What to Do If You're Having a Miscarriage

Having a miscarriage or other form of pregnancy loss is a very confusing and frightening place to be. You are worried about your baby, your fertility, and perhaps for yourself. That makes for a lot of stress and confusion. When you add to this the unknown, the long waiting periods often required in early pregnancy between some tests to ensure or confirm the miscarriage diagnosis, it can be a very troubling time for couples.

Deciding on Treatment for a Miscarriage

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Once you know that your pregnancy is no longer viable or that you are actively miscarrying, you will have various treatment options. You might be offered a dilatation and curettage (D & C), which is a surgery to remove the contents of the uterus. You may also be offered the opportunity to have a natural miscarriage. Both of these treatments, including waiting to decide, have their benefits and risks. Be sure to talk to your doctor or midwife about which is best for your situation.

Early Ultrasound — Photo © John Fedele/Getty Images

The treatment for an ectopic pregnancy (tubal pregnancy) will vary depending on how far along you are into your pregnancy, what damage may already be done, if you are already bleeding and your obstetrical history. You may be offered a non-surgical treatment if you qualify. There are also surgical options, some of which may result in the loss of your Fallopian tube. Again, this is a decision best discussed with your doctor because of the long-lasting ramifications on your reproductive future.

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Your physical recovery will depend on what type of treatment you had. Your practitioner can help guide you in your expectations. You will want to ask questions like:

How long will I bleed?
Many women will bleed for about the same amount as a period, followed by a longer period of spotting. This spotting can last up to six to eighter weeks for some women. Typically you will bleed longer the longer you have been pregnant.
What amount of pain and cramping is normal?
This is usually confined to a very intense few hours to a couple of days depending on the length of gestation, and if you have had medication to help speed the process along or required surgery. Your doctor will give you advice on coping with pain.
Will I know if I have an infection?
Signs of infection can include a fever, a foul smell to the discharge, severe pain, redness around any potential incisions, etc.
Do I need Rhogam?
If you are Rh- then you may need to have a special shot after your miscarriage or pregnancy loss. This may not be needed if your partner was also Rh- or your baby was Rh-. This information is not known, Rhogam is usually given.
When will my period return?
This too will depend on how long you've been pregnant and how your pregnancy ended.
When should I call your office?
In general, call if you have concerns or questions. Call if you have any of the warning signs discussed or when you have been asked to by your provider.

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It is important to note that everyone grieves and heals differently after a pregnancy loss. For some people, there is little to grieve while many others feel a very deep sense of loss and longing. You will have to learn to makes decisions that you didn't think about, like telling others about your miscarriage, including your other children. You should expect that people won't know what to say to you, which will usually lead to them saying things that they shouldn't. You may also have the need for formal therapy.