GYNAECOLOGY AND FERTILITY CENTRE
INFORMATION SHEET
Miscarriage
The Agora
Gynaecology and Fertility Centre
Ellen Street
Brighton and Hove
BN3 3LN
T: 01273 229410
Miscarriage
GYNAECOLOGY AND FERTILITY CENTRE
Miscarriage
If you have been affected by a miscarriage, we are sorry and hope that you will find this information leaflet useful.
Sometimes it is difficult to understand and remember everything that has been discussed during your consultation
so we have produced this information sheet for you to read in your own time. We hope it will answer some of your
questions, but please contact us at the Agora Clinic if you need any further advice or information.
Why me?
Miscarriage (defined as the loss of a pregnancy during the first 23 weeks) is very common, affecting around one
in every five pregnancies. The most common known cause of a miscarriage at this early stage is a chromosomal
abnormality where the fertilised egg fails to grow properly. We do not routinely carry out any further tests to look
for other causes unless a woman has had three miscarriages in a row. This is because most women will go on to
have normal pregnancies after a miscarriage.
However, the option of having further tests if you have had one or two miscarriages will be discussed with you
during your consultation so you can decide if you would like these to be carried out.
Could I have prevented it?
No. You have not done anything to cause this miscarriage. Women are often advised to rest when a miscarriage is
suspected, but this will not prevent a miscarriage and the normal activities of daily living should not interfere with
a healthy pregnancy.
What treatment will I need?
If there is no tissue from your pregnancy left in the womb, you won’t need to have any medical treatment. In most
cases we advise you to wait for up to two weeks to allow the tissue to pass out naturally, like a heavy period and if
pain and bleeding stops completely this usually means the miscarriage has finished. We will then recommend that
you have a pregnancy test to check, or we can carry out a scan.
However, if there is still some tissue left, there are three ways of managing the miscarriage:
• Conservatively (naturally, without medical intervention)
• Medically (with tablets); or
• Surgically (removing tissue from the inside of the womb, known as an ERPC Evacuation of Retained Products of Conception)
Your consultant will be able to advise you about the best treatment.
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What does medical management of my miscarriage involve?
• We will give you two types of tablets to cause the remaining tissue to pass out of your womb.
You can take the first one by mouth when you are in the clinic
• Two days later you will be given some more tablets. These are inserted into the vagina.
You can return to the clinic for these or you can insert them yourself. It is easiest to do this
by placing the tablets on top of a tampon (you will be given four tablets which all need to be
inserted at the same time)
• You are likely to experience some stomach aches and cramps during your treatment.
We will prescribe some tablets to help with this. However, it is important that you do
not take any extra paracetamol as there is already paracetamol in the tablets we will give you
What happens next?
• When a miscarriage happens, the sac and the lining of the womb will be shed. It is difficult to
predict when this will begin, but it is normally within a day or so of starting the treatment.
The bleeding may be like a very heavy period, possibly with clots and often with strong period type pain.
It will probably begin with a light bleed, becoming heavier before gradually stopping. We recommend that you
use sanitary towels rather than tampons during this bleeding to minimise any risk of infection.
• Follow-up appointments can be made to suit you but these are normally made at one week intervals
for a consultation and repeat scans to ensure that the miscarriage is complete. At these consultations you
can decide if you want to continue to let the miscarriage take its course or have an operation (ERPC – see below). Occasionally the miscarriage remains incomplete and surgery is required.
• The medication can sometimes make you feel (or actually be) sick and may make you feel warmer than usual.
However, if you suspect you may have a temperature, please call us as soon as possible.
What does surgical management of my miscarriage involve?
An ERPC can be arranged either at a local private hospital or through a referral to your nearest early pregnancy clinic.
In most cases this is performed as day case surgery. If complications arise during or after surgery you should be
prepared to stay the night. The operation involves a general anaesthetic and the surgery involves the use of a suction
device to remove the products of pregnancy from the womb.
When will my periods return?
Usually within two to six weeks following a miscarriage, but this can vary and it can take a few months for your
periods to return to normal. If your periods have not resumed after three months (and you are not pregnant) you
should discuss this with one of the consultants at the Agora Clinic or consult your GP.
When can I have sexual intercourse?
We advise that you wait until your bleeding has completely stopped before you resume sexual intercourse to reduce
any risk of infection.
Ovulation can occur any time after a miscarriage and before your next period so if you have unprotected sex during
this time you can become pregnant.
When can I re-start fertility treatment?
We usually recommend that you wait at least three months before commencing an assisted reproductive cycle.
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Is it normal to feel depressed for some time after a miscarriage?
Everyone reacts differently following a miscarriage. However, most women go through a grieving process not only
for the loss of the baby but for the future hopes and plans they had for the baby. Some women find that they can
get through it quite quickly with little emotional support. Others find that the feelings of grief and bereavement last
much longer and may require professional support. Both reactions are quite normal.
Talking with your partner about what has happened and how you feel can help and you may wish to arrange an
appointment with our counsellor (see details below). Your family doctor can also be contacted for help and advice.
Contact numbers
If you have any concerns or worries, please do not hesitate to contact the Agora Clinic on 01273 229410. We will try
to answer any questions straight away, or arrange for one of the specialists to contact you.
If you have any problems outside of clinic hours then please contact your own family doctor who will be able to
discuss your case with one of the gynaecology teams at your local hospital.
If your bleeding is very heavy and you feel you need more urgent medical attention then we suggest you go to the
Accident & Emergency Department at your local hospital, taking any relevant information from your clinic visits with
you.
Further information
The Miscarriage Association offers information and support to people affected by miscarriage, ectopic pregnancy and
other conditions. You can find out more by contacting them at:
The Miscarriage Association
Clayton Hospital
Northgate
Wakefield
West Yorkshire WF1 3JS
Tel: 01924 200799
[email protected]
www.miscarriageassociation.org.uk
Counselling
Our independent counsellor, Deborah Sloan, is based at:
Brighton Consulting Rooms
18A Clermont Road
Brighton
BN1 6SG
Please contact Deborah directly on Tel: 07736 705904 or email: [email protected] to arrange
an appointment.
The medical information in this leaflet is provided as an educational resource only. It is not intended to replace the
advice of your GP or medical team and should not be used or relied upon for any diagnostic or treatment purposes.
The information has been prepared by Dr Carole Gilling-Smith, Consultant Gynaecologist and Medical Director of
the Agora Gynaecology and Fertility Centre. It was last updated in August 2014.
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