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Printed at: 11:38:00 / 20-09-2021

Expectant Management Following a Miscarriage

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Produced by the Early Pregnancy Assessment Unit Tel No: 01908 996434 (internal calls Ext 86434)

We are sorry to have to tell you that very sadly your pregnancy has ended and we would like to offer you our condolences. We appreciate that this will be a distressing time for you and the aim of
this leaflet is to give you information about what may happen next.

Expectant Management
This is one of several options that are open to you when a pregnancy has ended. Expectant management is the term we give to waiting for a miscarriage to occur naturally without surgical and medical intervention when it is known that the pregnancy has ended.

What should be expected?
You may have crampy period pain which can be eased with whatever medication you normally take for period pains. You will also have vaginal bleeding which may be heavier than a normal period and you may also pass some blood clots. You will need to wear sanitary protection, however, we advise against the use of tampons in order to cut down the risk of infection. You may find that you pass some “tissue” as well as the blood, this is often described as grey and stringy.

If you think the bleeding is very heavy and/or the pain is unbearable please either discuss with your doctor or come to the A & E department.

How long will it take to miscarry?
Although the length of time taken for a miscarriage to complete is difficult to predict, in the majority of cases a pregnancy will miscarry within two weeks.

Is there a risk of infection?
The risk of infection is very small. If however, you start to feel shivery, or experience flu-like symptoms or notice that you have an offensive smelling vaginal discharge, these could be signs of an infection. We would then advise you to seek medical advice as you may require treatment with antibiotics.

What will happen to my baby?
Sadly, many early pregnancies are lost when you go to the toilet and you may not realise that you have “passed” anything. If you feel you have passed your baby and have the remains please contact
EPAU if you wish to arrange a cremation or alternatively discuss other options available to you.

Follow-up Plan
We would usually expect you to miscarry naturally within 2 weeks and we would therefore make arrangements for you to have a follow-up scan after this time. However, if you think you have miscarried and the bleeding has settled it may not be necessary for you to return for a follow-up scan. In this event, please could you ring the Early Pregnancy Unit Assessment Unit during the hours of 08.00 – 16.00 Monday – Friday on the following number 01908 996434 08.00 – 13.00 Saturday – Sunday.

What happens next?
You may continue to bleed ‘like a period’ for up to two weeks following the miscarriage. This is quite normal. You should not have intercourse until all the bleeding has settled as you will be more susceptible to infection during this time. You should use sanitary towels rather than tampons during this time, this will also reduce the risk of infection. You should get your period between four
to six weeks after the miscarriage. This period may be heavier than usual.

What happens if I don’t have a miscarriage within the two weeks?
If you have not had a miscarriage or had an incomplete miscarriage when you return for your scan you will be offered a surgical procedure or medication. If you are feeling well and do not wish to
have surgery, expectant management may continue with further follow up arranged at a later date. If at any stage during the expectant management you wish to change your mind about your treatment please contact the Early Pregnancy Assessment Unit.

Support
Following an early miscarriage some people are surprised by the strength of their feelings, and are not sure how to cope with them. You may find that you and your partner react differently. These emotions are all valid and can be very confusing. If you would like to talk to someone then please let us know.

Useful Numbers:
Hospital Chaplain 01908 996061 / 01908 996062
Hospital Bereavement Midwife 01908 997157 / 07833482243
The Miscarriage Association 01924 200799 www.miscarriageassociation.org.uk