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Miscarriage Treatment And Aftercare

by — Last updated: 2019-09-04 in Pregnancy

Table of Contents

Miscarriage — pregnancy loss before the twentieth week — is surprisingly common. What should every woman know about its symptoms, diagnosis, treatment and aftercare?

Managing Your Miscarriage Naturally

An actively progressing first-trimester miscarriage may or may not be managed medically, depending on your location and sometimes depending on your own individual choice. 

In most cases, it will be perfectly safe to let a miscarriage that has already begun complete on its own, in the comfort of your own home.

Your healthcare provider may ask you to save the tissues that you lose, but not always. You will certainly be asked to come in for an appointment after some time has passed. The timing depends on your location again. I was asked come back after two weeks following my miscarriage in one European country, and after four weeks in another.

When should you call your healthcare provider before the agreed follow-up appointment? If you show signs of infection:

  • A raised temperature

  • A tender abdomen

  • Flu-like symptoms

  • Foul-smelling vaginal discharge/blood

Also call your healthcare provider or go to the emergency room if you are losing a lot of blood and are feeling faint. You may be hemorrhaging. Around one percent of miscarrying women will need a blood transfusion. The pain you will inevitably experience can be managed with over-the-counter painkillers, but women who have a hard time coping can always call their doctor.

Missed Or Incomplete Miscarriage

Missed or incomplete miscarriages require medical management. An incomplete miscarriage is one that started naturally but did not complete; pregnancy-related tissues remain inside the uterus, where they threaten to create an infection. A missed miscarriage is one that did not start up at all, despite fetal demise. 

A dilation and curettage — more commonly referred to as a D&C — is the go-to procedure for incomplete and missed miscarriages. The procedure is usually carried out under general anesthesia, but can also be done with a local anesthetic.

During a D&C, your cervix is dilated (widened) and the contents of your uterus are surgically removed, along with the tissues that line it. 

After the procedure, you may receive painkillers to cope with your discomfort. You should also call your healthcare provider if you start bleeding heavily, feel faint, or notice the signs of infection described above. You should see your doctor for a follow-up appointment at a predetermined time. 

Missed and incomplete miscarriages may also be managed with medication that kick-starts the emptying of your uterus. Medical management of these miscarriage may involve a combination or oral and vaginal drugs, or only vaginal drugs. Patients may complete their miscarriages in hospital or at home. 

Second-Trimester Miscarriage Treatment

A second-trimester miscarriage is very different from one that occurs within the first 12 weeks. Women who miscarry at this point tend to have a lot more discomfort, as well as less choice in their treatment plan — since treatment is determined by their individual circumstances. 

Medical management of a second-trimester miscarriage is not only possible, but frequent too. The main difference between medical management of a first-trimester miscarriage and a second-trimester miscarriage is that you will almost always have to stay in hospital throughout your miscarriage if you were already in your second trimester.

In hospital, you will have access to pain relief (including epidural anesthesia) and careful monitoring to keep you safe. 

In some cases, a dilation and evacuation is carried out for second-trimester miscarriages. This procedure is similar to a D&C, but a little more invasive. Not every doctor is able to carry this procedure out, nor is it right in all circumstances.

Taking Care Of Yourself After Miscarriage

Miscarriage is a sad event that affects every woman differently. You may feel a little sad but also ready to move on, or your miscarriage may send you into full-blown grief mode.

There is no right or wrong way to deal with a miscarriage, beyond accepting your feelings and honoring your own needs. 

Some women (and their partners, too), will benefit from grief counseling following a pregnancy loss. They may also want to deal with fears about a possible next miscarriage in therapy. Many people who experienced pregnancy loss are helped by doing something special to commemorate their lost baby. This is highly individual, but it can range from an actual funeral to planting a tree, writing a poem, getting a tattoo or having a physical reminder of the lost baby in the house — a friend of mine has a little glass angel, for instance. 

Read More: Miscarriage Signs, Symptoms and Treatment in Early Pregnancy

It is generally very safe to try to conceive again very soon after a miscarriage. After a first-trimester miscarriage, you need to wait until your bleeding has stopped and you have had one period before starting again.

Women who conceive again within six months of a previous miscarriage were actually found to have safer pregnancies than those who did not miscarry recently.