(Updated February 2009)
When a pregnancy ends by itself before 20 weeks, it is called ‘miscarriage.’ It is sometimes also called ‘early pregnancy loss,’ or ‘spontaneous abortion.’ As many as 1 in 4 pregnancies before 20 weeks end in this way.
Warning Signs and When to See a Health Professional
It is important to prevent too much blood loss and prevent infection during miscarriage. If you have any of the symptoms below, contact a health care professional (doctor, nurse practitioner, physician assistant, or midwife) right away.
- Sudden decrease in pregnancy signs
- Mild to severe back pain (worse than normal period cramps)
- Weight loss
- Contractions (painful and happening regularly)
- Bleeding with or without cramps
- Passing tissue and/or clots
Treatment Options
Some women do not need any treatment after an early miscarriage. Women who have pregnancy tissue left in the body after miscarriage may need or want to have it removed. There are three safe and effective ways to be sure that all the tissue from the lost pregnancy is removed from your body. The method used will depend on: the number of weeks of pregnancy, your medical history and health condition, the training of the health care provider, the equipment available, and your preferences. The chart below compares these choices.
| Medication/Pills | Electric Vacuum Aspiration (EVA) or Manual Vacuum Aspiration (MVA) | |
| What happens? | The process will take place at home. It starts when you take some pills called misoprostol.
The process can take a few days to complete. 1-4 hours after taking the pills, you will notice heavy bleeding and cramps. The pregnancy tissue will clear from your body. If the loss is not complete after 3 days, you will need to take more pills or have a vacuum aspiration. |
EVA or MVA is performed by a health care provider. It takes place in a clinic or hospital.
The procedure takes 10-15 minutes. Anesthesia (medicine used to reduce the pain) is used. Instruments are inserted through the vagina into the uterus.
|
| How painful is it? |
Each person’s experience is different. Mild to very strong cramps |
|
| How much bleeding is there? | Many women have heavy bleeding with clots during the process. Continued light bleeding or spotting often occurs for a few weeks. | Light bleeding or spotting often occurs for a few weeks after the procedure. |
| How effective is it? | The medication works in about 8 out of 10 women if the pregnancy is 6-12 weeks along. For earlier pregnancies, medication works for about 7 out of 10 women. If all the tissues is not cleared using the pills, you will need to have a vacuum aspiration. | The aspiration procedure works in about 9 out of 10 women. If it fails, the procedure will need to be done again. |
| How safe is it? | It is very safe. This option has been used safely by millions of women for over 25 years. | Vacuum aspiration is a very safe medical procedure. The risk of problems is low. |
Coping with Loss
Miscarriage is very common and can affect anyone. Do not blame yourself for the pregnancy loss. Feelings of sadness and loss are normal and can be different for each person. Allow yourself time to grieve. Emotional healing may take much longer than physical healing. If you need help, talk with loved ones or your health care provider. It also may help to talk with a counselor.
About Audrey Kelly, PharmD