Understanding Miscarriage: During a Miscarriage

No two miscarriages are alike. Because of this, your healthcare provider will talk with you about the most appropriate treatment for you. If you’re in good health and early in the pregnancy, your body may expel all the pregnancy tissue on its own. If your body doesn’t expel all the tissue, your healthcare provider may recommend treatment to prevent infection and severe bleeding (hemorrhaging).

What happens during miscarriage

Some miscarriages happen without any signs or symptoms. Most miscarriages, however, start with bleeding and cramping, which may increase over time. The cramps may get very strong. This is normal when a miscarriage is happening. Cramping widens the passage (cervix) that tissue from the uterus must pass through to leave your body. Your healthcare provider may ask you for a sample of the tissue for lab testing. This is to make sure that the cells being shed from your body are normal.

Diagnosis

To confirm the miscarriage, your healthcare provider will do a pelvic exam. Your healthcare provider might order a blood test to measure the levels of a pregnancy hormone (hCG).  He or she may also have you get an ultrasound test to find out if all of the tissue has passed from the uterus. If a miscarriage happens very early in the pregnancy, an ultrasound is not needed.

Treatment

If any tissue remains in the uterus, your healthcare provider may suggest the following measures depending on your particular situation:

  • Medicine. This is prescribed for you to take at home. The medicine causes the uterus to expel any remaining tissue. Take the medicine exactly as directed.

  • Dilation and curettage (D & C). This procedure is done in your healthcare provider’s office or at the hospital. You are given medicine to prevent pain or to allow you to relax or sleep during the procedure. The healthcare provider uses instruments to widen the cervix (dilate). Tissue and blood that line the uterus are then removed (curettage).

Be sure you talk to your healthcare provider about the risks and benefits of these treatments.

If you have Rh-negative blood

If your blood is Rh negative, you may need treatment with Rho(D) immune globulin. This injection prevents substances in your blood from attacking the baby’s blood during a future pregnancy. Your healthcare provider can tell you more.

Follow-up care

Keep all follow-up appointments. These are needed to make sure that you are healing well. During these visits, mention if you’re feeling very sad or depressed. Your healthcare provider can suggest counseling or other resources to help you.

When to seek medical care

Contact your healthcare provider if you have any of the following:

  • Severe pain in the stomach, pelvis, or low back

  • Vaginal discharge that has a bad odor

  • Bleeding that soaks a new sanitary pad each hour

  • Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider



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