Your treatment for a miscarriage depends on whether there is any foetal tissue left in your womb (a complete or incomplete miscarriage).
Complete miscarriage
If there is no foetal tissue left in your womb (a complete miscarriage), no further medical treatment is required. However, a miscarriage can have a significant emotional effect and you and your partner may need counselling or support.
Read more about the complications of miscarriage, including what emotions you may experience and where to get support.
Incomplete miscarriage
If there is foetal tissue left in your womb (an incomplete miscarriage), this needs to be removed as there is a risk that it could become infected. This can be done in three ways:
- using minor surgery to remove the tissue
- using medication to remove the tissue
- waiting for the tissue to pass naturally out of your womb (expectant management)
There are benefits and risks of each option that you should consider when making your decision.
If you have surgery, any bleeding or pain you are experiencing because of your miscarriage should quickly improve. However, all surgical procedures carry their own risks. Medication avoids the need for surgery but can cause increased pain and bleeding. Waiting for the tissue to pass naturally avoids taking medication or having surgery, but can take several weeks. It is also possible that not all of the tissue will be removed, and that you will later require surgery.
Discuss the options with the doctor in charge of your care.
Surgery
Surgery usually takes place within a few days of a miscarriage. However, there are circumstances where you may be advised to have immediate surgery, including:
- if you experience continuous heavy bleeding
- if there is evidence that the foetal tissue has become infected
- if medication or waiting for the tissue to pass out naturally have been unsuccessful
Surgery is usually performed under general anaesthetic. Your cervix (neck of the womb) will be opened with a small tube, known as a dilator, and the tissue will be removed using a suction device. This type of surgery is known as evacuation of retained products of conception (ERPC).
Before surgery, you may be given medication to soften the cervix and to make it easier to perform the surgery.
This type of surgery is usually very safe. However, as with all surgery, there is a small risk of complications.
Possible complications include:
- infection
- excessive bleeding
- the womb or cervix being torn during the procedure: this may require further surgery to repair it
Around 2 in 100 women will experience a serious complication, such as a tear to their womb or cervix.
Medication
Using medication to remove the tissue involves taking tablets that cause the cervix to open, allowing the tissue to pass out. There are two types of tablets:
- tablets that you swallow
- tablets called pessaries that are inserted directly into your vagina, where they dissolve
The effects of the tablets usually begin within a few hours. You will experience symptoms similar to a heavy period, such as cramping and heavy vaginal bleeding. You may also experience vaginal bleeding for up to three weeks.
Medication is successful in removing foetal tissue in around 9 out of 10 cases. However, you will need to have surgery if the medication is unsuccessful.
Waiting method
If you wait for the tissue to pass naturally out of your womb, it may be some time before you experience vaginal bleeding. This tends to be heavier than your usual period and you may also experience cramping. Bleeding can last for up to three weeks.
If the bleeding becomes particularly heavy or you experience severe pain, contact your hospital. You should be given a 24-hour helpline number to call in case of emergency.
For more than half of miscarriages, this method is unsuccessful in removing foetal tissue. In this situation, you will need either medication or surgery.
After a miscarriage
You can discuss with the staff at the hospital what, if anything, you would like to do after your miscarriage.
It is possible to arrange a memorial and burial service. In some hospitals or clinics, it may be possible to arrange a burial within the grounds. You can also arrange to have a burial at home, although you will need to consult your local authority before doing so.
Cremation is an alternative to burial and can be performed at either the hospital or a local crematorium. However, not all crematoriums provide this service and they have no legal obligation to do so. There will not be any ashes for you to scatter after a cremation.
Treating the cause of the miscarriage
In some cases, if a cause of the miscarriage has been identified, it may be possible to have treatment to prevent this causing any more miscarriages.
Read more about the causes of miscarriage.
Hughes syndrome
Hughes syndrome, an autoimmune condition that causes blood clots, can be treated with medication. Research has shown that a combination of aspirin and heparin (a medicine used to prevent blood clots) can improve pregnancy outcomes in women with Hughes syndrome.
Read more about treating Hughes syndrome.
Weakened cervix
A weakened cervix, also known as cervical incompetence, can be treated with an operation to put a small stitch of strong thread around your cervix to keep it closed. This is usually carried out after the first 12 weeks of your pregnancy, and is removed around week 37.
Suggested treatments
Other suggested treatments for recurrent miscarriages have been studied. These include:
- hormone treatments during pregnancy
- using specially modified antibodies during pregnancy
- taking vitamin supplements during pregnancy
However, the results of all these studies have been disappointing so far and there is no evidence that these treatments can prevent miscarriages.
