What You Need to Do If You Suspect You're Having a Miscarriage
If you are experiencing miscarriage, go to the hospital. If you cannot make it to the hospital call emergency help lines. The responding paramedic will have you rest quietly and may give you medications as directed by the Emergency Room physician at the base hospital by phone. Bring all prescription drugs, herbs, and supplements you may be taking to the hospital, and be honest with the ER doctor if you drink or use drugs.
A nurse or midwife will record your vital signs, and if you have been bleeding excessively, will take your pulse twice:
• First when you have been lying down quietly for 5 minutes
• Second when you have been standing fairly still for 1-3 minutes
You will require a vaginal exam during which the doctor inserts a clean clamp (speculum) to hold your vagina open and shines a bright light on your perineum to see well. If you have not had a pap smear in the past year, the doctor scrapes your cervix with a wooden Popsicle stick, smears the sample on a slide, and sends it to the Pathology Lab.
Some miscarriages are inevitable, so remember, if your membranes break and you go into labor, a baby can only survive outside the uterus if it is at least 24 weeks old. If you have a molar pregnancy, remember that a proper fetus does not form, and the cellular mass cannot survive outside your body. If this is the case, your doctor may suggest a cervical dilatation and evacuation with suction (D&E) to remove the products of conception by the end of your first trimester (Week 12 of pregnancy).
For unavoidable miscarriages, the choice method is dilatation and curettage (D&C). The surgeon places a black "matchstick" of seaweed (a laminaria tent) to gently open your cervix overnight. In the operating room, the surgeon gradually makes the opening of your cervix bigger, spinning a series of increasingly larger dilator wands. Grasping your uterus with a tenaculum clamp, the surgeon scrapes clean the lining of your uterus with curettes.
If you have an ectopic pregnancy, surgery will be necessary to remove the fetus and products of conception from the fallopian tube. In some cases, the surgeon will be unable to salvage the fallopian tube and must remove it (salpingectomy).
In all cases, you will be taken to a Recovery Room for the anaesthetic to wear off. You will be encouraged to get up and walk soon after any surgery. This prevents pooling of body fluids and pneumonia. You cannot drive yourself home, so arrange for a friend to pick you up and monitor you overnight for complications. You can take a shower the day after your surgery, but avoid baths, douching, swimming, and intercourse for a month. Avoid heavy lifting. Wear absorbent sanitary napkins for a few days up to several weeks after surgery to catch the drainage. Do not use tampons because of risk of infection. Breast discomfort and leaking milk may last a week. If you develop fever, heavy bleeding or a foul-smelling discharge, you may need antibiotics to fight infection or ergometrine to stanch bleeding. Barring complications, you can return to work in two days, but book the week off work as a precaution. Most women can resume exercising in three weeks.
Miscarriage is often treatable if addressed immediately. Not every woman who spots during the first trimester has a miscarriage. If you are pregnant and spot or bleed, go to your doctor or the nearest Emergency room as soon as possible. Bring any tissue you pass with you in a clean container for the lab to test for abnormalities and to pinpoint your problem.