Loss of a pregnancy can be a sad and distressing experience, but it is not uncommon. Approximately one in six pregnancies end in miscarriage. The information given in this leaflet aims to answer some of your questions.

What happens now?

Some miscarriages are complete and require no further action. Blood loss, like a period, may continue for several days until the lining of the womb is all shed. Others may be incomplete with varying amounts of tissue being kept within the womb.

Another type of miscarriage is where the pregnancy is still intact but not growing any longer. This is called a silent or missed miscarriage. Both incomplete and silent miscarriages will probably completely miscarry if you prefer to let nature take its course.

There are three options for dealing with a pregnancy that is not ongoing. These options are the conservative or natural approach, medical approach and the surgical approach.

Should you wish, the nurse or doctor attending the Early Pregnancy Advisory Clinic (EPAC) can give you more in
depth advice.

Conservative approach

Although the length of time taken for a miscarriage to be complete is difficult to predict, in the majority of cases a pregnancy will miscarry within two to three weeks.

The contractions of the womb are usually felt as strong period-like pains. Paracetamol or a similar pain killer and a hot water bottle can often be of comfort. A risk of infection is small; wearing sanitary towels and not tampons is advised.

However, if you experience any of the following symptoms, you should contact the clinic on 01935 384385:

  • Excessive bleeding or pain
  • Unpleasant smelling/coloured discharge
  • High temperature/fever

In order to check if all the tissue has come away naturally. You will be advised to do a urine pregnancy test at home two to three weeks later. If you do not feel the miscarriage has happened or have a positive test two to three weeks later, please call the clinic on the number above.

Medical approach

Medicines may be used to induce a miscarriage if you prefer not to wait. You will be given vaginal pessaries to help relax the cervix (neck of the womb) and speed up the process.

You will need to stay in our Day Ward for most of the day when the pessaries are inserted. You will be given tablets or injections for pain relief. The bleeding is heavy initially – for a couple of hours, and you may pass some blood clots. After the pregnancy is passed, the bleeding settles but can continue like a period for up to 14 days.

In the majority of cases, the above treatment is all that is needed. In some cases (five to ten per cent) an operation is necessary should there still be some tissue left within the womb or the bleeding becomes heavier. It is advisable to do a urine pregnancy test two to three weeks later to ensure the procedure as complete.

Surgical approach

Evacuation of Retained Products of Conception (ERPC)

This method is carried out under general anaesthetic. The cervix is dilated and by using a device the pregnancy tissue is carefully suctioned out.

Like all operations involving anaesthesia there is a slight risk. There is also a small risk of infection or injury to the cervix or womb from the procedure.

Yeovil Hospital has arranged to bury tissue from failed pregnancies in a special area in Yeovil cemetery or can arrange an sensitive incineration. If you would prefer something else, please talk to the nurse who is looking after you. If in the future you would like to know where the tissue was buried, please contact the hospital chaplain via the Hospital switchboard on 01935 475122.

Generally, your chances of having a successful pregnancy in the future are the same whichever method you choose.
Following all the different approaches, it is normal to have a period-like loss for up to 14 days, which will diminish
over the period of time.

Contacts and telephone numbers

Early Pregnancy Assessment Clinic (EPAC)
Specialist nurses – Juliette Turton and Lisa Norman

Jasmine Ward
Telephone: 01935 384385

Miscarriage Association
Telephone: 01924 200799
www.miscarriageassociation.org.uk

Yeovil Pregnancy Crisis Centre
www.ypcc.co.uk

Ref:14-16-165
Review: 12/18