Why miscarriage happens:

Most miscarriages happen by chance. Your doctor will not be able to tell you the cause for your miscarriage. They are not caused by bending, stretching, carrying heavy weights, having sex, working long hours or having an emotional upset.

What to expect when a miscarriage happens:

When you have a miscarriage, your uterus may begin to contract to expel the pregnancy tissue.

Signs you may notice will include:

• More severe menstrual-like cramps and pain
• Heavier bleeding, which may include small clots smaller than a golf ball
• Passage of the placenta which may look like blood clots or liver
• These symptoms usually become less severe and disappear within 7 days. To help reduce the pain, your doctor may recommend taking acetaminophen/ Tylenol and/ or ibuprofen/ Advil as needed
• For the vaginal bleeding, you should use pads and not tampons

Will I require medical treatment for my miscarriage?

Your miscarriage may happen spontaneously, without the use of medical treatment. When you see a doctor, your treatment options will be discussed. Your options include letting the miscarriage naturally be completed, taking a medication that makes your uterus contract and expel the tissue or you may need a procedure/ operation called a D&C to remove the tissue left behind. If your chose the option of surgery, you will be referred to a gynecologist.

When to contact your doctor:

Call your doctor right away or go to the emergency department if it is outside regular office hours and you notice any of the following symptoms:

• Heavy or prolonged vaginal bleeding, soaking one pad in 10 minutes or less; soaking a pad every hour for more than 6-8 hours; passing clots larger than a golf ball
• Severe abdominal pain
• Fever or chills
• A bad odour from your vagina

Personal Care:

After having a miscarriage or D&C, it is okay to shower or have a bath. For 2 weeks after your miscarriage, you should continue to use pads instead of tampons as needed for your bleeding. Also avoid having sex.

Emotional Care:

Having a miscarriage can cause a variety of emotions including anger. Sadness, difficulty sleeping and a decreased appetite are common signs of grief; however, everyone shows their feelings in a different way. Your family and friends may not know how to respond to your loss. It may take longer for you to recover from the emotional effects of a miscarriage than the physical effects. Please talk to your doctor if you feel isolated, depressed, or just need to talk.

After a miscarriage, are you at risk for miscarrying again?

Miscarriage is usually a chance event, not a sign of an ongoing problem. If you have had one miscarriage, your chances for future successful pregnancies are good. It is unusual to have three or more miscarriages in a row. But if you do, your doctor may do tests to see if a health problem may be causing the miscarriages.

References:

PIPC

Adapted From: UNC Department of Obstetrics and Gynecology: ‘Dealing with Miscarriage’ [patient

handout] www.med.unc.edu New Zealand www.miscarriagesupport.org.nz

The Foundation for Medical Practice Education: www.fmpe.org