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Reproductive Health Access Project
 
 

There are three ways a miscarriage can be treated:

  1. Watch and wait: Wait for the miscarriage to happen on its own.
  2. Medication:Use pills called misoprostol at home to make the cramping and bleeding happen at a more certain time.
  3. Suction procedure:Have a clinician remove the pregnancy tissue using a simple office procedure.

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Success rates:

Some treatments work better than others. It depends on which type of miscarriage you have.

1. Incomplete miscarriage:
    When the pregnancy tissue is already passing on its own

  • This type of miscarriage will pass on its own more than 90% of the time, but it can take weeks.
  • Using misoprostol, it passes more than 90% of the time within 1 week.
  • A suction procedure works 100% of the time.

2. Fetal or embryonic demise:
    When the pregnancy has stopped growing but is not passing on its own

  • This type of miscarriage will pass on its own, without treatment, about 75% of the time, but it can take weeks.
  • Using misoprostol, it passes almost 90% of the time within 1 week.
  • A suction procedure works 100% of the time.

3. Anembryonic pregnancy or “empty sac”:
    When the pregnancy stopped growing before the fetus developed

  • This type of miscarriage will pass on its own only 66% of the time, and may take many weeks.
  • Using misoprostol, it passes about 80% of the time.
  • An aspiration procedure works 100% of the time.

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Changing from one treatment to another:

  • You can choose to watch and wait. If it takes too long, you can come back to your health care provider at any time for pills or a suction procedure.
  • If you have chosen to take the medication and it didn’t work, you can come back for a suction procedure.

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Safety:

  • All 3 treatments are safe and none of them affect your ability to get pregnant in the future.

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What to expect if you “watch and wait”:

When you wait for the cramping and bleeding to happen on its own, you won’t know when it will start. The cramping and bleeding is usually heavier than a period. The heavy bleeding is not dangerous and usually lasts from 3 to 5 hours. Lighter bleeding often lasts 1 to 2 weeks and it may stop and start a few times. Ibuprofen (up to 800 milligrams every 8 hours) and a heating pad can help relieve painful cramps.

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What to expect with misoprostol:

You will place the misoprostol pills in your vagina at a time you choose. Cramps usually start 2-6 hours after placing the pills and last for 3-5 hours. Pain medicine can be used for cramps. Ibuprofen (up to 800 milligrams every 8 hours) and/or a prescription narcotic may be used. A heating pad may help relieve the cramps. Some women get nausea, diarrhea or chills soon after using misoprostol. This should get better in a few hours. Taking the Ibuprofen before taking the misoprostol helps prevent some of the side effects. The bleeding may be much heavier than a period. This heavy bleeding is not risky; it means the treatment is working. Lighter bleeding often lasts 1 to 2 weeks and it may stop and start a few times.

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What to expect with a suction procedure:

Before the procedure you will be given pain medication to help with the cramping. The beginning of the procedure is like a Pap smear or routine GYN exam. Local anesthesia is injected around the opening of the uterus, the cervix. Next, the cervix is gently stretched and the pregnancy is removed with a small plastic device. The procedure usually takes less than 10 minutes. After resting for 15-30 minutes you will be able to go home. Most women are able to return to their usual activities the next day.

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Care Following Your Miscarriage

You can contact your physician at any time. You should call if:

  • The bleeding soaks through more than 2 maxi pads per hour for 2 hours in a row.
  • You have a fever greater than 102°F (a low-grade fever is common with misoprostol).
  • You feel very ill and have lower abdominal pain after the heavy cramping and bleeding is over.

At your follow-up visit your health care provider will make sure that the miscarriage is over by using an ultrasound, a blood test, or both. Once the miscarriage is over you can begin trying to get pregnant again as soon as you feel ready. If you do not want to get pregnant right away, ask your doctor about birth control.

The follow-up visit is also a chance to talk with your health care provider if you are feeling very emotional following the miscarriage. It is common to wonder what caused the miscarriage, and you must remember that you did not make it happen. A miscarriage is nature’s way of ending a pregnancy that would not have been healthy. Miscarriage is not caused by daily activities like stress, sports or sexual activity.

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These forms are not intended to provide legal, medical or other professional advice. They are not a substitute for consultation with a healthcare provider or for independent judgment by healthcare providers or other professionals regarding individual conditions and situations.