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.
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
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:
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.
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)
- 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.
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.