How to ease miscarriage pains

Common Treatments for Miscarriage | AAFP

What is a miscarriage?

A miscarriage is something that happens when a pregnancy stops growing. It is sometimes found when women have bleeding in early pregnancy, or it may be found during routine tests.

Miscarriage happens in a pregnancy that would not have been healthy for reasons beyond your control. It is not caused by stress or regular activities like playing sports or having sex.

What happens during a miscarriage?

If you are having a miscarriage and the pregnancy tissue hasn't fully come out, there are three treatment options:

Watch and wait: wait for the miscarriage to happen on its own.
Medicine: use pills called misoprostol (brand name: Cytotec) to make the miscarriage happen sooner.
Suction procedure: have a doctor remove the pregnancy tissue using a simple office procedure.

All three treatment options are safe and will not affect your ability to get pregnant.

Which treatment should I choose?

The most effective treatment for you may depend on the type of miscarriage you have:

Incomplete miscarriage is when the pregnancy tissue begins to pass on its own. Using the watch-and-wait option, it will pass on its own more than 90 percent of the time, but this can take weeks. Using misoprostol, the tissue passes more than 90 percent of the time within one week.
Fetal or embryonic [EM-bree-ON-ik] demise is when the pregnancy has stopped growing but is not passing on its own. Using the watch-and-wait option, this type of miscarriage will pass on its own about 75 percent of the time, but it can take weeks. Using misoprostol, the tissue passes almost 90 percent of the time within one week.
Anembryonic [AN-EM-bree-ON-ik] pregnancy or “empty sac” is when the pregnancy stopped growing before the fetus developed. Using the watch-and-wait option, this type of miscarriage will pass on its own only 66 percent of the time, and may take many weeks. Using misoprostol, the tissue passes about 80 percent of the time within one week.

Many women choose to watch and wait as their first option. If this takes too long, you can come back to the doctor at any time to try another option. If medicine doesn't work, you may come back for a suction procedure. A suction procedure works 100 percent of the time with any type of miscarriage.

Once I choose my treatment, what should I expect to happen?

What to expect if you choose to watch and wait:

Cramping and bleeding can start at any time. Usually the cramping is worse and the bleeding is heavier than during a period. The heavy bleeding is not dangerous and usually lasts from three to five hours. Lighter bleeding often lasts one to two weeks and it may stop and start a few times. Taking ibuprofen (up to 800 mg every eight hours) and using a heating pad can help ease painful cramps.

What to expect if you choose to use medicine:

Misoprostol pills are placed in the vagina at a time chosen by you. Cramps and bleeding usually start two to six hours after placing the pills and last for three to five hours. A heating pad, ibuprofen, and/or a prescription pain medicine may be used to help ease cramps.

Some women get nausea, diarrhea, or chills soon after using misoprostol. This should get better in a few hours. Taking ibuprofen before using 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 one to two weeks and may stop and start a few times.

What to expect if you have a suction procedure:

Taking pain medicine before the procedure helps to ease cramps. The start of the procedure is like a Pap smear or a routine pelvic exam. To numb pain, local anesthesia is injected around the opening of your uterus, called the cervix. Next, the cervix is gently stretched and the pregnancy tissue is removed with a small plastic device.

The procedure usually takes less than 10 minutes. After resting for 15 to 30 minutes, you will then be able to go home. Most women are able to return to their usual activities the next day. It is normal to have mild cramping and bleeding for a few days after the procedure.

What happens after a miscarriage?

You will be given take-home instructions. Call your doctor if you have any of the following:

Bleeding that soaks more than two maxi pads per hour for two hours in a row.
Fever greater than 102°F (a slight fever of 102°F or less is common with misoprostol use).
Feeling very ill, with lower abdominal pain after the heavy cramping and bleeding are over.

At your follow-up visit, your doctor will make sure the miscarriage is over using ultrasonography, a blood test, or both. This visit is also a chance to talk about any emotional issues you may have after the miscarriage.

Once the miscarriage is over, you can try to get pregnant again as soon as you and your partner feel ready. If you do not want to become pregnant right away, be sure to use birth control.

Where can I get more information?

Your doctor

AAFP's Patient Education Resource

Web site: https://familydoctor.org/miscarriage/

National Institutes of Health: Medline Plus

Web site: http://www.nlm.nih.gov/medlineplus/miscarriage.html

What to Expect As You Miscarry at Home

Losing a pregnancy can be devastating. You may feel like nobody knows what you’re going through or feel anxious about the physical process.

Thing is — you’re not alone. Around 10 to 20 percent of known pregnancies end in miscarriage. Those statistics may even be quite a bit higher if you factor in miscarriages that occur before a woman knows she’s pregnant.

What is a natural miscarriage?

A miscarriage is the loss of pregnancy before 20 weeks’ gestation. Babies born before 20 weeks do not have developed enough lungs to survive. Most miscarriages happen before week 12.

If you have a natural miscarriage, it means you miscarry the contents of your uterus without medical interventions such as surgery or medication. This isn’t always possible, and that’s OK. But in many scenarios, it’s an option.

Related: A breakdown of miscarriage rates by week

But you probably don’t care so much about the numbers right now, and that’s understandable. You might be asking yourself: Why? Well, rest assured: You likely didn’t do anything to cause this. The vast majority of miscarriages happen due to issues with the developing baby’s chromosomes.

Whatever the cause, a loss is a loss. And the way you manage your miscarriage is up to you. Here’s more about what you can expect from a miscarriage, how long it might take, and ways to cope both physically and emotionally.

Your doctor may have given you the option to let your miscarriage progress naturally — what’s called “expectant management.” What does this mean exactly?

Well, in some cases your first sign of miscarriage may be spotting or bleeding. Other symptoms include cramps and severe abdominal pain. If the miscarriage is already underway, it may progress naturally. (And some women who have bleeding and cramping in their pregnancy can go on to carry to term and have a healthy baby.)

On the other hand, you may have no outward physical signs, and you may not learn that your baby has passed until you have an ultrasound. (This is usually called a missed miscarriage. )

A natural miscarriage with this scenario is typically a waiting game. You can opt to see when your body will begin the process on its own. If the baby isn’t alive, it’s not uncommon to begin having contractions on your own and passing the fetus and placenta.

Some people don’t start into labor on their own, and need help to begin contractions. Sometimes the doctor recommends waiting a few days to see if you start on your own before intervening. No matter what your experience will be, it’s common to have emotions racing, and feelings of loss and grief.

Some options to manage miscarriage include:

Medication

There are drugs, like misoprostol, that can help start the miscarriage if it’s not starting on its own. They work by making the uterus contract and expel the fetal tissue, placenta, and other contents through the cervix.

The pills can be taken orally or inserted into the vagina. Side effects include nausea and diarrhea. Generally, this option takes about 24 hours to complete and is successful 80 to 90 percent of the time.

Dilation and curettage

Also called a D and C, this surgical procedure is an option if your miscarriage doesn’t start on its own or if you experience retained tissue, infection, or particularly heavy bleeding.

Your doctor dilates your cervix and then uses a tool called a curettage to remove tissue from the uterine lining.

What you choose has to do with things like:

what type of miscarriage you have (early, late, blighted ovum, missed miscarriage)
how fast your body deals with the loss on its own
whether or not you show signs of infection

Of course, your personal choice weighs heavily here, too.

Bottom line: It’s your body. If you aren’t at risk, it’s safe to wait and let your body progress naturally (with medical guidance). Ask your doctor what’s best for you.

Some women opt for a natural miscarriage because it may already be progressing on its own with no need for intervention. Others may choose a natural miscarriage because they don’t want medication side effects or the stress of a surgical procedure.

Here are some things to consider:

Time. Natural miscarriage may happen quickly or it make take up to 3 to 4 weeks to begin. The timeline is very individual, and the “not knowing” may be unnerving to some people. If this describes you, you might prefer medical intervention.
Emotional toll. Losing a baby can be highly emotional. So, waiting for the miscarriage to happen prolongs the experience — and possible lingering physical effects may make the process of healing emotionally more difficult.
Risks. If too much time passes and the fetal tissue remains in the body, you may risk developing a septic miscarriage, which can become a severe infection if left untreated.
Lifestyle. You may also not have the time to wait to let your miscarriage happen naturally. Maybe you have to travel for work or have other pressing obligations — again, these are all personal things to think about.
Being alone. You may be concerned about seeing the fetal tissue if you choose to go the natural route. It can be upsetting to see, particularly if you are farther along.

No two miscarriages are the same. What you experience will have to do with how far along you were and how long your body ultimately takes to expel the products of conception. The process may also look different if you were carrying twins or other multiples.

If you weren’t very far along, you may only experience what seems like a heavy period. You’ll likely feel cramping and see more clotting than usual, too. The bleeding may only last a few hours.

Some women may have bleeding 5 days to a week or more. Others may experience spotting for up to 4 weeks afterward. Again, the bleeding can range from light to heavy with clotting, tissue loss, cramps, and abdominal pain. If the cramping continues, talk with your doctor. If you develop signs of infection such as fever or feeling unwell, see your doctor.

Over time, the cramping should ease up and your bleeding should taper off — the color may change from red to dark brown to pink.

Missed miscarriage timing

If your miscarriage hasn’t yet begun, your doctor may give you a couple of weeks to start on your own. Once the process begins, it will progress much like any other miscarriage.

As with other miscarriages, seek immediate medical help if you develop a fever or have other signs of infection, such as chills or foul-smelling discharge.

Related: What does a miscarriage look like?

Speak with your doctor if you have concerns about the progress of your natural miscarriage. The process can take time. If you feel something isn’t quite right, it’s a good idea to be checked to rule out infection or other complications.

A word of warning
As far as speeding the miscarriage process along, there isn’t much research on anything that’s safe and proven.
Be wary of information you read online or in forums about certain herbs, supplements, or other methods to bring about miscarriage. These methods may be dangerous and not help your miscarriage progress regardless of their risk.

Try to take care of yourself as much as possible. This means:

eating well (whole foods, fruits and vegetables, low-sugar snacks)
staying hydrated
getting light activity as it feels good
checking in with your emotions

If the waiting game is getting to be too much, understand that there are medical options for you if you change your mind or if your body simply doesn’t cooperate. Your doctor can help explain any side effects or risks of medications and surgical procedures.

Related: What to know about your first period after miscarriage

There are a few things you can do to make your miscarriage more comfortable.

Above everything else, be kind to yourself during this time. It’s OK to grieve, and that may look different for everybody.

For example, you may be crying a lot. Or maybe you’re angry or in disbelief. You may want to surround yourself with loved ones for support. Or you may want to be alone. You may want to tell people or you might not be ready to yet.

Listen to your heart and ask that people respect your wishes.

Things that may help:

Pain medication. You can use over-the-counter (OTC) pain meds, like ibuprofen (Motrin) to ease pain and cramping. Consider taking up to 800 milligrams every 8 hours. Your doctor can give you more specific guidelines.
Other tools. A heating pad or hot water bottle is a drug-free way to help ease pain and cramping. The warmth may also provide some added comfort.
Environment. When you experience the heaviest bleeding, you may find it more practical to sit on your toilet. Use a washable pillow to prop behind your back for added support. Make the room more appealing by lighting a candle and diffusing your favorite scent.
Fluids. Stay hydrated by drinking plenty of water. Teas or other non-caffeinated hot beverages (or warm broth) may also be soothing during this time. If you’re hungry, consider having a basket of your favorite snacks nearby so you can stay put.
Rest. Allow yourself to be in bed and rest as much as possible. Try rescheduling upcoming meetings or events and asking for help from family and friends. If you’re uncomfortable sharing why, you can always just say that you aren’t feeling well.
Pads. You shouldn’t insert anything into the vagina during a miscarriage. This includes tampons, so stock up on pads (thick, thin, cloth — whatever your preference) and use them until the heavy bleeding has stopped.

Related: Processing the pain of miscarriage

Be sure to check your temperature periodically during and after your miscarriage. If you develop a fever over 100°F, that may mean you have an infection and should contact your doctor ASAP.

Other signs of infection include:

heavy bleeding (starting after it had tapered off)
chills
pain
foul-smelling discharge

You should also schedule an appointment with your doctor for after your miscarriage, especially if you’re concerned it may not be complete. Your doctor can look inside your uterus using ultrasound and check for retained tissue.

In some cases, if the miscarriage isn’t complete, you may need a D and C to remove any remaining products of conception.

Related: This test may help find the cause of many miscarriages

While common, having one miscarriage doesn’t necessarily mean you won’t go on to have a healthy pregnancy.

In fact, you can get pregnant as soon as 2 weeks after your miscarriage — so if you feel you need more time, you may want to consider some type of birth control until you feel emotionally ready for the possibility of another pregnancy.

And know that having one miscarriage doesn’t necessarily increase your risk of having another. Only 1 percent of women experience recurrent miscarriages (meaning two or more consecutive losses).

Take care of yourself. Understand that there’s no right or wrong way to feel about your loss. Give yourself time to grieve and reach out for support if and when you need it.

Help with early miscarriage

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How to avoid early miscarriage

A miscarriage occurs when the fetus is shed from the endometrium, the inner lining of the uterus. According to experts, two out of 10 clinically established pregnancies end in spontaneous abortion. It is necessary to understand in more detail the causes, symptoms and methods of dealing with miscarriage.

How an early miscarriage occurs

There are three successive steps in this process. First, the fetus dies, after which it detaches from the endometrial layer. This is manifested by the fact that bleeding begins.

At the third stage, everything that has exfoliated is removed from the uterine cavity. The process may be complete or incomplete. In the early stages - five to six weeks - the process resembles ordinary menstruation. They are characterized by painful and much more unpleasant sensations. You can find out that it was just an early miscarriage by taking tests for the ratio of hCG in the blood.

Symptoms of a miscarriage

Signs of spontaneous abortion are abdominal cramps, cramps or bloody discharge. However, they do not always appear. It is necessary to note the most typical manifestations of the presented state and their main characteristics.

Temperature

For a short period of time, hyperthermia may well not be observed. Fever is not the most common symptom. In some cases, the thermometer readings really rise to 38 degrees or more.

At the same time, when hyperthermia is accompanied by a number of additional symptoms, a septic miscarriage is likely. These are its signs:

severe pain in the abdomen and in the depths of the vagina;
increase in the tone of the uterus, which is felt by jerks inside;
pungent, pungent and unpleasant odour.

All this indicates that the infection has joined. In such a case, emergency hospitalization is strongly recommended to stop the development of the process. It is better not to engage in self-medication or the use of folk recipes.

Discharge

Early miscarriage can indeed be accompanied by discharge. They may be habitual, as during menstruation. Also, the discharge may be smearing, insignificant.

Secretion brown, scanty, much less likely to end in spontaneous abortion. Most often, this is indicated by abundant and bright red discharge. It is blood that normally appears when the fetus is rejected from the inner layer of the uterus.

Pain

The severity of unpleasant and specific sensations may differ from each other depending on the duration of pregnancy. Probably the accession of pain, similar to menstruation. Most often, a similar symptom indicates an early miscarriage - no more than six weeks.

Probably cramping pains in the abdomen, which pull in the back. Their strength can vary from subtle to much more pronounced. In the rarest cases, when the clinical picture is complicated by a long course, this leads to a state of shock.

Another typical manifestation of pain is discomfort in the back or abdomen. Only then are the discharges identified. A similar situation is most typical for spontaneous abortion at the seventh or eighth week of pregnancy.

Causes of miscarriage

The first factor is genetic abnormalities in the development of the fetus. It is they who most often lead to miscarriage in the early stages. Violations can be expressed in qualitative or quantitative failures in chromosomes. In this regard, the female body recognizes the defect, and therefore does not allow such a fetus to develop further. Most often, such rejection is noted in the third week of pregnancy.

The next reason that an early miscarriage has developed may be disturbances in the functioning of the endocrine gland. Hormones determine not only the success and regularity of the cycle, but also how well the fetus is attached to the mucous surface of the uterus. If, due to a malfunction of the thyroid gland, the endometrium is not able to provide the fetus with all the necessary components, the pregnancy will not go well. Most often, a miscarriage occurs at the beginning or at the end of the fourth week.

Other reasons why pregnancy is terminated:

Rhesus conflict. If the parents have different Rh factors, then the risk that a miscarriage will occur after the first weeks of pregnancy increases significantly. This happens if a woman has a negative Rh, and the child has a positive, inherited from the father. In such a situation, the female body recognizes the fetus as a foreign object. Therefore, it is excreted from the uterus. Timely diagnosis allows you to save the child through full-fledged drug therapy.
Sexually transmitted diseases, other infections. Similar problematic conditions also lead to spontaneous abortion. In this case, the embryo is infected at a very early stage. That is why the body will perceive it as a foreign object. In this regard, a miscarriage will occur already in the fifth week.
Previous abortions. Another common reason why a miscarriage occurred. Abortion is a huge stress for the reproductive system, which leads to thinning of the lining of the uterus. That is why the risk of miscarriage may be greater.

Abdominal injuries should not be excluded from the list. Sharp pressure on the peritoneum, including when lifting weights, can provoke an abortion. Also on the list are severe stress, anxiety and depression. Anything that violates the normal state of a woman can lead to serious consequences.

How to avoid miscarriage

The main goal of treatment is to relieve tension in the uterus. It will be equally important to stop the bleeding and prolong the pregnancy, but only on the condition that the fetus is viable. The sooner medical assistance is provided, the higher the likelihood of preserving the fetus, without the need to determine the expected timing of miscarriages.

Our specialists will help you with this. Only we have the most qualified and experienced doctors who know exactly how to treat even the most difficult cases. They will conduct a full diagnosis and prescribe the most effective, effective medicines.

Drug treatment

Hormonal drugs are used. They at an early stage determine the normal course of pregnancy. Medicines based on the hormone progesterone are effective.

The use of hemostatic drugs. In the case of pregnant women, droppers are used with drugs such as Dicinon or Tranexam. They are needed to stop bleeding.
Antispasmodics. Experts recommend injections of Drotaverin, followed by a switch to painkillers such as No-shpa. Papaverine suppositories, droppers with the addition of magnesia are also used. All of them are necessary in order to remove a number of signs of a pathological condition, namely, an increased tone of the uterus and pronounced pain.
Use of Tocopherol. Vitamin E is an indispensable component for women, including pregnant women. It ensures the normal and full functioning of the ovaries. Tocopherol also strengthens the vascular walls, eliminates the formation of blood clots.
Sedative preparations. Use motherwort or valerian tincture. The presented measure is recommended for increased irritability or nervousness of a pregnant woman.

To prevent early miscarriage, our clinic's specialists recommend glucocorticosteroids. Apply Dexamethasone or Metipred. They are prescribed to patients with diagnosed immune disorders that can lead to early termination of pregnancy.

A special relief ring can be fitted as an option. The presented procedure is carried out in the second trimester, or rather after the 20th week of gestation.

Remove such a device not earlier than 38 weeks. It is necessary for a woman to maintain the correct position of the uterus. Also, the unloading ring helps to prevent premature birth.

Additional measures

To prevent early miscarriage, it is recommended to stop physical activity. Especially when it comes to jumping, lifting weights. Rest, lack of sudden physical activity and adherence to bed rest will help to keep the pregnancy.

Another preventive measure will be the exclusion of sudden movements. At any stage of pregnancy, they can provoke detachment of the embryo or lead to serious complications in its development.

To exclude an early miscarriage will allow:

emotional calm and absence of stress;
refusal to take a hot bath or visit a bath, sauna - this is due to the fact that high temperatures provoke increased bleeding, as well as detachment of the fetus;
restriction of sexual intercourse - if there is a threat that an early miscarriage will occur, they refuse to have sex;
exclusion of alcohol, nicotine addiction.

It is also important to stop eating certain foods. The ban applies to chocolate, coffee, and any other caffeinated drinks. In no case should you self-medicate. The fact is that the use of drugs without the appointment of a specialist will only aggravate the situation. It is not recommended to use folk remedies to stop bleeding, relieve pain. All medicines and prescriptions used must be coordinated with a specialist, because there is a high probability of harm to the embryo.

It is really possible to exclude such a problem as an early miscarriage. It is necessary to observe all safety measures, fully and in a timely manner to be treated. It is in this case that the pregnancy will end with the birth of a healthy child.

Treatment and prevention of miscarriage

Miscarriage. Symptoms

Causes of a miscarriage

Questions to ask your doctor about a miscarriage

Diagnosis of a miscarriage

If there is a risk of a miscarriage, your doctor may recommend rest until the bleeding or pain stops. Your doctor may also recommend that you abstain from sports and sexual activity. It is better not to travel, and especially not to travel to places where it is difficult to get emergency medical care.

Thanks to the widespread use of ultrasound, it is much easier these days to know if an embryo has died or not formed at all, and to know for sure that a miscarriage will occur. In this case, there are several options:

Expectant tactics. Before ultrasound was used in early pregnancy, most women had no idea that they were going to have a miscarriage. Some women allow the process to develop naturally. Usually a miscarriage occurs a few weeks after the death of the embryo is established. Unfortunately, this process can take three to four weeks. From an emotional point of view, this can be quite a difficult period.

Conservative treatment for miscarriage. If, after diagnosing a miscarriage, a woman decides to speed up the process, then the removal of the embryonic tissue and placenta from the body can be provoked by taking certain drugs. Some medications are taken by mouth, but your doctor may prescribe intravaginal medications to increase their effectiveness and reduce the risk of side effects such as nausea, abdominal pain, and diarrhea. Most likely, a miscarriage will occur at home. The time of action of the drug may vary. You may also need more than one dose of the drug. In 70% of cases, the drug begins to act within a day, and a miscarriage occurs in the next few days or weeks.

Surgical treatment. Another treatment option is vacuum aspiration and curettage. During this procedure, the doctor opens the cervix and, using a special device, gently sucks tissue from the uterus. Sometimes a special metal surgical instrument with a loop at the end (curette) is used to scrape the walls of the uterus after vacuum aspiration. Complications are rare, but the connective tissue of the cervix or the wall of the uterus may be damaged.

In the event of an unavoidable miscarriage, surgery is necessary to stop the bleeding.

Lifestyle and home care

Physical recovery

In most cases, physical recovery from a miscarriage takes a few hours to a few days. It will take 4-6 weeks to return to a normal lifestyle. During this period, if you experience heavy bleeding, fever, chills or severe pain, you should contact your doctor. These signs and symptoms may indicate an infection. For two weeks after a miscarriage, you should not have sex, use tampons, or flush your vagina.

Subsequent pregnancy

It is possible to become pregnant during your period immediately after a miscarriage. If you and your partner decide to try for a baby, make sure you are emotionally and physically ready for it. The doctor may recommend to postpone this process until the next menstruation, and maybe even more.

More than three miscarriages in a row should be investigated to determine the underlying causes, such as uterine abnormalities, coagulation problems, or abnormalities at the chromosomal level. In some cases, the doctor will suggest that you get tested after two miscarriages in a row, but two miscarriages still may not have hidden medical reasons. If the cause of miscarriages cannot be determined, do not lose hope. 60-70% of women who have had consecutive miscarriages can become pregnant in the future, even without treatment.

Coping with illness and finding support

Psychological recovery can take much longer than physical recovery. A miscarriage is a painful loss that others will not be able to fully understand. You can experience completely different feelings: from anger to despair. Give yourself time to process this grief and find support from loved ones. Don't blame yourself for what happened. You may not be able to forget all the hopes and dreams you had for this pregnancy, but over time, acceptance will ease the pain. Talk to your healthcare provider if you are experiencing deep sadness or depression.

Prevention

With so many possible causes of miscarriage, there is simply no way to prevent it. It is better to concentrate all your energy on taking care of yourself and your unborn child.