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What is a miscarriage?
- Miscarriage is the loss of a pregnancy before 20 weeks. This can be physically and emotionally painful.
- Miscarriages happen most often before 12 weeks.
- 10 to 20% (10 to 20 out of 100) of known pregnancies end in miscarriage. Some studies show it may be closer to 30% (30 out of 100). Miscarriage is common, but that does not make it feel any better. We want you to know that there is likely nothing wrong with your body. Future pregnancies can and should go well.
What do these words mean?
Chemical pregnancy:
- This is a pregnancy loss before it can be found on ultrasound. It is found only with a hormone test.
Blighted ovum or anembryonic gestation:
- Early in pregnancy, a fertilized egg attaches to the uterus wall. An embryo will not grow.
Intrauterine fetal demise:
- The fetus stops growing and dies in early pregnancy.
Molar or partial molar pregnancy:
- This pregnancy is not viable (will not result in a living baby). There is an extra set of chromosomes, abnormal placenta, and abnormal fetus.
What may cause miscarriage?
We often cannot find an answer for why a pregnancy stops growing. It is important to know you did not cause the miscarriage. Most happen because the fetus did not develop normally. They are not caused by:
- Normal activity
- Sex
- Exercise
- Working
You may be at higher risk of miscarriage due to:
- Age (35 years old and older)
- As we get older, the chance of miscarriage gets higher.
- History of 2 or more miscarriages in a row
- Uncontrolled diabetes
- Uncontrolled high blood pressure
- Uncontrolled thyroid disease
- Problems with your uterus or cervix
- Infection
- Hormonal problems
- Smoking, heavy alcohol use, or illicit drug use (marijuana, methamphetamine, heroine, or cocaine)
See your care team if you are worried before trying to get pregnant.
What is a uterine aspiration?
- A uterine aspiration is a procedure that can be done in clinic to take out the products of pregnancy with suction. No scraping, incisions, cutting, or stitches are used.
- During the procedure, you are given IV (intravenous) sedation. This helps you feel relaxed and helps with pain. These medicines do not usually "put people to sleep.” We want you to be comfortable. Numbing medicine will be placed into your cervix.
- Your cervix is gently stretched enough to pass a small cannula (tube) into your uterus. A gentle suction is then used to take out the pregnancy tissue.
- A uterine aspiration usually takes 10 minutes or less.
- You will not be able to eat before your procedure. Your care team will tell you more about this. If you do not follow the eating and drinking instructions, your procedure may be delayed or cancelled.
What happens after a uterine aspiration?
- You may have low back pain. This should lessen quickly.
- You may have low abdominal (belly) cramps on and off for a few days. Take medicine as needed and told by your care team.
- You may have spotting or light bleeding for a few days up to 2 weeks.
- It may be heavier than your normal period during the first few days but should then lessen.
- Some people do not have bleeding after the procedure, and that is also normal.
- Your bleeding should slowly fade in color (from red to pink to brown).
- Your next period should start at its normal time or within 4 weeks. It may be lighter or heavier than normal.
Call your care team and go to the emergency room if you:
- Soak 1 maxi pad in 1 hour, for 2 to 3 hours
- Feel lightheaded or dizzy
Call your care team if you:
- Have bright red vaginal bleeding for more than 2 weeks
- Brown discharge is okay and may last longer.
- Pass clots larger than a golf ball
- Have severe pain in your abdomen (belly)
- Have bad smelling vaginal blood or discharge
- Have a temperature above 100.4º Fahrenheit
How do I care for myself after a miscarriage?
Blood type
- Call your care team if you do not know your blood type or if you are Rh negative.
- You may need Rh D immune globulin (Rhogam®) within 72 hours if your blood type is Rh negative and your pregnancy is more than 12 weeks along.
- If you have questions about Rh, go to this website: acog.org/womens-health/faqs/the-rh-factor-how-it-can-affect-your-pregnancy.
Sexual activity
- No sex, tampons or douching for 2 weeks.
- Pregnancy can happen with unprotected sex.
- Start birth control as talked about with your care team.
- Wait at least 1 normal period before you try to get pregnant.
- You may feel sex will never be the same due to feeling tired, physical pain, or anxiety. Tell your partner how you feel.
Temperature
- Take your temperature each day between 4:00 and 8:00 p.m. for 1 week.
- A fever is not normal.
Rest and exercise
- Slowly start your normal day-to-day activities. No strenuous exercise, like running or biking (or anything that raises your heart rate and blood pressure), for 2 or 3 days.
- Your energy level may be low for the first week.
- Naps may be helpful.
- You may go back to work as told by your care team.
Bathing
- You may shower and wash hair.
- You may have a tub bath.
- No swimming pools, hot tubs, lakes, or rivers for at least 1 week.
Diet
- Take your prenatal vitamin.
- Eat a balanced healthy diet. Cut down on food and drinks with sugar.
- Drink 6 to 8 glasses of fluid each day.
- Limit caffeine and alcohol.
Breast care
- Most people do not have breast symptoms that bother them if they are less than 17 weeks at the time of a miscarriage.
- Your breast may feel tender and full.
- They may leak milk. Use breast pads to protect your clothing.
- Wear a bra that gives good support.
- Use ice packs under your arms and on breasts for 20 minutes every 2 hours if they are sore.
- Take acetaminophen and ibuprofen as needed.
- Do not stimulate or pump your breasts.
- Do not let hot water fall on your breasts in the shower.
- Cabbage leaves can help with breast pain and swelling.
- Put green or red cabbage leaves in the refrigerator.
- Rinse the leaves with cold water and pat dry.
- Put a cold leaf in your bra on your breast.
- Leave the leaf in place for 20 minutes or until warm.
- Do again with a fresh leaf as needed.
Emotions
- Each person will feel different. It may help to talk about your feelings.
- A support group or grief and loss website may be helpful.
Certificate of nonviable birth
You may ask for a certificate of nonviable birth from the Iowa Department of Public Health pursuant to Iowa Code section 144.31B. When you ask, your care team will give you a letter certifying the nonviable birth.
Call:
The Women’s Health Clinic at 1-319-356-2294 Monday through Friday from 8 a.m. to 4:30 p.m.
For urgent questions or concerns
- Call the Hospital Operator at 1-319-356-1616 on nights, weekends, and holidays
- Ask for the gynecology resident on call.
Toll-free at 1-800-777-8442, 24 hours a day
- Ask for the gynecology resident on call.
- You may be asked some questions when using the toll-free number.
Send a MyChart message for non-urgent questions or concerns.