Miscarriage
Miscarriage happens when a pregnancy stops growing. Eventually, the pregnancy tissue will pass out of the body. Some women will feel crampy, period-like pain and in most cases there will be vaginal bleeding.
Miscarriage is very common in the first few weeks of pregnancy. Studies show that up to one in five women, who know they are pregnant, will have a miscarriage before 20 weeks. Mostly this will happen in the first 12 weeks. The actual rate of miscarriage is even higher because some women have very early miscarriages without ever realising that they were pregnant. When women miscarry three or more times, tests can be done to look for a cause. Testing is not usually offered to women who miscarry once or twice because it is very unlikely that anything would be found.
What causes a miscarriage?
Usually no treatable cause is found for a miscarriage. Research tells us that about half of all miscarriages happen because the chromosomes in the embryo are abnormal and the pregnancy doesn’t develop properly from the start. In this case, miscarriage is nature’s way of dealing with an abnormal embryo. Nothing can be done to prevent miscarriage from occurring if a pregnancy is developing abnormally.
Treatment for miscarriage is aimed at avoiding heavy bleeding and infection. It is also aimed at looking after you, physically and emotionally.
Treatment with medicine
Medicine is available that can speed up the process of passing the pregnancy tissue. For an incomplete miscarriage, the medicine will usually encourage the pregnancy tissue to pass within a few hours. At most it will happen within a day or two. For a missed miscarriage, it may happen quickly, but it can take up to two weeks and, occasionally, longer.
Things to know:
- The pregnancy tissue will pass between four to six hours after taking the medicine, during which time you may be in hospital. After a few hours, if the pregnancy hasn’t passed, you may be sent home to wait. This will depend on where you are and which hospital you are in.
- The pregnancy tissue will pass between four to six hours after taking the medicine, during which time you may be in hospital. After a few hours, if the pregnancy hasn’t passed, you may be sent home to wait. This will depend on where you are and which hospital you are in.
- After receiving the medication there may be some spotting or bleeding like a period. When the pregnancy tissue passes, you are likely to notice heavier bleeding and clots with strong cramping, period-like pains. You can use sanitary pads and take pain relieving tablets such as paracetamol.
- Some women may need stronger pain killers or a pain relieving injection.
- A few women still need to have surgery, sometimes urgently, if they develop infection, bleed heavily or if the tissue does not pass.
Surgical Treatment (curette)
A D&C (or ‘curette’) is a minor operation. The full name is dilatation and curettage. It is done in an operating theatre, usually under general anaesthetic. There is no cutting involved because the surgery happens through the vagina. The cervix (neck of the uterus) is gently opened and the remaining pregnancy tissue is removed so that the uterus is empty. Usually the doctor is not able to see a recognisable embryo. The actual procedure usually only takes five to ten minutes, but you will usually need to be in the hospital for around four to five hours. Most of this time will be spent waiting and recovering. You may have to wait a day or two to have a curette and sometimes, while you are waiting, the pregnancy tissue will pass on its own. If this happens and all of the tissue is passed you may not need to have a curette.