What is a miscarriage?
It is the spontaneous loss of a pregnancy before the 20th week.
- This can be both physically and emotionally painful.
- They often happen before 12 weeks
10 to 20 percent of known pregnancies end in a miscarriage.
- Chemical pregnancy
- A pregnancy loss before it can be found on ultrasound. It is found only with a hormone test.
- Blighted ovum
- Early in pregnancy, a fertilized egg attaches to the uterus wall. No embryo will develop.
- Intrauterine fetal demise
- The baby stops developing and dies in early pregnancy.
- Molar or partial molar pregnancy
- Is not viable. There is an extra set of chromosomes, abnormal placenta, and abnormal fetus.
What is expectant management?
It is when a non-viable pregnancy passes without medication or a procedure (spontaneous miscarriage).
What are the signs of a miscarriage?
Vaginal bleeding or spotting
- May be like a period.
- You may bleed for a few days, or on and off for a few weeks.
- Call your care team or go to the Emergency Room if you:
- Soak one maxi pad in one hour, for 2 to 3 hours.
- Feel lightheaded or dizzy.
- When you lie down blood collects in the vagina. When you stand up, blood may pass:
- In a large gush.
- As a large clot.
- Small clots, no larger than a golf ball are normal.
- Bleeding will change from red to pink to brown.
- Discharge should not be foul smelling.
- Use maxi pads for the first two weeks.
- After 2 weeks, tampons can be used.
Tissue passing from your vagina
After you have passed all the tissue your bleeding should slow to like a light period.
Pain or cramps in your abdomen or lower back
You may take acetaminophen and ibuprofen.
Call your provider if you:
- Have vaginal bleeding for more 2 weeks.
- Brown discharge is ok and may last longer.
- Soak one maxi pad, in one hour, for 2 or 3 hours.
- Pass clots larger than a golf ball.
- Have severe pain in your abdomen.
- Have foul smelling vaginal discharge or bleeding.
- Temperature above 100.4 Degrees F.
How do I take care of myself after a miscarriage?
- Call your care team if you do not know your blood type or you are Rh negative.
- You may need Rh D immune globulin (Rhogam®) within 72 hours after you miscarry.
Get a blood pregnancy test 2 weeks after your miscarriage
Take a home pregnancy test if you cannot come to the lab.
- Call your care team if it is positive after 2 weeks.
- You may need more testing.
- No sex, tampons, or douching for 2 weeks.
- Pregnancy can happen with unprotected sex.
- Start contraception as discussed with your provider.
- We recommend waiting until after 2 normal periods to attempt pregnancy again.
- You may feel that sex will never be the same due to fatigue, physical discomfort, or anxiety.
- You should tell your partner how you feel.
Take your temperature each day between 4 and 8 p.m. for 1 week.
Rest and exercise
- Slowly start normal activity.
- No strenuous exercise (such as running or aerobics) for 2 or 3 days.
- Your energy level may be low for the first week.
- Naps may be helpful.
- You may return to work as told by your care team.
- You may shower and wash hair.
- You may have a tub bath.
- No swimming pools, hot tubs, lakes, or rivers for at least 2 weeks.
- Take your prenatal vitamin.
- Eat a balanced healthy diet.
- Cut down on food and drinks containing sugar.
- Drink 6 to 8 glasses of fluid each day.
- Limit caffeine and alcohol intake.
- Your breast may be tender or feel 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.
- Avoid hot water directly hitting your breasts in the shower.
- Cabbage leaves can help with breast pain and swelling.
- Place green or red cabbage leaves in the refrigerator.
- Rinse the leaves with cold water and pat dry if desired.
- Place cold leaf in your bra on your breast.
- Leave in place for 20 minutes or until warm.
- Repeat with a fresh leaf as needed.
- Each person will feel different.
- It may help to talk about your feelings.
- A support group or grief and loss website may be helpful.
What may cause a miscarriage:
You did not cause the miscarriage. Most miscarriages happen because the fetus has not developed normally.
They are not caused by:
- Normal activity
Conditions that may increase the risk of a miscarriage:
- A person age 35 has a 20 in 100 chance of miscarrying.
- A person age 40 has a 40 in 100 chance of miscarrying.
- A person age 45 has an 80 in 100 chance of miscarrying.
- History of 2 or more miscarriages in a row
- Uncontrolled diabetes
- Uncontrolled thyroid disease
- Problems with your uterus or cervix
- Hormonal problems
- Smoking, heavy alcohol use, or illicit drug use
See your care team if you are worried before trying to get pregnant.
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.