Miscarriage management

Miscarriages are common
Miscarriages (spontaneous abortions) are common; about one in six established pregnancies will stop growing – they miscarry. Usually, this does not mean there is anything wrong with you physically nor does it increase the risk of a second miscarriage. Miscarriages can often happen naturally without any treatment but sometimes it may be faster, easier, and safer to be treated medically. A miscarriage can be a difficult experience emotionally and we offer supportive and compassionate early pregnancy loss management in our clinic.

Tests:
You will need confirmation by ultrasound or blood tests that the pregnancy has stopped growing to be able to make an appointment with us to complete the miscarriage. We offer medical or aspiration treatment of miscarriages. Miscarriages can happen naturally without any treatment but sometimes it can take a long time. You may or may not start bleeding when a pregnancy stops growing.

  1. Medication: We provide instructions and a prescription for misoprostol which causes the uterus to contract and expel the pregnancy tissue. Some people get side effects for a few hours such as fever, chills, diarrhea, headache or vomiting. We always check afterwards to make sure all the tissue is gone because with either a natural miscarriage (no treatment), or a medically managed miscarriage there is a 5-10% chance of having retained tissue that needs further treatment. You will not start ovulating and be able to try again for a pregnancy until all the pregnancy tissue is gone.
  2. Surgery: we do a surgical aspiration of the pregnancy tissue in our clinic. We use local anesthetic (freezing) and IV sedation. The procedure is very safe. There is less than 1% chance of infection or complications requiring a second procedure. For more information please see our surgical abortion information.
  3. Watchful waiting: we will monitor how you are doing with ultrasound checks and provide you with medication as needed.

If you want, you can discuss these options with a counsellor and our medical staff. We can also help with support and resources for afterwards as well as information about birth control if you want.

What causes a miscarriage:
Most miscarriages happen because the fertilized does not develop normally due to chromosomal abnormalities and/or low sperm quality. Other less common causes of miscarriage include structural problems of the uterus or cervix, infection, maternal autoimmune disorders, maternal thrombophilia and sperm DNA fragmentation.

Recurrent miscarriages are not common
Although first trimester miscarriages are common, having more than one miscarriage in a row is not. Simply put, you are much more likely to have a successful pregnancy after a miscarriage than you are to have a second miscarriage.

Can I prevent a miscarriage from happening again?
A miscarriage that has already started cannot be stopped, and miscarriages under 12 weeks cannot be prevented. However, if you have experienced recurrent miscarriages there may be options to strengthen the pregnancy and reduce the chances of miscarrying again.
For more information about recurrent pregnancy loss please contact the Early Pregnancy Assessment Clinic at BC Women’s Hospital. Ask your physician to send a referral (fax 604-875-3136) and to include supporting documentation (previous ultrasounds, pathology reports, consultations).

Feelings after a miscarriage
The loss of a pregnancy can be very hard to accept. You may wonder why it happened or blame yourself, but a miscarriage is no one’s fault. Every pregnancy loss is different and there is no right or wrong way to feel about it. How you feel will depend on your circumstances, your experience of miscarriage and what the pregnancy meant to you. You may feel fine, and that’s okay.

Alternatively, you may feel sad, shocked, angry, guilty, or have a physical sense of loss. You may also feel lonely, especially if others don’t understand. In the immediate aftermath, your feelings of grief may be strong. The falling hormones in your body can even amplify your sadness to a point that it feels overwhelming, but this should get better once your menstrual period returns and your body recovers. Allowing yourself to grieve the loss – in your own way and at your own pace – can actually help you come to terms with it in the long run. It’s common to feel fine one day and terrible the next.

Coping
Sharing and comparing experiences with others who have been through the same thing is often reassuring. You may be surprised to find out how many women have experienced miscarriage. Joining a support group may help. If your feelings start to interfere with your ability to get along in daily life, or if your sadness doesn’t lessen after a couple of months, talk with your health care provider. You might benefit from a referral to a mental health counsellor or therapist. We can provide referrals to supportive counsellors for on-going support if you want.

Coping as a couple
People can respond to a miscarriage. Often, partners shift into problem-solving mode when faced with a crisis. They may end up feeling helpless and inadequate when they aren’t able to “fix” their partner’s grief. Miscommunication is also a common problem. If discussing the miscarriage or childbearing brings tear and sadness, we may start to avoid these conversations. It may be helpful to know that sadness and grief are normal. It may also be helpful for both partners to try to be kind to each other, and to open up and share their feelings. Our counselling staff can provide strategies for better communication as well as referrals for couples counselling.

Ready to try again?
It is safe to try again right after a miscarriage. There is no need to wait. However, you might be advised to have medical tests first to determine the cause of your miscarriage. Also, your emotions may need a little more healing time than your body. It’s best to wait until you’re ready physically and emotionally before getting pregnant again.

210 – 2525 Commercial Drive, Vancouver, BC
Phone hours: 9:30 am – 4:00 pm
Monday to Friday

Appointments: 604-322-6692
business inquiries only: 604-322-6576
Fax: 604-322-6632

Everywoman’s sits on the traditional, ancestral, and un-ceded territory of the Coast Salish peoples– xʷməθkʷəy̓əm (Musqueam),  Səl̓ílwətaʔ/Selilwitulh (Tsleil-Waututh), and Sḵwx̱wú7mesh (Squamish).