Miscarriage: Should I Have Treatment to Complete a Miscarriage?
Miscarriage: Should I Have Treatment to Complete a Miscarriage?Skip to the navigationYou may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them. Miscarriage: Should I Have Treatment to Complete a Miscarriage?Get the factsYour options- Wait to see if your body completes the
miscarriage on its own.
- Take medicine to
complete the miscarriage.
- Have surgery to complete the
miscarriage.
Key points to remember- There is no treatment that can stop a
miscarriage after it has started. The goal of
treatment is to prevent an infection and the loss of too much blood. These
problems are most likely to occur when the uterus does not completely empty.
(This is called an incomplete miscarriage.)
- For many women, the
body completes the miscarriage on its own. If you decide not to treat your
miscarriage, see your doctor. He or she will watch you closely during the time
you wait for the miscarriage to complete.
- If you have heavy
bleeding or infection during a miscarriage, you will likely need surgery to empty your uterus.
-
Medicine makes the uterus squeeze and empty. Medicine
takes longer than a procedure to empty your uterus, and it can cause pain and
side effects.
- Surgery has risks, including infection and a
possible hole (puncture) or scarring in the uterus.
- Using medicine
or waiting for the uterus to empty on its own doesn't always work. If medicine,
waiting, or both don't empty the uterus after several weeks, you may need
surgery.
FAQs A
miscarriage is the loss of a pregnancy during the
first 20 weeks. (After 20 weeks, pregnancy loss is known as a stillbirth.)
The risk of miscarriage increases as a woman ages. The loss of
a pregnancy can be very hard to accept. You may wonder why it happened or blame
yourself. But a miscarriage is no one's fault. You can't prevent it. Common signs of a miscarriage can include: - Vaginal bleeding.
- Pain in the
belly, lower back, or pelvis.
- Passing fetal tissue from the
vagina.
Bleeding may be light or heavy, and it may be constant or
come and go. It can sometimes be hard to know if light bleeding is a sign of
miscarriage. But if you have pain along with bleeding, the chance of a
miscarriage is high. Call your doctor or nurse-midwife right away if
you have symptoms of a miscarriage. Getting medical advice and care can lower
your chance of any problems from the miscarriage. Your doctor or nurse-midwife
will check to see if you: - Might be losing too much blood or getting an infection.
- Could have anectopic pregnancy, which can be
deadly. You may need emergency surgery to remove the
embryo or
fetus.
- Are at risk forRh sensitization, which may be
dangerous to a fetus in your next pregnancy. If your blood type is Rh-negative,
you will probably need treatment.
There is no
treatment to stop a miscarriage. For many women, the body completes the
miscarriage on its own. There are several treatments
to help complete a miscarriage. Depending on your condition, you may be able to
choose: - Watchful waiting
(known as
expectant management), which means that you see your
doctor and he or she watches you closely during the time you wait for the
miscarriage to complete on its own.
- Medicine
to complete the miscarriage, known as
medical management.
- Surgical treatment, such as dilation and curettage (D&C), to complete the miscarriage.
If your doctor or nurse-midwife is sure that your first-trimester or early second-trimester miscarriage is complete and all tissue has passed from your uterus, the bleeding is
likely to taper off within about a week. Unless you have a fever or heavy
bleeding, you will not need treatment. But your doctor or nurse-midwife may
want to see you sometime during the next month. Compare your options | |
|---|
What is usually involved? |
| |
|---|
What are the benefits? |
| |
|---|
What are the risks and side effects? |
| |
|---|
Take
medicineTake medicine- You take pills that empty your
uterus.
- You can be at home.
- After several hours, you will have bleeding and cramps as the
medicine starts to work. The miscarriage may take days or weeks to end.
- It completes a miscarriage more
quickly than waiting.
- You don't have the risks from surgery or anesthesia.
- It causes cramping
and bleeding. You may have more cramping than if the miscarriage ended on its
own.
- It doesn't work as well for second-trimester
miscarriages.
- It can cause side effects such as:
- Pain.
- Nausea.
- Vomiting.
- Diarrhea.
- You still may need surgery if the medicine doesn't complete the miscarriage.
Have surgeryHave surgery- It's the quickest way to complete a
miscarriage.
- You could have less bleeding than with medicine or no
treatment.
- You may have pain (but for a shorter time than with
medicine).
- Possible risks
include:
- A reaction to the
anesthesia.
- An infection.
- A
hole (puncture) or scarring in the uterus.
Have no treatmentHave no treatment- You talk to your doctor to see
if it's okay to wait for the miscarriage to end on its own.
- You can be at home.
- It could take days
or weeks for the miscarriage to end.
- You see your doctor to make sure that the miscarriage is
over.
- You don't have the risks from
medicine or surgery.
- You may have to
wait weeks for the bleeding to end.
- You still may need medicine or surgery if the miscarriage doesn't
complete on its own.
When I
learned that I was having a miscarriage, I couldn't bear the thought of it. I
knew right away that I needed to get through the physical process of the
miscarriage as quickly as possible. This way, I could begin to emotionally cope
with my loss, rather than suffering through the extra days of waiting for the
miscarriage to end. I asked my doctor to do a D&C right away.
I actually didn't have a choice about having a
D&C when I miscarried, because I was bleeding so heavily. I think that I
would have chosen to let my body miscarry on its own, but my nurse-midwife said
that this was an urgent situation. I'm just grateful that I came through it as
well as I did. It was late in my first trimester when my
doctor told me that I had started a miscarriage, probably a couple of weeks
before. She said that this is called an "incomplete miscarriage," and that I
had some choices. I could wait a little longer for bleeding to start, I could
have a D&C, or I could take a medicine that would make the miscarriage
progress. Either way, I'd have to have an Rh immunoglobulin injection, because
my blood is Rh-negative. I can't stand the idea of surgery, and I felt I had to
do something, so I chose the medicine. While I was taking it, I felt
miserable. I had stomach pain and nausea. My husband had to take care of me for
a few days. The treatment worked. And after I bled for a couple of weeks, the
miscarriage was done. I also saw a counselor a few times. She really helped me
out with recovering emotionally from my miscarriage. My doctor
is experienced with using medicine to treat miscarriage. And as a nurse, I'm
familiar with the drugs used. So I felt comfortable with choosing this kind of
treatment for ending a miscarriage. When I began to bleed during my 10th week, I went in to
see my doctor. She examined me and told me that I might be miscarrying,
but we'd have to wait to see for sure. That was a terrible time. A couple of
days later, it was clear that I was miscarrying, because I was passing some
tissue. My doctor told me that I could have a D&C or let the miscarriage
happen on its own. I decided that the natural course of things was best for me.
After a couple of weeks, the bleeding tapered off. It took me a while before I
was ready to try to get pregnant again, and I met with a counselor to help me
get through those first few months. I think it helped me, though, to have gone
through the slower process of physically and emotionally losing the
pregnancy. When my doctor told me that I was
miscarrying, I told him that I really didn't want a D&C. He agreed, saying
that he prefers a "watch and wait" approach with a miscarriage. He said that he
hardly ever uses surgery or medicine to treat a miscarriage anymore-only if
it's requested or if there are complications. I did have to have an Rh immunoglobulin injection because I'm Rh-negative and the fetus could have been
Rh-positive. Well, unfortunately, a day later, I started to bleed heavily. I
went right in to get checked, and my doctor said that I was going to lose too
much blood if he didn't do a D&C. After the D&C, I had light bleeding
for a week or so, which apparently is normal. What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
I would rather take medicine or have surgery than wait for the miscarriage to end on its own. Not important Somewhat important Very important I want to avoid surgery if I can. Not important Somewhat important Very important I would rather wait and let nature takes its course. Not important Somewhat important Very important I'm concerned about the pain and side effects from medicine or surgery. Not important Somewhat important Very important It would be harder for me emotionally to wait for the miscarriage to end on its own. Not important Somewhat important Very important My other important reasons: Not important Somewhat important Very important Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Taking medicine NOT taking medicine Leaning toward Undecided Leaning toward Having surgery NOT having surgery Leaning toward Undecided Leaning toward Waiting for the miscarriage to end NOT waiting Leaning toward Undecided Leaning toward What else do you need to make your decision?1.
How sure do you feel right now about your decision? Not sure at all Somewhat sure Very sure Your SummaryHere's a record of your answers. You can use it to talk with your doctor or loved ones about your decision. Next stepsWhich way you're leaningHow sure you areYour commentsKey concepts that you understoodKey concepts that may need reviewCredits | Author | Healthwise Staff |
|---|
| Primary Medical Reviewer | Sarah Marshall, MD - Family Medicine |
|---|
| Primary Medical Reviewer | Kathleen Romito, MD - Family Medicine |
|---|
| Primary Medical Reviewer | Adam Husney, MD - Family Medicine |
|---|
| Specialist Medical Reviewer | Kirtly Jones, MD - Obstetrics and Gynecology |
|---|
References Other Works Consulted - American College of Obstetricians and Gynecologists (2015). Early pregnancy loss. ACOG Practice Bulletin No. 150. Obstetrics and Gynecology, 125(5): 1258-1267.
- Wallace RR, et al. (2010). Counseling women with early pregnancy failure: Utilizing evidence, preserving preference. Patient Education and Counseling, 81(3): 454-461.
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them. Miscarriage: Should I Have Treatment to Complete a Miscarriage?Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision. - Get the facts
- Compare your options
- What matters most to you?
- Where are you leaning now?
- What else do you need to make your decision?
1. Get the FactsYour options- Wait to see if your body completes the
miscarriage on its own.
- Take medicine to
complete the miscarriage.
- Have surgery to complete the
miscarriage.
Key points to remember- There is no treatment that can stop a
miscarriage after it has started. The goal of
treatment is to prevent an infection and the loss of too much blood. These
problems are most likely to occur when the uterus does not completely empty.
(This is called an incomplete miscarriage.)
- For many women, the
body completes the miscarriage on its own. If you decide not to treat your
miscarriage, see your doctor. He or she will watch you closely during the time
you wait for the miscarriage to complete.
- If you have heavy
bleeding or infection during a miscarriage, you will likely need surgery to empty your uterus.
-
Medicine makes the uterus squeeze and empty. Medicine
takes longer than a procedure to empty your uterus, and it can cause pain and
side effects.
- Surgery has risks, including infection and a
possible hole (puncture) or scarring in the uterus.
- Using medicine
or waiting for the uterus to empty on its own doesn't always work. If medicine,
waiting, or both don't empty the uterus after several weeks, you may need
surgery.
FAQs What is a miscarriage?A
miscarriage is the loss of a pregnancy during the
first 20 weeks. (After 20 weeks, pregnancy loss is known as a stillbirth.)
The risk of miscarriage increases as a woman ages. The loss of
a pregnancy can be very hard to accept. You may wonder why it happened or blame
yourself. But a miscarriage is no one's fault. You can't prevent it. Common signs of a miscarriage can include: - Vaginal bleeding.
- Pain in the
belly, lower back, or pelvis.
- Passing fetal tissue from the
vagina.
Bleeding may be light or heavy, and it may be constant or
come and go. It can sometimes be hard to know if light bleeding is a sign of
miscarriage. But if you have pain along with bleeding, the chance of a
miscarriage is high. What should you do if you are or might be miscarrying?Call your doctor or nurse-midwife right away if
you have symptoms of a miscarriage. Getting medical advice and care can lower
your chance of any problems from the miscarriage. Your doctor or nurse-midwife
will check to see if you: - Might be losing too much blood or getting an infection.
- Could have anectopic pregnancy, which can be
deadly. You may need emergency surgery to remove the
embryo or
fetus.
- Are at risk forRh sensitization, which may be
dangerous to a fetus in your next pregnancy. If your blood type is Rh-negative,
you will probably need treatment.
How is a miscarriage treated?There is no
treatment to stop a miscarriage. For many women, the body completes the
miscarriage on its own. There are several treatments
to help complete a miscarriage. Depending on your condition, you may be able to
choose: - Watchful waiting
(known as
expectant management), which means that you see your
doctor and he or she watches you closely during the time you wait for the
miscarriage to complete on its own.
- Medicine
to complete the miscarriage, known as
medical management.
- Surgical treatment, such as dilation and curettage (D&C), to complete the miscarriage.
If your doctor or nurse-midwife is sure that your first-trimester or early second-trimester miscarriage is complete and all tissue has passed from your uterus, the bleeding is
likely to taper off within about a week. Unless you have a fever or heavy
bleeding, you will not need treatment. But your doctor or nurse-midwife may
want to see you sometime during the next month. 2. Compare your options| | Take medicine | Have surgery |
|---|
| What is usually involved? | - You take pills that empty your
uterus.
- You can be at home.
- After several hours, you will have bleeding and cramps as the
medicine starts to work. The miscarriage may take days or weeks to end.
| |
|---|
| What are the benefits? | - It completes a miscarriage more
quickly than waiting.
- You don't have the risks from surgery or anesthesia.
| - It's the quickest way to complete a
miscarriage.
- You could have less bleeding than with medicine or no
treatment.
|
|---|
| What are the risks and side effects? | - It causes cramping
and bleeding. You may have more cramping than if the miscarriage ended on its
own.
- It doesn't work as well for second-trimester
miscarriages.
- It can cause side effects such as:
- Pain.
- Nausea.
- Vomiting.
- Diarrhea.
- You still may need surgery if the medicine doesn't complete the miscarriage.
| - You may have pain (but for a shorter time than with
medicine).
- Possible risks
include:
- A reaction to the
anesthesia.
- An infection.
- A
hole (puncture) or scarring in the uterus.
|
|---|
| | Have no treatment |
|---|
| What is usually involved? | - You talk to your doctor to see
if it's okay to wait for the miscarriage to end on its own.
- You can be at home.
- It could take days
or weeks for the miscarriage to end.
- You see your doctor to make sure that the miscarriage is
over.
|
|---|
| What are the benefits? | - You don't have the risks from
medicine or surgery.
|
|---|
| What are the risks and side effects? | - You may have to
wait weeks for the bleeding to end.
- You still may need medicine or surgery if the miscarriage doesn't
complete on its own.
|
|---|
Personal storiesPersonal stories about miscarriage treatment
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"When I learned that I was having a miscarriage, I couldn't bear the thought of it. I knew right away that I needed to get through the physical process of the miscarriage as quickly as possible. This way, I could begin to emotionally cope with my loss, rather than suffering through the extra days of waiting for the miscarriage to end. I asked my doctor to do a D&C right away." "I actually didn't have a choice about having a D&C when I miscarried, because I was bleeding so heavily. I think that I would have chosen to let my body miscarry on its own, but my nurse-midwife said that this was an urgent situation. I'm just grateful that I came through it as well as I did." "It was late in my first trimester when my doctor told me that I had started a miscarriage, probably a couple of weeks before. She said that this is called an "incomplete miscarriage," and that I had some choices. I could wait a little longer for bleeding to start, I could have a D&C, or I could take a medicine that would make the miscarriage progress. Either way, I'd have to have an Rh immunoglobulin injection, because my blood is Rh-negative. I can't stand the idea of surgery, and I felt I had to do something, so I chose the medicine. While I was taking it, I felt miserable. I had stomach pain and nausea. My husband had to take care of me for a few days. The treatment worked. And after I bled for a couple of weeks, the miscarriage was done. I also saw a counselor a few times. She really helped me out with recovering emotionally from my miscarriage." "My doctor is experienced with using medicine to treat miscarriage. And as a nurse, I'm familiar with the drugs used. So I felt comfortable with choosing this kind of treatment for ending a miscarriage." "When I began to bleed during my 10th week, I went in to see my doctor. She examined me and told me that I might be miscarrying, but we'd have to wait to see for sure. That was a terrible time. A couple of days later, it was clear that I was miscarrying, because I was passing some tissue. My doctor told me that I could have a D&C or let the miscarriage happen on its own. I decided that the natural course of things was best for me. After a couple of weeks, the bleeding tapered off. It took me a while before I was ready to try to get pregnant again, and I met with a counselor to help me get through those first few months. I think it helped me, though, to have gone through the slower process of physically and emotionally losing the pregnancy." "When my doctor told me that I was miscarrying, I told him that I really didn't want a D&C. He agreed, saying that he prefers a "watch and wait" approach with a miscarriage. He said that he hardly ever uses surgery or medicine to treat a miscarriage anymore-only if it's requested or if there are complications. I did have to have an Rh immunoglobulin injection because I'm Rh-negative and the fetus could have been Rh-positive. Well, unfortunately, a day later, I started to bleed heavily. I went right in to get checked, and my doctor said that I was going to lose too much blood if he didn't do a D&C. After the D&C, I had light bleeding for a week or so, which apparently is normal." 3. What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
I would rather take medicine or have surgery than wait for the miscarriage to end on its own. Not important Somewhat important Very important I want to avoid surgery if I can. Not important Somewhat important Very important I would rather wait and let nature takes its course. Not important Somewhat important Very important I'm concerned about the pain and side effects from medicine or surgery. Not important Somewhat important Very important It would be harder for me emotionally to wait for the miscarriage to end on its own. Not important Somewhat important Very important My other important reasons: Not important Somewhat important Very important 4. Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Taking medicine NOT taking medicine Leaning toward Undecided Leaning toward Having surgery NOT having surgery Leaning toward Undecided Leaning toward Waiting for the miscarriage to end NOT waiting Leaning toward Undecided Leaning toward 5. What else do you need to make your decision?
Check the facts
1.
If I have a miscarriage, I will have to get treatment with medicine or surgery. That's right. A miscarriage often completes on its own. 2.
I may need to have surgery even if I wait or take medicine. You're right. You may need surgery if waiting or medicine doesn't work. 3.
If I have heavy bleeding or an infection, surgery is my best choice. You're right. You may need surgery if you have heavy bleeding or an infection. Decide what's next1.
Do you understand the options available to you? 2.
Are you clear about which benefits and side effects matter most to you? 3.
Do you have enough support and advice from others to make a choice? Certainty1.
How sure do you feel right now about your decision? Not sure at all Somewhat sure Very sure 2.
Check what you need to do before you make this decision. Credits | By | Healthwise Staff |
|---|
| Primary Medical Reviewer | Sarah Marshall, MD - Family Medicine |
|---|
| Primary Medical Reviewer | Kathleen Romito, MD - Family Medicine |
|---|
| Primary Medical Reviewer | Adam Husney, MD - Family Medicine |
|---|
| Specialist Medical Reviewer | Kirtly Jones, MD - Obstetrics and Gynecology |
|---|
References Other Works Consulted - American College of Obstetricians and Gynecologists (2015). Early pregnancy loss. ACOG Practice Bulletin No. 150. Obstetrics and Gynecology, 125(5): 1258-1267.
- Wallace RR, et al. (2010). Counseling women with early pregnancy failure: Utilizing evidence, preserving preference. Patient Education and Counseling, 81(3): 454-461.
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.Current as of:
March 16, 2017 Last modified on: 8 September 2017
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