Miscarriage: Should I Have Treatment to Complete a Miscarriage?
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?
Get the facts
Your 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.
For some, the loss of a pregnancy can be very hard. You may wonder why it happened.
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 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 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 your doctor 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 procedure, such as dilation and evacuation, to complete the miscarriage.
If your doctor or 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 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 surgical procedure right away.
I actually didn't have a choice about having a surgical procedure 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 midwife said that this was an urgent situation.
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 surgical procedure, or I could take a medicine that would make the miscarriage progress. I chose the medicine. While I was taking it, I felt miserable. I had stomach pain and nausea. My family had to take care of me for a few days. And after I bled for a couple of weeks, the miscarriage was done.
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 surgical procedure 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 counsellor 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.
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
3. Use the following space to list questions, concerns, and next steps.
Your Summary
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
Next steps
Which way you're leaning
How sure you are
Your comments
Key concepts that you understood
Key concepts that may need review
Credits
| Author | Healthwise Staff |
|---|
| Clinical Review Board | Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals. |
|---|
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 Facts
Your 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.
For some, the loss of a pregnancy can be very hard. You may wonder why it happened.
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 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 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 your doctor 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 procedure, such as dilation and evacuation, to complete the miscarriage.
If your doctor or 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 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 stories
Personal 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 surgical procedure right away."
"I actually didn't have a choice about having a surgical procedure 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 midwife said that this was an urgent situation."
"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 surgical procedure, or I could take a medicine that would make the miscarriage progress. I chose the medicine. While I was taking it, I felt miserable. I had stomach pain and nausea. My family had to take care of me for a few days. And after I bled for a couple of weeks, the miscarriage was done."
"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 surgical procedure 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 counsellor 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."
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 next
1. 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?
Certainty
1. 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.
3. Use the following space to list questions, concerns, and next steps.
Credits
| By | Healthwise Staff |
|---|
| Clinical Review Board | Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals. |
|---|
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: July 10, 2023
Author: Healthwise Staff
Clinical Review Board
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
