, we expect that you may have some tummy pains and bleeding with small clots from your front passage (vagina) for up to 3 weeks after your miscarriage. Please do not use tampons for this bleeding. It is safer to use pads to avoid the risk of infection.
If you are worried about anything such as heavy bleeding, severe pain, smelly discharge or high temperatures during this time, please contact your Gynaecology Ward or Early Pregnancy Unit on the telephone numbers on the front cover of this booklet.
Pregnancy Test in 3 weeks
We recommend that you do another pregnancy test 3 weeks after your miscarriage or treatment for miscarriage.
If the test is negative and you have no bleeding or pain at this time, we know that your body has recovered.
If your pregnancy test is positive after 3 weeks, or you still have bleeding or pain, you may need some more tests to check on your recovery.
Until your pregnancy test is negative, you can contact your Gynaecology Ward or Early Pregnancy Unit on the telephone numbers on the front cover of this booklet.
Is there anything else I should know?
After a miscarriage, you may need time to recover physically as well as emotionally. You may find it helpful to speak to someone about how you are feeling. The following people or organisations may be helpful for you.
Hospital Pastoral & Spiritual Care Team
Grimsby and Scunthorpe Hospitals/Telephone: 03033 302489
National Support Groups
The Miscarriage Association
C/o Clayton Hospital
Northgate
Wakefield
West Yorkshire WF1 3JS
Telephone: 01924 200799 (Mon-Fri 9am to 4pm)
Fax: 01924 298334
www.miscarriageassociation.org.uk
SANDS (Stillbirth & Neonatal Death Society)
28 Portland Place,
London
W1B 1LY
Tel: 0808 164 3332
https://www.uk-sands.org/
Local Support Groups
Grimsby & Cleethorpes SANDS (Stillbirth & Neonatal Death Society)
Local helpline: 07548 355913
Email: [email protected]
Facebook: Facebook.com/Grimsbycleesands
Meeting Date & Time
First Wednesday of every month between 7:30 pm – 9:30 pm
Venue
Holiday Inn Express, 3-9 Wellowgate, Grimsby, DN32 0RA
Scunthorpe SANDS (Stillbirth & Neonatal Death Society)
Local Helpline: 07522 938821
Email: [email protected] Facebook: https://www.facebook.com/pg/Sands-Scunthorpe-2171063973121340/about/?ref=page_internal
Meeting Date & Time
Second Wednesday of every month between 7.15pm – 9.15pm
Venue
1, Printers Yard, Fenton Street, Scunthorpe, DN15 6QX
Further Information
Further information can be obtained from your nurse or doctor or the following websites:
Miscarriage Association
https://www.miscarriageassociation.org.uk/
NHS Website
https://www.nhs.uk/conditions/Miscarriage/
Any Comments, Compliments, Concerns or Complaints
If you have any other concerns please talk to your nurse, therapist or doctor. Our Patient Advice and Liaison Service (PALS) is available on 03033 306518 (Grimsby, Scunthorpe and Goole). You can also contact [email protected]
As a Trust we value equality of access to our information and services, therefore alternative formats are available on request at [email protected]
Review information
Date of Issue: December 2023
Review Period: December 2026