No matter when it happens, pregnancy loss can be a heartbreaking, shocking, and confusing experience for women and their partners. A woman might blame her body for the loss, or experience feelings of guilt or isolation at this time. While any of these reactions are normal, it’s still important that women undergo treatment, as it supports their bodies through the miscarriage and helps them heal afterwards.
Nonsurgical treatment for miscarriage is usually recommended before surgical treatment, and it involves two options: expectant management and medical management. Here’s some information about both options, and why each might be used.
Natural or expectant management (‘watch and wait’)
This option involves letting the miscarriage happen on its own, without intervention. If it’s safe to do so, and particularly if the loss occurs in the first eight or nine weeks of pregnancy, a healthcare provider may recommend this option. This also may be a good choice for women who prefer to avoid the hospital, or who want their experience to be more personal.
- How long it takes: Anywhere from a few days to a few weeks, depending on the situation.
- What it feels like: For the average women, it feels like a very heavy period with more intense cramping and heavier bleeding, often with large blood clots. Many women take pain-relieving medication to manage the cramping.
- Follow-up: Women usually have to return to the hospital for a few follow-up appointments, to have their hCG levels monitored. They may also be asked to take a home pregnancy test. If the pregnancy test is positive or the provider determines there’s still tissue in the uterus, the woman may be prescribed medication or she might need to undergo surgery.
- Risks: The risks are low, and include a raised temperature, flu-like symptoms, bleeding or cramps that get worse over time. Hospitals give women antibiotics to protect against these risks.
Medical management involves the woman taking medication, in the form of pills or vaginal tablets, to help speed up the process of a miscarriage. Medical management may not be safe for women with conditions like asthma or anemia, but if the provider deems it safe, it’s a good alternative to surgical intervention.
- How long it takes: Normally about a week.
- What it feels like: The medication might make a woman feel nauseous, or in some cases, it can cause them to have diarrhea or flu-like symptoms.
- Follow-up: Women might need to take a few doses of treatment or go to several follow-ups after the initial appointment. For some women, medication isn’t enough and they do have to undergo surgery.
- Risks: Risks involve infection and hemorrhage, but like natural management, they are low, and happen to one to four women out of every 100.
How to prepare for nonsurgical treatment
The specifics of how to prepare for natural or medical management vary, depending on a woman’s unique circumstances. But if you undergo nonsurgical treatment for a miscarriage, there are a few things you can do to prepare for these two kinds of treatment.
- Stock up on sanitary pads, and buy over-the-counter painkillers or discuss the option of a prescription with your provider
- Make a list of emergency contact numbers and keep it accessible
- Reach out to make sure that a partner, friend, or family member is on hand to provide support
- Gather the things you might normally use for period relief, like heating pads, comfortable slippers, and fluids to drink
- Avoid reading about other people’s experiences online. There’s a lot of incorrect, confusing, or even scary information that won’t help you, and may make your worries worse.
Deciding on treatment for pregnancy loss is not a decision that any woman wants to make. Sadly though, it is a reality for many women. When it comes to pregnancy loss, the type of treatment that a woman chooses does matter. But what matters more is that she feels adequately supported and educated to choose what feels right to her.
- “Early pregnancy loss.” ACOG. FAQ 090 from American College of Obstetricians and Gynecologists, Aug 2015. Web.
- Mayo Clinic Staff. “Treatment.” MayoClinic. Mayo Foundation for Medical Education and Research, Jul 20 2016. Web.