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Patient Early miscarriage

Information
Introduction
This leaflet gives you information about early miscarriage.
Miscarriage can be a distressing experience, not only because
you feel the deep emotional sadness of losing a baby, but also
the changes that your body will go through may affect the way
that you are feeling.
We would like to offer our condolences to you and will try to
help by answering any questions you have.

What is a miscarriage?
Miscarriage is the loss of a pregnancy before 24 weeks. It is
estimated that 1 in every 4 pregnancies ends in miscarriage and
about 80 in 100 of these happen before 12 weeks.
Most women who have a miscarriage go on to have a
successful pregnancy next time.

Why did I miscarry?

It is usually impossible to find a reason for any individual
miscarriage, but we do know that in at least one third of
miscarriages, there is something wrong with the pregnancy.
This means that if a baby had survived until birth it would
probably have been born with significant abnormality. Although
this can be proved in one third of miscarriages, in reality this
probably happens in a higher number than that.
This means that a large number of miscarriages are nature’s
way of stopping or ending a pregnancy that is going wrong,
rather than the loss of what would otherwise have been normal
full-term pregnancy.
Reference No.
GHPI0870_12_21
Department
Obstetrics and
Gynaecology
Review due
December 2024

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Patient Common causes for miscarriage are thought

Information to be:
• Genetic - about half of all early miscarriages are due to
abnormal development from the beginning of the pregnancy
• Hormonal - women who have irregular periods may find it
harder to conceive and when they do, they are more likely to
miscarry
• Immunological - sometimes problems with blood vessels to
the placenta can lead to miscarriage
• Infection - this does not include coughs and colds.
Infections that cause very high temperatures and some
infections such as rubella (German Measles) may cause
miscarriage
• Anatomical - a weak cervix (neck of the womb), irregular
shaped uterus or the presence of fibroids may increase the
risk of miscarriage

Could anything that I have done have caused

me to miscarriage?
If the pregnancy is normal, and there is no infection affecting it,
then minor alterations in behaviour do not usually affect the
pregnancy.
We do know that smoking, poor diet, alcohol, certain illnesses
and some medications can make miscarriage more likely, but
otherwise, a healthy pregnancy is usually quite resilient (strong).

Is this miscarriage likely to affect my chance

of having another baby?
A miscarriage itself does not affect future chances, as long as
some physical reason is not found. If a physical reason for your
miscarriage is found, you will be involved in discussions about
any treatment that may be needed. The likelihood that a woman
who has experienced a miscarriage will eventually have a
healthy baby is good; even if they have had more than one
miscarriage.

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Patient How long should we wait until trying for

Information another baby?
After the bleeding from a miscarriage has ended and a urine
pregnancy test is no longer positive, there is usually no reason
to wait to try again for another pregnancy. In terms of your
emotional health, you may feel that you want to wait a bit longer
before you try again.
There are some circumstances, however, where a health
professional may advise you to wait a little longer before trying
again. The reasons will have been discussed with you and the
information provided. These include ectopic pregnancy and
hydatidiform mole.

How long should we wait before resuming

intercourse?
Your womb should settle within 2 weeks, and you would be
unlikely to cause any harm with intercourse after that.
It is important to wait until any bleeding has stopped and that
you have a negative pregnancy test before resuming
unprotected intercourse.

When do I need to start using contraception

following a miscarriage, if I want to wait
before trying for another baby?
You can ovulate (produce an egg) any time after a miscarriage,
so if you have intercourse, it is possible to become pregnant
before your next period.
Condoms
You can resume intercourse with condoms as soon as your
bleeding has stopped.
The pill
Please discuss this with your hospital doctor, nurse practitioner,
GP or the Family Planning Clinic.
The diaphragm
If you use the diaphragm (cap), it is important to have the size
checked before you use it again as your body may have
changed slightly.

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Patient The coil

Information If you want an Intrauterine Contraceptive Device (IUCD) fitted,
this can be fitted by an experience nurse or doctor immediately
after your miscarriage.
Implant
If you would like the contraceptive implant, this can be fitted by
an experienced nurse or doctor straight after a miscarriage or
within 5 days of starting your next period.
You can discuss contraception with your hospital doctor, GP or
Family Planning Clinic. If you are waiting to start using your
chosen contraceptive, you should use a condom or sheath in
the meantime.

Do I need an operation to make sure my

womb is empty?
Not necessarily. This is a very personal choice. When the nurse
practitioner or doctor tells you that you are miscarrying, you can
talk about the options available for managing the miscarriage.

You may be offered a choice of the following:

1. To let things happen naturally (known as conservative
management), coming in for an outpatient appointment 14
days after the start of miscarriage. You can contact us with
any concerns during this time via the Ward 9a Helpline (the
telephone number is at the end of this leaflet)
2. To induce the miscarriage with medication (medical
management), then allow the process to happen naturally,
coming in to see us 14 to 21 days after taking the medication
3. To have an operation to clear the womb (surgical
management of miscarriage)
There are risks and benefits to all of these options and these
will be discussed with you by your nurse practitioner or doctor.

How long will I bleed after a miscarriage?

This varies but generally, the bleeding should gradually reduce
over 7 to 10 days from the time that you actually miscarry the
pregnancy and usually stops within 3 weeks.

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Patient We advise you to use sanitary towels not tampons during the
Information bleeding following a miscarriage.
If the bleeding does not seem to be stopping, is getting heavier,
if you have a lot of pain or you have an unpleasant smelling
discharge you should contact the Ward 9a Helpline or your GP.

How soon after miscarriage will my periods

return?
Your body will still contain some pregnancy hormone and a
pregnancy test may stay positive for 2 to 4 weeks after
miscarriage.
Once the pregnancy hormone has fallen to a level which is not
detected from a urine pregnancy test, your body will start the
next menstrual cycle. This varies with each person but is
usually about 4 to 6 weeks following miscarriage.

How soon can I have a bath or swim?

There is no reason to avoid having a bath or shower on the day
following a miscarriage. It is advised to use warm water rather
than very hot water.
You can resume swimming as soon as you feel fit enough to do
so although it is advisable to wait until any vaginal bleeding or
discharge has stopped.

How soon can I resume normal activities?

This varies from person to person depending on how long your
physical recovery takes and on the amount of emotional
distress. It is important to take things gently until your physical
strength returns. If you have any questions, please contact your
GP.

How soon should I go back to work?

Most women feel fit enough to return to work after a week, but
others need longer. Your GP will advise and support you in the
best way forward for you.

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Patient Will my breasts produce milk?

Information A woman who has had a miscarriage after about 14 weeks of
pregnancy may experience hardness of her breasts and may
have some milk production. This does not need any treatment
and although distressing, it will ease after a few days.

Can we know the sex of the baby we lost?

If you miscarry before 18 weeks of pregnancy, the sex of the
baby is unlikely to be known. After this time it becomes easier
to determine the sex as the baby is more developed.

Can we see a photograph of the baby?

We do not offer photographs to women who miscarry under 14
weeks because it is difficult to take pictures due to the size of
the baby. After 14 weeks we do our best to take photographs
that you are able to keep as part of a precious memory.
For women who choose to have an operation to remove the
miscarriage, we are sorry to say that it is not possible for us to
take photographs.

Can we arrange to have a blessing said for

our baby?
There is a hospital chaplain available to support your spiritual
needs and we will try to accommodate all religious beliefs.
There is a book of remembrance held within the hospital and
the Trust also holds a yearly service in remembrance of the
babies who die before and around birth which you are welcome
to attend. If you wish to know more about either of these, please
ask your nurse or doctor for further details.

It is weeks since I miscarried, yet I still feel

upset and depressed, is this normal?
Every woman is different. Some women find that they recover
quickly after a miscarriage and others take much longer.

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Patient Most women appear to cope very well at the time, focusing on
Information the physical aspects of the miscarriage but once the bleeding
and pain have settled find that they are very upset and tearful.
Some of the feelings associated with loss are difficult to talk
about. You may feel shocked or angry, or you may feel empty.
Some women feel really tired and lose interest in everyday life
and in sexual relationships with their partner. Some women feel
guilty or as if they have failed as well as feeling isolated and
alone.
The loss of a baby is very sad and what you are feeling is
normal.
Do not expect too much of yourself and please allow yourself
time to grieve. Most people never forget the loss of a baby, but
the pain will get easier over time.
Men and women react differently to the loss of a baby and
although it is difficult, it is important to communicate your
feelings with each other through this difficult time.
The leaflet on miscarriage, available on the Miscarriage
Association website (address at the end of this leaflet)
discusses the different feelings you and your partner might be
experiencing and may help you to understand each other and
offer more support.

Our friends and relatives avoid the subject of

my miscarriage, why is this?
It can be very hurtful when people avoid talking about
something that is very important to you, but most people find
another person’s loss and grief very difficult to talk about.
Usually, people avoid talking about it because they do not know
what to say and very much want to avoid saying the wrong thing
and hurting your feelings. People often feel that they do not
want to remind you about it, when of course it is actually at the
front of your mind. You may feel hurt when people avoid the
subject, but might feel able to raise the subject yourself which in
turn can encourage others to be more open.

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Patient I’m really worried about getting pregnant

Information again, because I’ll be so anxious about
miscarrying, what can I do about that?
You are likely to feel like this, especially around the time of year
when you miscarried, but be reassured that having this
miscarriage does not increase your risk of miscarrying next
time.

Is there something we can do to give our

baby a better chance?
Healthier parents have more chance of producing healthier
babies. Try to spend the time maximising your health before
you start trying for another baby for example you could both
give up smoking, improve your diets and take regular exercise.

Will I receive a follow up appointment after

my miscarriage?
Many women like to book a follow up appointment with their GP
after they are discharged from the Early Pregnancy Clinic. If you
would like to arrange for a health visitor to visit you at home to
discuss the emotional aspects of your miscarriage, this can be
arranged at your GP’s surgery.

Contact information
Early Pregnancy Assessment Clinic
Gloucestershire Royal Hospital
Tel: 0300 422 5549
This line is open from 8:00am to 4:00pm, 7 days a week.

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Patient Further information

Information
Miscarriage Association
17 Wentworth Terrace
Wakefield
WF1 3QW
Tel: 01924 200 799
Monday to Friday, 9:00am to 4:00pm
Website: www.miscarriageassociation.org.uk

Other written information is available from the hospital, please

ask your nurse or doctor if you would like a copy of:
• Conservative (expectant) management of miscarriage
(information sheet)
• Surgical management of miscarriage (leaflet) GHPI1223
• Medical management of miscarriage (information sheet)
• Information and support following the loss of your baby
before completion of 24 weeks (leaflet) GHPI0502
• Surgical management of miscarriage under local
anaesthesia (leaflet) GHPI1454

Content reviewed: December 2021

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